TY - JOUR A1 - Allgaier, Johannes A1 - Schlee, Winfried A1 - Probst, Thomas A1 - Pryss, Rüdiger T1 - Prediction of tinnitus perception based on daily life mHealth data using country origin and season JF - Journal of Clinical Medicine N2 - Tinnitus is an auditory phantom perception without external sound stimuli. This chronic perception can severely affect quality of life. Because tinnitus symptoms are highly heterogeneous, multimodal data analyses are increasingly used to gain new insights. MHealth data sources, with their particular focus on country- and season-specific differences, can provide a promising avenue for new insights. Therefore, we examined data from the TrackYourTinnitus (TYT) mHealth platform to create symptom profiles of TYT users. We used gradient boosting engines to classify momentary tinnitus and regress tinnitus loudness, using country of origin and season as features. At the daily assessment level, tinnitus loudness can be regressed with a mean absolute error rate of 7.9% points. In turn, momentary tinnitus can be classified with an F1 score of 93.79%. Both results indicate differences in the tinnitus of TYT users with respect to season and country of origin. The significance of the features was evaluated using statistical and explainable machine learning methods. It was further shown that tinnitus varies with temperature in certain countries. The results presented show that season and country of origin appear to be valuable features when combined with longitudinal mHealth data at the level of daily assessment. KW - tinnitus KW - gradient boosting machine KW - mobile health KW - machine learning KW - multimodal data KW - explainable machine learning Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-281812 SN - 2077-0383 VL - 11 IS - 15 ER - TY - JOUR A1 - Schlee, Winfried A1 - Neff, Patrick A1 - Simoes, Jorge A1 - Langguth, Berthold A1 - Schoisswohl, Stefan A1 - Steinberger, Heidi A1 - Norman, Marie A1 - Spiliopoulou, Myra A1 - Schobel, Johannes A1 - Hannemann, Ronny A1 - Pryss, Rüdiger T1 - Smartphone-guided educational counseling and self-help for chronic tinnitus JF - Journal of Clinical Medicine N2 - Tinnitus is an auditory phantom perception in the ears or head in the absence of a corresponding external stimulus. There is currently no effective treatment available that reliably reduces tinnitus. Educational counseling is a treatment approach that aims to educate patients and inform them about possible coping strategies. For this feasibility study, we implemented educational material and self-help advice in a smartphone app. Participants used the educational smartphone app unsupervised during their daily routine over a period of four months. Comparing the tinnitus outcome measures before and after smartphone-guided treatment, we measured changes in tinnitus-related distress, but not in tinnitus loudness. Improvements on the Tinnitus Severity numeric rating scale reached an effect size of 0.408, while the improvements on the Tinnitus Handicap Inventory (THI) were much smaller with an effect size of 0.168. An analysis of user behavior showed that frequent and intensive use of the app is a crucial factor for treatment success: participants that used the app more often and interacted with the app intensively reported a stronger improvement in the tinnitus. Between study allocation and final assessment, 26 of 52 participants dropped out of the study. Reasons for the dropouts and lessons for future studies are discussed in this paper. KW - tinnitus KW - self-help KW - ecological momentary assessment KW - ehealth KW - smart-phone KW - intervention Y1 - 2022 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-267295 SN - 2077-0383 VL - 11 IS - 7 ER - TY - JOUR A1 - Holfelder, Marc A1 - Mulansky, Lena A1 - Schlee, Winfried A1 - Baumeister, Harald A1 - Schobel, Johannes A1 - Greger, Helmut A1 - Hoff, Andreas A1 - Pryss, Rüdiger T1 - Medical device regulation efforts for mHealth apps during the COVID-19 pandemic — an experience report of Corona Check and Corona Health JF - J — Multidisciplinary Scientific Journal N2 - Within the healthcare environment, mobile health (mHealth) applications (apps) are becoming more and more important. The number of new mHealth apps has risen steadily in the last years. Especially the COVID-19 pandemic has led to an enormous amount of app releases. In most countries, mHealth applications have to be compliant with several regulatory aspects to be declared a “medical app”. However, the latest applicable medical device regulation (MDR) does not provide more details on the requirements for mHealth applications. When developing a medical app, it is essential that all contributors in an interdisciplinary team — especially software engineers — are aware of the specific regulatory requirements beforehand. The development process, however, should not be stalled due to integration of the MDR. Therefore, a developing framework that includes these aspects is required to facilitate a reliable and quick development process. The paper at hand introduces the creation of such a framework on the basis of the Corona Health and Corona Check apps. The relevant regulatory guidelines are listed and summarized as a guidance for medical app developments during the pandemic and beyond. In particular, the important stages and challenges faced that emerged during the entire development process are highlighted. KW - mHealth KW - mobile application KW - MDR KW - medical device regulation KW - medical device software Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-285434 SN - 2571-8800 VL - 4 IS - 2 SP - 206 EP - 222 ER - TY - JOUR A1 - Beierle, Felix A1 - Schobel, Johannes A1 - Vogel, Carsten A1 - Allgaier, Johannes A1 - Mulansky, Lena A1 - Haug, Fabian A1 - Haug, Julian A1 - Schlee, Winfried A1 - Holfelder, Marc A1 - Stach, Michael A1 - Schickler, Marc A1 - Baumeister, Harald A1 - Cohrdes, Caroline A1 - Deckert, Jürgen A1 - Deserno, Lorenz A1 - Edler, Johanna-Sophie A1 - Eichner, Felizitas A. A1 - Greger, Helmut A1 - Hein, Grit A1 - Heuschmann, Peter A1 - John, Dennis A1 - Kestler, Hans A. A1 - Krefting, Dagmar A1 - Langguth, Berthold A1 - Meybohm, Patrick A1 - Probst, Thomas A1 - Reichert, Manfred A1 - Romanos, Marcel A1 - Störk, Stefan A1 - Terhorst, Yannik A1 - Weiß, Martin A1 - Pryss, Rüdiger T1 - Corona Health — A Study- and Sensor-Based Mobile App Platform Exploring Aspects of the COVID-19 Pandemic JF - International Journal of Environmental Research and Public Health N2 - Physical and mental well-being during the COVID-19 pandemic is typically assessed via surveys, which might make it difficult to conduct longitudinal studies and might lead to data suffering from recall bias. Ecological momentary assessment (EMA) driven smartphone apps can help alleviate such issues, allowing for in situ recordings. Implementing such an app is not trivial, necessitates strict regulatory and legal requirements, and requires short development cycles to appropriately react to abrupt changes in the pandemic. Based on an existing app framework, we developed Corona Health, an app that serves as a platform for deploying questionnaire-based studies in combination with recordings of mobile sensors. In this paper, we present the technical details of Corona Health and provide first insights into the collected data. Through collaborative efforts from experts from public health, medicine, psychology, and computer science, we released Corona Health publicly on Google Play and the Apple App Store (in July 2020) in eight languages and attracted 7290 installations so far. Currently, five studies related to physical and mental well-being are deployed and 17,241 questionnaires have been filled out. Corona Health proves to be a viable tool for conducting research related to the COVID-19 pandemic and can serve as a blueprint for future EMA-based studies. The data we collected will substantially improve our knowledge on mental and physical health states, traits and trajectories as well as its risk and protective factors over the course of the COVID-19 pandemic and its diverse prevention measures. KW - mobile health KW - ecological momentary assessment KW - digital phenotyping KW - longitudinal studies KW - mobile crowdsensing Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-242658 SN - 1660-4601 VL - 18 IS - 14 ER - TY - JOUR A1 - Schlee, Winfried A1 - Simoes, Jorge A1 - Pryss, Rüdiger T1 - Auricular acupressure combined with self-help intervention for treating chronic tinnitus: a longitudinal observational study JF - Journal of Clinical Medicine N2 - Tinnitus is a phantom sound perception in the ears or head and can arise from many different medical disorders. Currently, there is no standard treatment for tinnitus that reliably reduces tinnitus. Individual patients reported that acupressure at various points around the ear can help to reduce tinnitus, which was investigated here. With this longitudinal observational study, we report a systematic evaluation of auricular acupressure on 39 tinnitus sufferers, combined with a self-help smartphone app. The participants were asked to report on tinnitus, stress, mood, neck, and jaw muscle tensions twice a day using an ecological momentary assessment study design for six weeks. On average, 123.6 questionnaires per person were provided and used for statistical analysis. The treatment responses of the participants were heterogeneous. On average, we observed significant negative trends for tinnitus loudness (Cohen's d effect size: −0.861), tinnitus distress (d = −0.478), stress (d = −0.675), and tensions in the neck muscles (d = −0.356). Comparison with a matched control group revealed significant improvements for tinnitus loudness (p = 0.027) and self-reported stress level (p = 0.003). The positive results of the observational study motivate further research including a randomized clinical trial and long-term assessment of the clinical improvement. KW - tinnitus KW - acupressure KW - self-help KW - ecological momentary assessment KW - stress Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-246209 SN - 2077-0383 VL - 10 IS - 18 ER - TY - JOUR A1 - Allgaier, Johannes A1 - Schlee, Winfried A1 - Langguth, Berthold A1 - Probst, Thomas A1 - Pryss, Rüdiger T1 - Predicting the Gender of Individuals with Tinnitus based on Daily Life Data of the TrackYourTinnitus mHealth Platform JF - Scientific Reports N2 - Tinnitus is an auditory phantom perception in the absence of an external sound stimulation. People with tinnitus often report severe constraints in their daily life. Interestingly, indications exist on gender differences between women and men both in the symptom profile as well as in the response to specific tinnitus treatments. In this paper, data of the TrackYourTinnitus platform (TYT) were analyzed to investigate whether the gender of users can be predicted. In general, the TYT mobile Health crowdsensing platform was developed to demystify the daily and momentary variations of tinnitus symptoms over time. The goal of the presented investigation is a better understanding of gender-related differences in the symptom profiles of users from TYT. Based on two questionnaires of TYT, four machine learning based classifiers were trained and analyzed. With respect to the provided daily answers, the gender of TYT users can be predicted with an accuracy of 81.7%. In this context, worries, difficulties in concentration, and irritability towards the family are the three most important characteristics for predicting the gender. Note that in contrast to existing studies on TYT, daily answers to the worst symptom question were firstly investigated in more detail. It was found that results of this question significantly contribute to the prediction of the gender of TYT users. Overall, our findings indicate gender-related differences in tinnitus and tinnitus-related symptoms. Based on evidence that gender impacts the development of tinnitus, the gathered insights can be considered relevant and justify further investigations in this direction. KW - computer science KW - machine learning KW - psychology KW - signs and symptoms Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-261753 VL - 11 IS - 1 ER - TY - JOUR A1 - Prakash, Subash A1 - Unnikrishnan, Vishnu A1 - Pryss, Rüdiger A1 - Kraft, Robin A1 - Schobel, Johannes A1 - Hannemann, Ronny A1 - Langguth, Berthold A1 - Schlee, Winfried A1 - Spiliopoulou, Myra T1 - Interactive system for similarity-based inspection and assessment of the well-being of mHealth users JF - Entropy N2 - Recent digitization technologies empower mHealth users to conveniently record their Ecological Momentary Assessments (EMA) through web applications, smartphones, and wearable devices. These recordings can help clinicians understand how the users' condition changes, but appropriate learning and visualization mechanisms are required for this purpose. We propose a web-based visual analytics tool, which processes clinical data as well as EMAs that were recorded through a mHealth application. The goals we pursue are (1) to predict the condition of the user in the near and the far future, while also identifying the clinical data that mostly contribute to EMA predictions, (2) to identify users with outlier EMA, and (3) to show to what extent the EMAs of a user are in line with or diverge from those users similar to him/her. We report our findings based on a pilot study on patient empowerment, involving tinnitus patients who recorded EMAs with the mHealth app TinnitusTips. To validate our method, we also derived synthetic data from the same pilot study. Based on this setting, results for different use cases are reported. KW - medical analytics KW - condition prediction KW - ecological momentary assessment KW - visual analytics KW - time series Y1 - 2021 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-252333 SN - 1099-4300 VL - 23 IS - 12 ER - TY - JOUR A1 - Pryss, Rüdiger A1 - Schlee, Winfried A1 - Hoppenstedt, Burkhard A1 - Reichert, Manfred A1 - Spiliopoulou, Myra A1 - Langguth, Berthold A1 - Breitmayer, Marius A1 - Probst, Thomas T1 - Applying Machine Learning to Daily-Life Data From the TrackYourTinnitus Mobile Health Crowdsensing Platform to Predict the Mobile Operating System Used With High Accuracy: Longitudinal Observational Study JF - Journal of Medical Internet Research N2 - Background: Tinnitus is often described as the phantom perception of a sound and is experienced by 5.1% to 42.7% of the population worldwide, at least once during their lifetime. The symptoms often reduce the patient's quality of life. The TrackYourTinnitus (TYT) mobile health (mHealth) crowdsensing platform was developed for two operating systems (OS)-Android and iOS-to help patients demystify the daily moment-to-moment variations of their tinnitus symptoms. In all platforms developed for more than one OS, it is important to investigate whether the crowdsensed data predicts the OS that was used in order to understand the degree to which the OS is a confounder that is necessary to consider. KW - crowdsensing KW - ecological momentary assessment KW - mHealth KW - machine learning KW - mobile operating system differences KW - tinnitus KW - mobile phone Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-229517 VL - 22 IS - 6 ER - TY - JOUR A1 - Kraft, Robin A1 - Birk, Ferdinand A1 - Reichert, Manfred A1 - Deshpande, Aniruddha A1 - Schlee, Winfried A1 - Langguth, Berthold A1 - Baumeister, Harald A1 - Probst, Thomas A1 - Spiliopoulou, Myra A1 - Pryss, Rüdiger T1 - Efficient processing of geospatial mHealth data using a scalable crowdsensing platform JF - Sensors N2 - Smart sensors and smartphones are becoming increasingly prevalent. Both can be used to gather environmental data (e.g., noise). Importantly, these devices can be connected to each other as well as to the Internet to collect large amounts of sensor data, which leads to many new opportunities. In particular, mobile crowdsensing techniques can be used to capture phenomena of common interest. Especially valuable insights can be gained if the collected data are additionally related to the time and place of the measurements. However, many technical solutions still use monolithic backends that are not capable of processing crowdsensing data in a flexible, efficient, and scalable manner. In this work, an architectural design was conceived with the goal to manage geospatial data in challenging crowdsensing healthcare scenarios. It will be shown how the proposed approach can be used to provide users with an interactive map of environmental noise, allowing tinnitus patients and other health-conscious people to avoid locations with harmful sound levels. Technically, the shown approach combines cloud-native applications with Big Data and stream processing concepts. In general, the presented architectural design shall serve as a foundation to implement practical and scalable crowdsensing platforms for various healthcare scenarios beyond the addressed use case. KW - mHealth KW - crowdsensing KW - tinnitus KW - geospatial data KW - cloud-native KW - stream processing KW - scalability KW - architectural design Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-207826 SN - 1424-8220 VL - 20 IS - 12 ER - TY - JOUR A1 - Kraft, Robin A1 - Schlee, Winfried A1 - Stach, Michael A1 - Reichert, Manfred A1 - Langguth, Berthold A1 - Baumeister, Harald A1 - Probst, Thomas A1 - Hannemann, Ronny A1 - Pryss, Rüdiger T1 - Combining Mobile Crowdsensing and Ecological Momentary Assessments in the Healthcare Domain JF - Frontiers in Neuroscience N2 - The increasing prevalence of smart mobile devices (e.g., smartphones) enables the combined use of mobile crowdsensing (MCS) and ecological momentary assessments (EMA) in the healthcare domain. By correlating qualitative longitudinal and ecologically valid EMA assessment data sets with sensor measurements in mobile apps, new valuable insights about patients (e.g., humans who suffer from chronic diseases) can be gained. However, there are numerous conceptual, architectural and technical, as well as legal challenges when implementing a respective software solution. Therefore, the work at hand (1) identifies these challenges, (2) derives respective recommendations, and (3) proposes a reference architecture for a MCS-EMA-platform addressing the defined recommendations. The required insights to propose the reference architecture were gained in several large-scale mHealth crowdsensing studies running for many years and different healthcare questions. To mention only two examples, we are running crowdsensing studies on questions for the tinnitus chronic disorder or psychological stress. We consider the proposed reference architecture and the identified challenges and recommendations as a contribution in two respects. First, they enable other researchers to align our practical studies with a baseline setting that can satisfy the variously revealed insights. Second, they are a proper basis to better compare data that was gathered using MCS and EMA. In addition, the combined use of MCS and EMA increasingly requires suitable architectures and associated digital solutions for the healthcare domain. KW - mobile crowdsensing (MCS) KW - crowdsourcing KW - ecological momentary assessments (EMA) KW - mobile healthcare application KW - chronic disorders KW - reference architecture Y1 - 2020 U6 - http://nbn-resolving.de/urn/resolver.pl?urn:nbn:de:bvb:20-opus-200220 SN - 1662-453X VL - 14 IS - 164 ER -