On Thursday 15th and Friday 16th of May, the 9th edition of the ‘Supporting Health by Technology’ conference was organized by the University Medical Center Groningen in collaboration with the Centre for eHealth & Wellbeing Research of the University of Twente. The program contained two fantastic keynotes, demonstrations, poster sessions, and presentations about how technology can facilitate the treatment of people with medical and psychological illnesses. The four delegates of the Digital Society Health & Well-being program line who attended the conference will share their highlights here.
Keynote by Professor Giuseppe Riva
The conference started with a keynote by Professor Giuseppe Riva from the Università Cattolica de Sacro Cuore, Milan. His presentation titled ‘Neuroscience of Virtual Reality’ focused on how virtual reality (VR) can contribute to health care. For example, with the aid of VR, burn victims experienced less pain while having their bandages changed. Changing these bandages is usually extremely painful. Professor Giuseppe Riva hypothesised that the relief may have been caused by an experience of disembodiment that can be triggered with VR. The pain relief was also reflected by less activation of brain areas involved in pain processing.
Monitoring, Feedback and Depression
The rest of the day was filled with parallel sessions and symposia. In the session on monitoring, feedback and depression, researchers presented their work on detecting early signs of depression or mania, and developing a personalized app for mental health care. Depression can be a lifelong illness that consists of recurrent depressive episodes for most patients. Technology that helps to predict the likelihood and timing of recurrence would be very useful for people suffering from depression. Patients could be alerted of the risk and hence get a chance to take preventative measures early (e.g. to talk to a health care professional). One small-scale study (7 patients) by Arnout Smit (University of Groningen) showed that significant changes in a person’s self-reported experience of restlessness when medication is tapered off could predict relapse into depression two months later. Restlessness is a mental and bodily sensation of feeling agitated, irritable, impatient, tense, uneasy and unable to relax. The data was recorded via an easy to use mobile app on the participant’s smartphone. This is an example of how mobile phones can be used to collect smart data that may be of real benefit to patients. We are excited to see larger-scale studies with this app to see if the initial results are reliable.
E-health technology engagement
During the next parallel session on Health advise and Technology, Saskia Kelders from the University of Twente introduced a new questionnaire to measure engagement to e-health technology. In e-health (technology that supports health), engagement is viewed as an important factor in explaining why interventions are beneficial to some and not others. However, a shared understanding of what engagement is and how to measure it, was missing. Therefore, Saskia and her team created a new scale to measure engagement, based on a systematic literature review and interviews with engaged app users. This new scale, called TWEETS (TWente Engagement with Ehealth Technologies Scale) covers behavioral, cognitive, and affective aspects of engagement. First results indicate that the scale is reliable and valid, although more work is needed to investigate the validity of this scale.
Adherence and Engagement
In the sessions on adherence and engagement researches presented their work on measuring adherence to treatment, factors of success and failures in applying app-based treatments, and on the recruitment and uptake of an app for cancer fatigue. Lutz Siemer presented a measure of adherence to blended treatments. In blended treatments, patients undergo a mix of online and face-to-face treatment sessions, which are often intertwined. This type of treatment is increasingly investigated, but it is difficult to measure if participants adhere to the treatment and complete the face-to-face as well as the online sessions. Siemer and colleagues tested two types of adherence: time based (time spend on treatment) and features based (active use of treatment features). They concluded that both types had good validity, and could be a useful way to assess adherence to blended care.
Reorganizing the AED network in Milan
During the session on monitoring and coaching, Lorenzo Gianquintieri (Polytechnic University of Milan) gave an interesting presentation about reorganizing the network of defibrillators to improve public access to defibrillators in the city of Milan. The rationale for this study was that Public Access Defibrillation programs are currently based on local and sparse initiatives for the installation of publicly accessible Automated External Defibrillators (AEDs) in Milan (and other places). When a person is in a life-threatening situation, such as arrhythmia, the time to save the person and effectively use a defibrillator is 6 minutes. Lorenzo and his team hypothesized that a centralized and data-driven planning for the deployment of AEDs could be more efficient. To test their hypothesis, the group first computed the catchment areas of currently located devices. A catchment area is the area where AEDs can be used within the time limit of 6 minutes if a cardiac event occurs. They then developed a machine learning algorithm to compute a geographic risk function for cardiac arrests that occur ‘out of hospital’ (e.g. at home) and to simulate different distributions of AEDs. Their study revealed that the current distribution is strongly inefficient, and a centralized and data-driven planning could improve the potential exploitation of resources, especially if targeting residential areas.
Presenting the Digital Society Initiative
During the lunch break, researchers had the opportunity to present a poster displaying their work. Roos van der Vaart (Leiden) represented the Digital Society Health & Well-being program line by presenting a poster on our aims. Roos van der Vaart: “It was a really nice opportunity to present our program to the research field and to talk about our goals for the upcoming years. Many people were positively surprised by the initiative of the Digital Society program and fully agreed that working together on such a large multidisciplinary scale is the best way to create impact”.
Machine learning and Diabetes
In the session on machine learning & big data researchers showed interesting studies on how e-health solutions can use previous information to optimize treatment. For instance, one of the e-health apps, presented by Henri ter Hofte, for medication management was able to take into account previous data such as leftover blood insulin levels to more accurately calculate how much insulin a patient needs to inject. As a result, patients are less likely to inject too much insulin which can result in hypoglycemia. Hypoglycemia can occur when blood sugar levels drop too low; possible symptoms can be irregular heart rhythm, fatigue, shakiness and also confusion and loss of consciousness.
Keynote by Professor Isabela Granic
The second day ended with a keynote presentation by professor Isabela Granic from Radboud University, Nijmegen, the Netherlands, titled ‘Bridging Developmental science & Game Design to Create Video Games that Promote Emotional & Mental Health in Youth’. With the Games for Emotional and Mental Health (GEMH) lab, she aims to develop gamified treatments for children. For instance, she showed a neurofeedback intervention for children with anxiety. In this game children are confronted with scary situations such as walking through a dark haunted house. The players have to learn to relax in order to proceed in the game. When they relax, a flashlight that is attached to their (virtual) head lightens up which then sheds light on new solutions to proceed in the game. By playing this game, children learn to relax in a situation that makes them feel anxious.
Overall findings
Overall, we were positively surprised by the variety and breath of e-health interventions and applications. The conference succeeded at giving space to a range of high quality scientific digital health enterprises that aim to improve the care of patients and citizens. Given that these digital interventions could theoretically be used anywhere in the world, we would like to see more policy work on an international and European level to standardize and implement evidence-based solutions across national healthcare systems.
We are looking forward to the next Supporting Health by Technology conference on the 11 and 12 June 2020!
