Lay Users Research Articles

Counterfactual Explanation Analytics: Empowering Lay Users to Take Action Against Consequential Automated Decisions

Machine learning is routinely used to automate consequential decisions about users in domains such as finance and healthcare, raising concerns of transparency and recourse for negative outcomes. Existing Explainable AI techniques generate a static counterfactual point explanation which recommends changes to a user's instance to obtain a positive outcome. Unfortunately, these recommendations are often difficult or impossible for users to realistically enact. To overcome this, we present FACET, the first interactive robust explanation system which generates personalized counterfactual region explanations. FACET's expressive explanation analytics empower users to explore and compare multiple counterfactual options and develop a personalized actionable plan for obtaining their desired outcome. Visitors to the demonstration will interact with FACET via a new web dashboard for explanations of a loan approval scenario. In doing so, visitors will experience how lay users can easily leverage powerful explanation analytics through visual interactions and displays without the need for a strong technical background.

Lay User Involvement in Developing Human-centric Responsible AI Systems: When and How?

Artificial Intelligence (AI) is increasingly used in mainstream applications to make decisions that affect a large number of people. While research has focused on involving machine learning and domain experts during the development of responsible AI systems, the input of lay users has too often been ignored. By exploring the involvement of lay users, our work seeks to advance human-centric responsible AI development processes. To reflect on lay users’ views, we conducted an online survey of 1,121 people in the United Kingdom. We found that respondents had concerns about fairness and transparency of AI systems, which requires more education around AI to underpin lay user involvement. They saw a need for having their views reflected at all stages of the AI development lifecycle. Lay users mainly charged internal stakeholders to oversee the development process but supported by an ethics committee and input from an external regulatory body. We also probed for possible techniques for involving lay users more directly. Our work has implications for creating processes that ensure the development of responsible AI systems that take lay user perspectives into account.

Use of Mobile Health Applications by Lay Users in Kuwait

Aim/Purpose: This study aims to explore the use of mobile health applications (mHealth apps) by lay users in Kuwait. Specifically, it seeks to: (i) identify and highlight the impact of factors that contribute to their use of mHealth apps and (ii) validate a model of these users’ usage of mHealth apps. Background: The advancement of information technologies has paved the way for efficiency and effectiveness in healthcare sectors in developed countries. Kuwait has attempted to revolutionise healthcare systems through mobile applications of information technology solutions to educate users on better methods of receiving customised health services. However, end-user usage of mHealth apps remains in the infancy in developing countries, including Kuwait. Lay users are often vulnerable and frequently overlooked by researchers and health technology providers. Methodology: A cross-sectional study was conducted among 225 lay users of mHealth apps in Kuwait using an online questionnaire to achieve the study objectives. A purposive sampling method utilising convenience and snowballing sampling techniques was used in which all the respondents were lay users. Descriptive statistics, Pearson correlation, and regression analyses were employed to analyse the collected data. Contribution: The study contributes to the extant literature on health informatics and mHealth by providing a comprehensive understanding of how technological, social, and functional factors are related to mHealth apps in the context of developing countries. It identifies key drivers of mHealth app use, suggests expanding the TAM model, and facilitates comparisons with developed countries, addressing gaps in mHealth research. Findings: Four factors (i.e., perceived trust (PT), perceived ease of use (PEU) and behaviour control (PBC), perceived usefulness (PU), and subjective norms (SN)) were identified that influence the use of mHealth apps. These four identified factors also contributed to lay users’ use of these mHealth apps. Among these four factors, perceived trust (PT) was the main contributor to lay users’ use of these mHealth apps. Recommendations for Practitioners: Based on the empirical results, this study provides feasible recommendations for the government, healthcare providers, and developers of mHealth apps. The findings urge developers to enhance app functionality by prioritising privacy and security to build user trust while outlining guidelines for future development focused on user-centric design and compliance with data privacy regulations. Additionally, the government should establish supportive policies and funding, ensure regulatory oversight, and promote public awareness to foster trust. Healthcare providers should integrate mHealth apps into their services, train staff for practical use, gather users’ feedback, and collaborate with developers to create tailored healthcare solutions. Future Research: Additional research is required to apply probability sampling techniques and increase the sample size to generate more reliable and generalisable findings. Additionally, the young age segment must be considered here, and research must be extended to consider the moderating role of demographic factors like age, gender, and educational levels to better understand the adoption of mHealth apps.

Evaluation Dimensions for Assessing Question Answer Systems for Lay Users: The Case of DiseaseGuru

Question answer (QA) systems can serve as vital tools to address lay users’ information needs in healthcare. While QA systems have the potential to lessen information overload and provide quality answers to users, it is important to holistically evaluate their performance. Here we propose multiple dimensions for this purpose comprising lexical similarity, semantic similarity, absence of contradictions and readability of responses. We then use the dimensions to evaluate DiseaseGuru, a generative large language model-based chronic disease QA system we developed that integrates knowledge graph technology to provide quality responses to lay users. The results are presented comparing it with three benchmark algorithms across the different dimensions. We also propose metrics for lay users and medical professionals for a future field study to evaluate the system.

Social Media and Apps in Urology.

In this study, we aimed to review the common social media (SoMe) apps used and how they have impacted the practice and exchange of information, as well as the challenges of using SoMe in urology. SoMe has become increasingly popular in the urology community. Lay users often turn to SoMe to learn about urological health and share their own experiences, while medical professionals may use it for career development, networking, education, and research purposes. It is important to recognize the power of SoMe and to use it responsibly and ethically, particularly given the potential risks of encountering low-quality or misleading information.

Usability testing to evaluate user experience on cyclers for automated peritoneal dialysis

BackgroundIn the development of medical devices usability is an important aspect standing alongside performance and safety. Peritoneal dialysis (PD) can be provided by use of automated PD (APD), assisted by a cycler performing the solution exchanges. The present study has been executed to simulate training on APD cyclers to evaluate learnability and usability through established questionnaires.MethodsUsability of two APD cyclers (sleep•safe harmony, Fresenius Medical Care, Bad Homburg, Germany and HomeChoice Pro, Baxter International Inc., Deerfield (IL), USA) were evaluated with the User Experience Questionnaire (UEQ), the NASA TLX Questionnaire, and the System Usability Scale (SUS), both after training and after experience sessions.ResultsLay persons (n = 10) and health care personnel (HCPs, n = 11) participated in the study. The respondents consistently gave positive ratings in the UEQ after training and experience session. The ratings from the NASA TLX Questionnaire were mostly below 50 points indicating a low workload. Lay users and HCPs gave high ratings in the SUS evaluation both after the training and experience sessions confirming a good learnability and usability of the devices.ConclusionsThe usability study to assess learnability and use-related safety revealed consistent results with all applied instruments, which demonstrated good learnability and ease-of-use of the studied APD cyclers.

Experts by Experience. Lay Users as Authorities in Slimming Remedy Advertisements, 1918–1939

This article analyses Dutch newspaper advertisements for slimming remedies in the 1920s and 1930s in order to investigate which authorities patients relied on in the past when deciding which pharmaceuticals to take. I argue that lay users, not doctors, were the most prominent cultural authorities in these advertisements. My main sources are newspaper advertisements extracted from the digital newspaper database of the Dutch National Library. In addition to the historical analysis the article also offers a practical guide for extracting relevant sources from such large digital repositories. This article is part of the special issue ' Blurring Boundaries: Towards a Medical History of the Twentieth Century '. Dit artikel analyseert advertenties voor afslankmiddelen in Nederlandse kranten uit het Interbellum, om te onderzoeken op welke autoriteiten mensen destijds vertrouwden wanneer ze beslisten om bepaalde medicijnen wel of niet te gebruiken. Ik laat zien dat in de bestudeerde advertenties niet dokters de belangrijkste autoriteit waren, maar leken die zelf het middel gebruikt hadden. Ik gebruik de gedigitaliseerde kranten van de Koninklijke Bibliotheek. Naast mijn historische analyse bied ik ook een praktische handleiding voor het vinden van relevante bronnen in dergelijke grote digitale databestanden. Dit artikel maakt deel uit van het themanummer ' Blurring Boundaries: Towards a Medical History of the Twentieth Century '.

Novel centrifugal technology for measuring sperm concentration in the home

To evaluate the analytical performance and usability of the Trak Male Fertility Testing System, a semiquantitative (categorical) device recently US Food and Drug Administration (FDA)-cleared for measuring sperm concentration in the home by untrained users. A three-site clinical trial comparing self-reported lay user results versus reference results obtained by computer-aided semen analysis (CASA). Simulated home use environments at fertility centers and urologist offices. A total of 239 untrained users. None. Sperm concentration results reported from self-testing lay users and laboratory reference method by CASA were evaluated semiquantitatively against the device's clinical cutoffs of 15M/mL (current World Health Organization cutoff) and 55M/mL (associated with faster time to pregnancy). Additional reported metrics include assay linearity, precision, limit of detection, and ease-of-use ratings from lay users. Lay users achieved an accuracy (versus the reference) of 93.3% (95% confidence interval [CI] 84.1%-97.4%) for results categorized as ≤15M/mL, 82.4% (95% CI 73.3%-88.9%) for results categorized as 15-55M/mL, and 95.5% (95% CI 88.9%-98.2%) for results categorized as >55M/mL. When measured quantitatively, Trak results had a strong linear correlation with CASA measurements (r = 0.99). The precision and limit of detection studies show that the device has adequate reproducibility and detection range for home use. Subjects generally rated the device as easy to use. The Trak System is an accurate tool for semiquantitatively measuring sperm concentration in the home. The system may enable screening and longitudinal assessment of sperm concentration at home. ClinicalTrials.gov identifier: NCT02475395.

Exploring the Open Problems and Future Trends Concerning Handovers in Heterogeneous Wireless Networks: A Review

The advancements in the telecoms industry have led to the emergence of many new technologies to meet communication requirements worldwide. Consumers have largely been using GSM, CDMA and WiFi. New developments have given birth to more robust communication systems including WiMax and LTE. Lay users are not aware of the technicalities, advantages and disadvantages of these technologies. Therefore, there is a state of great confusion among the users of this generation as to which technology is the best for them to use. Each of these technologies has pros and cons over one another. For example, LTE covers a large area and offers the highest speed, but the user has to pay for it; however, WiFi covers only hotspots but the use is free. Future heterogeneous networks (HetNets) will enable users to achieve seamless connectivity through vertical handovers while providing them the beneficial features of each technology. For HetNets many issues still need to be addressed. This paper explores some of the open problems and future trends related to the handovers in heterogeneous wireless networks. The dynamics with respect to handovers and the network load of cellular architecture in the coming era in the field of wireless communications are also presented. In addition, first a foundation is laid on the IEEE media independent handover and its importance and then the problem of load balancing and its impact on the realization of future HetNets is explained. Finally, an important problem during vertical handovers, known as the ping-pong effect is explained. The open problems for researchers have been identified for the aforementioned issues.

A Question of Accessibility: Understanding Lay Users Of Medical Devices

<i>A Question of Accessibility:</i> Understanding Lay Users Of Medical Devices

Conducting Home-Based Usability Tests of Home Healthcare Devices

As life expectancy increases and medical technologies become more advanced, medical devices are being used more often at home by lay users—individuals without formal medical training. Lay users might be patients or nonprofessional caregivers, such as relatives or friends, who operate a device on someone else’s behalf. When developing medical devices for lay users, it is important to evaluate users’ ability to interact with the device safely and effectively in the home environment. Conducting home-based usability testing provides a unique opportunity to achieve this goal, understand the home environment, and see firsthand how the environment affects the lay users’ ability to use a device appropriately. This article focuses on unique aspects of home-based testing rather than providing suggestions and input regarding conducting usability tests in general. Home healthcare device usability tests can be conducted in various locations, including a usability lab, a conference room, a hotel suite, and of course, the patient’s home. Selecting the most appropriate test environment depends on the stage of device development and the test goals, as well as the importance of conducting testing in a controlled and consistent environment. It is valuable to conduct formative (i.e., exploratory) testing in the home to gain as many insights as possible regarding the actual use environments and whether users are likely to comply with prescribed device use when at home. Home-based testing enables researchers to learn about a device’s portability and placement inside, and sometimes outside, of the home. For example, if testing a respiratory therapy system that must be used continuously, the moderator could ask the participant to demonstrate how s/he positions the system when commuting or grocery shopping. The moderator might also want to learn how the user positions and uses the system while sleeping. However, it might be best to conduct a summative (i.e., validation) usability test—a test intended to validate device use-safety—in a more controlled environment, such as a usability lab or conference room set up to simulate the home environment. By testing in a controlled environment, the possibility of unexpected conditions and distractions that might arise in a home are removed, so tasks can be presented consistently and devices validated in a “cleaner” manner. Notably, the controlled environment should still represent the home environment and consist of more than a table and two chairs in an otherwise empty room. The home can be simulated by introducing realistic distractions, setting up certain pieces of furniture (e.g., a refrigerator and kitchen table; or a bed, dresser, and nightstand), and setting lighting levels to simulate daytime and/or nocturnal use. Conducting Home-Based Usability Tests of Home Healthcare Devices

Patient Empowerment by Increasing the Understanding of Medical Language for Lay Users

Patient empowerment is important in order to increase the quality of medical care and the life quality of the patients. An important obstacle for empowering patients is the language barrier the lay patient encounter when accessing medical information. To design and develop a service that will help increase the understanding of medical language for lay persons. The service identifies and explains medical terminology from a given text by annotating the terms in the original text with the definition. It is based on an original terminology interpretation engine that uses a fuzzy matching dictionary. The service was implemented in two projects: a) into the server of a tele-care system (TELEASIS) with the purpose of adapting medical text assigned by medical personnel for the assisted patients. b) Into a dedicated web site that can adapt the medical language from raw text or from existing web pages. The output of the service was evaluated by a group of persons, and the results indicate that such a system can increase the understanding of medical texts. Several design decisions were driven from the evaluation, and are being considered for future development. Other tests measuring accuracy and time performance for the fuzzy terminology recognition have been performed. Test results revealed good performance for accuracy and excellent results regarding time performance. The current version of the service increases the accessibility of medical language by explaining terminology with a good accuracy, while allowing the user to easily identify errors, in order to reduce the risk of incorrect terminology recognition.

Performance of a New Test Strip for FreeStyle Blood Glucose Monitoring Systems

a new strip, designed to enhance the ease of use and minimize interference of non-glucose sugars, has been developed to replace the current FreeStyle (Abbott Diabetes Care, Alameda, CA) blood glucose test strip. We evaluated the performance of this new strip. laboratory evaluation included precision, linearity, dynamic range, effects of operating temperature, humidity, altitude, hematocrit, interferents, and blood reapplication. System accuracy, lay user performance, and ease of use for finger capillary blood testing and accuracy for venous blood testing were evaluated at clinics. Lay users also compared the speed and ease of use between the new strip and the current FreeStyle strip. for glucose concentrations <75 mg/dL, 73%, 100%, and 100% of the individual capillary blood glucose results obtained by lay users fell within ± 5, 10, and 15 mg/dL, respectively, of the reference. For glucose concentrations ≥75 mg/dL, 68%, 95%, 99%, and 99% of the lay user results fell within ± 5%, 10%, 15%, and 20%, respectively, of the reference. Comparable accuracy was obtained in the venous blood study. Lay users found the new test strip easy to use and faster and easier to use than the current FreeStyle strip. The new strip maintained accuracy under various challenging conditions, including high concentrations of various interferents, sample reapplication up to 60 s, and extremes in hematocrit, altitude, and operating temperature and humidity. our results demonstrated excellent accuracy of the new FreeStyle test strip and validated the improvements in minimizing interference and enhancing ease of use.

Evaluation of an Over-the-Counter Glycated Hemoglobin (A1C) Test Kit

Glycated hemoglobin (A1C) monitoring is an integral component of diabetes management. This study was conducted to evaluate the performance of the A1CNow® SELFCHECK device when used by lay users and health care professionals (HCPs) to measure A1C. Subjects performed two A1CNow SELFCHECK finger-stick self-tests followed by a finger-stick test of the subject's blood by a HCP. The primary endpoint assessed accuracy of the subject and HCP A1CNow SELFCHECK readings. Secondary endpoints included precision, comprehension of instructional material (written material±DVD), and product satisfaction. For accuracy comparison, a venous blood sample was drawn from each subject and tested by laboratory (TOSOH) analysis. Subject comprehension of product instructional material was evaluated via first-time failure (FTF) rate as recorded by the HCP, and subject satisfaction was assessed through written survey. A total of 110 subjects with (n=93) and without (n=17) diabetes participated. Of 177 subject A1C values, 165 (93.2%) were within the acceptable range of ±13.5% of the laboratory reference value and considered accurate. Regression analysis showed good correlation of subject values to laboratory and HCP results (R2=0.93 for both). The average within-subject coefficient of variation was 4.57% (n=74). The FTF rates with and without instructional DVD were 11.3% (n=56) and 39.6% (n=54), respectively. Subjects with diabetes/prediabetes overwhelmingly indicated that they were "very" to "extremely" likely (93.5%) to discuss their home A1C results with their HCP. Lay users found the A1CNow SELFCHECK easy to use, and both lay users and HCPs were able to measure A1C accurately.

SpermCheck® Fertility, an immunodiagnostic home test that detects normozoospermia and severe oligozoospermia

A simple and inexpensive home sperm test could be of considerable value to couples attempting to conceive and to men curious about their fertility potential. A two-strip lateral flow immunochromatographic diagnostic device that allows men to evaluate their sperm count at low cost in the privacy of their own homes is described. The ability of SpermCheck Fertility to predict sperm counts obtained using a hemacytometer procedure based on standard World Health Organization methodology was assessed. Test results obtained by lay users were also compared with those obtained by trained laboratory professionals, and the ease of use of the device was evaluated in consumer studies. A total of 225 semen samples were analyzed in the method comparison, and the performance of SpermCheck Fertility was excellent with over 96% of all samples correctly classified as normozoospermic (> or =2 x 10(7) sperm/ml), oligozoospermic (5 x 10(6)-2 x 10(7) sperm/ml) or severely oligozoospermic (<5 x 10(6) sperm/ml). Consumer studies with 164 lay users demonstrated that SpermCheck Fertility was easy to use. Lay users and laboratory professionals agreed 95% of the time when reading the same test independently. Overall, the correct response rate on a 20-question survey about the test was over 97%. SpermCheck Fertility is a simple and reliable immunodiagnostic test that can quickly inform men as to whether their sperm count is normal, low or very low. This home test can assist couples in deciding whether to seek comprehensive clinical evaluation of the fertility status of the male partner.

Clinical Performance of the TRUE2go Blood Glucose System—A Novel Integrated System for Meter and Strips

The complications of diabetes may be minimized by adequate glycemic control, which is aided by self-monitoring of blood glucose (SMBG) levels. A new SMBG system, TRUE2go (Home Diagnostics, Inc., Fort Lauderdale, FL), does not require calibration of test strips, thereby eliminating the potential source of error in blood glucose determination associated with mis-calibration. This study tested the performance of the TRUE2go system. The very small size and attachment of the meter to a vial of test strips make the TRUE2go system unique. The studies were carried out with adult patients with type 1 or 2 diabetes, using procedures for testing accuracy as specified in International Organization for Standardization (ISO) 15197:2003. The evaluation included patients' compliance with the TRUE2go system's written instructions, ease of understanding the supplied instructions, and ease of use of the system. The study demonstrated the accuracy and precision of the TRUE2go system, with 100% of glucose test results falling within ISO-recommended limits for glucose concentrations ranging from 24 mg/dL to 549 mg/dL. There was agreement between data obtained with TRUE2go when used by healthcare professionals and by lay users on capillary blood from both fingertip and a forearm sticks. Lay users' understanding of and compliance with TRUE2go system instructions were excellent, as was their satisfaction with the system. The TRUE2go system is accurate and convenient to use, and its instructions are easily understood by lay users. TRUE2go features that contribute to convenience, and therefore could improve compliance with monitoring regimens, include its small size, attachment to the vial of strips, easy-to-read display, automatic calibration for test strips, and suitability for fingertip as well as forearm testing.

Evaluation of a new blood glucose monitoring system with auto-calibration for home and hospital bedside use

A new self-calibrating blood glucose monitoring system (BGMS) was evaluated in a series of clinical studies with both ambulatory subjects and with hospitalized patients. The new BGMS requires a 0.6 μL sample volume, provides results in 15 s, and uses a glucose dehydrogenase chemistry that is oxygen independent. In the first study, Ascensia ® Contour™ meters calibrated to whole blood were tested by health care professionals (HCP) and lay users at two clinical sites. Both HCPs and lay users obtained results that fulfilled the ISO 15197:2003 criteria that 95% of self-monitoring blood glucose (SMBG) measurements should fall within ±20% (for blood glucose (BG) concentrations ≥ 4.2 mmol/L or ±0.83 mmol/L for BG concentrations < 4.2 mmol/L) of the laboratory value. Lay users and HCPs obtained 97.2 and 96.7% of glucose results within ISO criteria, respectively. In a second study, HCPs assayed blood samples from patients at the hospital bedside using meters calibrated to give whole blood glucose and meters calibrated to give plasma glucose results. Overall, 94.7% of the measurements met the ISO 15197:2003 criteria. Most lay subjects rated the BGMS as either excellent or very good in a questionnaire, and were able to use it properly without training. These findings indicate that this new BGMS is a convenient and accurate instrument system suitable for both hospital bedside use by HCPs and for SMBG by people who routinely monitor their blood glucose.

Evaluation of a New Blood Glucose Monitoring System with Auto-Calibration

The Ascensia CONTOUR System (Bayer HealthCare LLC, Elkhart, IN) is a new blood glucose (BG) monitoring system (BGMS) that uses glucose dehydrogenase chemistry and that combines low sample volume, fast response time, an auto-control marking feature, and an auto-calibration function in a small package. The system was evaluated at four diabetes clinics with ambulatory subjects who had diabetes. The BGMS was tested by both health care professionals (HCPs) and lay users. It was also evaluated at high altitude (10,200 feet) and, in conjunction with the Ascensia MICROLET VACULANCE (Bayer), for use with samples obtained from four alternative anatomical sites. When the system was used with blood from fingersticks, both lay users and HCPs obtained results that fulfilled the International Organization for Standardization (ISO) 15197:2003 accuracy criteria, which advocate that 95% of BG measurements should fall within +/-15 mg/dL (for BG concentrations <75 mg/dL) or +/-20% (for BG concentrations > or = 75 mg/dL) of the laboratory value. Lay users obtained 96.9% of glucose results, and HCPs obtained 96.4% of glucose results, within ISO accuracy criteria. People with diabetes who had no prior experience using the system also obtained acceptable results (97.0%), as did the HCP using fingerstick samples from subjects in the high altitude study (97.0%). Among the alternative anatomical sites tested, only the results from the palm met the ISO criteria (97.5%), although the results from all four sites (palm, thigh, abdomen, and forearm) were clinically acceptable when assessed using error grid analysis. Most subjects rated the BGMS as either excellent or very good in a questionnaire, and were able to use it properly without training. These findings indicate that the Ascensia CONTOUR System, which does not require calibration by the user, is a convenient and accurate instrument with useful features for people who routinely monitor BG.

Health information on the Internet: a qualitative study of NHS Direct Online users

Examines the way the general public exploits the Internet for health information, the motives behind usage, attitudes towards issues such as quality concerns, and the extent to which Internet interventions affect the doctor‐patient relationship. Although a questionnaire survey was used (posted on the NHS Direct Web site), the questions asked were open, and invited free‐text “qualitative” answers. This method was a success in terms of the amount and richness of the data accrued. Results suggested that the Internet is exploited in a wide variety of ways, by users acting in a number of roles – patient, intermediary or professional. Some health professionals are now so comfortable with the Internet that they encourage Internet usage by their patients. Lay users demonstrated a high level of understanding of issues raised, and showed a (healthy?) scepticism regarding the information provided. Many users felt that their consultations with doctors had been enriched by Internet‐acquired information.

Rx medication information for the public and the WWW: quality issues.

Misuse of prescription medications is a serious problem largely due to lack of information. Lay users are making use of resources available on the World Wide Web in order to bridge this information gap. It has already been noted though that health and medicine oriented sites present serious shortcomings with regard to quality and reliability of their content. In this review, checklists were used to determine to which extent the criteria suggested for quality evaluation of on-line health information are observed by sites offering information on Rx medications to the public. Also evaluated was the sites' comprehensiveness in coverage of important subject specific topics. The reviewed sites met inadequately the proposed quality criteria and presented significant variations in their coverage of the subject. Evaluation of information accuracy remains an unresolved problem in quality assessment, while techniques for automated review and retrieval are urgently needed. In the meantime, though, quality guidelines could prove more useful in getting valuable feedback from information providers and lay users alike, improving quality of information at its point of production.