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Rethinking Human-AI Collaboration in Complex Medical Decision Making: A Case Study in Sepsis Diagnosis. 反思复杂医疗决策中的人机协作:败血症诊断案例研究》。
Pub Date : 2024-05-01 Epub Date: 2024-05-11 DOI: 10.1145/3613904.3642343
Shao Zhang, Jianing Yu, Xuhai Xu, Changchang Yin, Yuxuan Lu, Bingsheng Yao, Melanie Tory, Lace M Padilla, Jeffrey Caterino, Ping Zhang, Dakuo Wang

Today's AI systems for medical decision support often succeed on benchmark datasets in research papers but fail in real-world deployment. This work focuses on the decision making of sepsis, an acute life-threatening systematic infection that requires an early diagnosis with high uncertainty from the clinician. Our aim is to explore the design requirements for AI systems that can support clinical experts in making better decisions for the early diagnosis of sepsis. The study begins with a formative study investigating why clinical experts abandon an existing AI-powered Sepsis predictive module in their electrical health record (EHR) system. We argue that a human-centered AI system needs to support human experts in the intermediate stages of a medical decision-making process (e.g., generating hypotheses or gathering data), instead of focusing only on the final decision. Therefore, we build SepsisLab based on a state-of-the-art AI algorithm and extend it to predict the future projection of sepsis development, visualize the prediction uncertainty, and propose actionable suggestions (i.e., which additional laboratory tests can be collected) to reduce such uncertainty. Through heuristic evaluation with six clinicians using our prototype system, we demonstrate that SepsisLab enables a promising human-AI collaboration paradigm for the future of AI-assisted sepsis diagnosis and other high-stakes medical decision making.

当今用于医疗决策支持的人工智能系统往往在研究论文中的基准数据集上取得成功,但在实际应用中却失败了。这项工作的重点是败血症的决策制定,败血症是一种危及生命的急性系统性感染,需要临床医生在高度不确定的情况下进行早期诊断。我们的目标是探索人工智能系统的设计要求,以支持临床专家为败血症的早期诊断做出更好的决策。这项研究从一项形成性研究开始,调查临床专家为何放弃电子健康记录(EHR)系统中现有的人工智能脓毒症预测模块。我们认为,以人为本的人工智能系统需要在医疗决策过程的中间阶段(如生成假设或收集数据)为人类专家提供支持,而不是只关注最终决策。因此,我们基于最先进的人工智能算法建立了败血症实验室(SepsisLab),并对其进行了扩展,以预测败血症的未来发展预测,将预测的不确定性可视化,并提出可操作的建议(即可以收集哪些额外的实验室测试)以减少这种不确定性。通过对使用我们原型系统的六位临床医生进行启发式评估,我们证明了脓毒症实验室为未来人工智能辅助脓毒症诊断和其他高风险医疗决策提供了一种前景广阔的人类-人工智能合作模式。
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引用次数: 0
MigraineTracker: Examining Patient Experiences with Goal-Directed Self-Tracking for a Chronic Health Condition. 偏头痛追踪器:研究慢性病患者的目标导向自我追踪体验。
Pub Date : 2024-05-01 Epub Date: 2024-05-11 DOI: 10.1145/3613904.3642075
Yasaman S Sefidgar, Carla L Castillo, Shaan Chopra, Liwei Jiang, Tae Jones, Anant Mittal, Hyeyoung Ryu, Jessica Schroeder, Allison Cole, Natalia Murinova, Sean A Munson, James Fogarty

Self-tracking and personal informatics offer important potential in chronic condition management, but such potential is often undermined by difficulty in aligning self-tracking tools to an individual's goals. Informed by prior proposals of goal-directed tracking, we designed and developed MigraineTracker, a prototype app that emphasizes explicit expression of goals for migraine-related self-tracking. We then examined migraine patient experiences in a deployment study for an average of 12+ months, including a total of 50 interview sessions with 10 patients working with 3 different clinicians. Patients were able to express multiple types of goals, evolve their goals over time, align tracking to their goals, personalize their tracking, reflect in the context of their goals, and gain insights that enabled understanding, communication, and action. We discuss how these results highlight the importance of accounting for distinct and concurrent goals in personal informatics together with implications for the design of future goal-directed personal informatics tools.

自我跟踪和个人信息学为慢性病管理提供了重要的潜力,但这种潜力往往因难以将自我跟踪工具与个人目标相结合而受到削弱。根据之前提出的目标导向跟踪建议,我们设计并开发了偏头痛跟踪器(MigraineTracker),这是一款强调明确表达偏头痛相关自我跟踪目标的原型应用程序。然后,我们在一项部署研究中考察了偏头痛患者平均 12 个多月的经历,其中包括与 3 位不同临床医生合作的 10 位患者的共计 50 次访谈。患者能够表达多种类型的目标,随着时间的推移不断发展自己的目标,根据自己的目标调整跟踪,个性化跟踪,根据自己的目标进行反思,并获得有助于理解、沟通和行动的见解。我们将讨论这些结果如何凸显了在个人信息学中考虑不同目标和并行目标的重要性,以及对未来目标导向型个人信息学工具设计的影响。
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引用次数: 0
Understanding the Role of Large Language Models in Personalizing and Scaffolding Strategies to Combat Academic Procrastination. 了解大语言模型在个性化和支架式策略中的作用,以应对学习拖延症。
Pub Date : 2024-05-01 Epub Date: 2024-05-11 DOI: 10.1145/3613904.3642081
Ananya Bhattacharjee, Yuchen Zeng, Sarah Yi Xu, Dana Kulzhabayeva, Minyi Ma, Rachel Kornfield, Syed Ishtiaque Ahmed, Alex Mariakakis, Mary P Czerwinski, Anastasia Kuzminykh, Michael Liut, Joseph Jay Williams

Traditional interventions for academic procrastination often fail to capture the nuanced, individual-specific factors that underlie them. Large language models (LLMs) hold immense potential for addressing this gap by permitting open-ended inputs, including the ability to customize interventions to individuals' unique needs. However, user expectations and potential limitations of LLMs in this context remain underexplored. To address this, we conducted interviews and focus group discussions with 15 university students and 6 experts, during which a technology probe for generating personalized advice for managing procrastination was presented. Our results highlight the necessity for LLMs to provide structured, deadline-oriented steps and enhanced user support mechanisms. Additionally, our results surface the need for an adaptive approach to questioning based on factors like busyness. These findings offer crucial design implications for the development of LLM-based tools for managing procrastination while cautioning the use of LLMs for therapeutic guidance.

传统的学业拖延干预措施往往无法捕捉到导致学业拖延的细致入微的个体特定因素。大型语言模型(LLMs)允许开放式输入,包括根据个人独特需求定制干预措施的能力,因此在弥补这一不足方面具有巨大潜力。然而,在这种情况下,用户对 LLMs 的期望和潜在局限性仍未得到充分探索。为了解决这个问题,我们对 15 名大学生和 6 名专家进行了访谈和焦点小组讨论,并在讨论中介绍了一种用于生成个性化建议以管理拖延症的技术探针。我们的研究结果突出表明,有必要让学习管理软件提供结构化、以截止日期为导向的步骤,并加强用户支持机制。此外,我们的结果还表明,有必要根据忙碌程度等因素采用自适应的提问方式。这些发现为开发基于 LLM 的拖延管理工具提供了重要的设计意义,同时也提醒人们不要将 LLM 用于治疗指导。
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引用次数: 0
Understanding Contexts and Challenges of Information Management for Epilepsy Care. 理解癫痫护理信息管理的背景和挑战。
Pub Date : 2023-04-01 Epub Date: 2023-04-19 DOI: 10.1145/3544548.3580949
Aehong Min, Wendy R Miller, Luis M Rocha, Katy Börner, Rion Brattig Correia, Patrick C Shih

Epilepsy is a common chronic neurological disease. People with epilepsy (PWE) and their caregivers face several challenges related to their epilepsy management, including quality of care, care coordination, side effects, and stigma management. The sociotechnical issues of the information management contexts and challenges for epilepsy care may be mitigated through effective information management. We conducted 4 focus groups with 5 PWE and 7 caregivers to explore how they manage epilepsy-related information and the challenges they encountered. Primary issues include challenges of finding the right information, complexities of tracking and monitoring data, and limited information sharing. We provide a framework that encompasses three attributes - individual epilepsy symptoms and health conditions, information complexity, and circumstantial constraints. We suggest future design implications to mitigate these challenges and improve epilepsy information management and care coordination.

癫痫是一种常见的慢性神经系统疾病。癫痫患者及其护理人员在癫痫管理方面面临着一些挑战,包括护理质量、护理协调、副作用和污名管理。信息管理背景下的社会技术问题和癫痫护理的挑战可以通过有效的信息管理来缓解。我们进行了4个焦点小组,包括5名PWE和7名护理人员,探讨他们如何管理癫痫相关信息以及他们遇到的挑战。主要问题包括寻找正确信息的挑战、跟踪和监测数据的复杂性以及有限的信息共享。我们提供了一个包含三个属性的框架——个体癫痫症状和健康状况、信息复杂性和环境约束。我们提出了未来的设计启示,以减轻这些挑战,改善癫痫信息管理和护理协调。
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引用次数: 0
Investigating the Role of Context in the Delivery of Text Messages for Supporting Psychological Wellbeing. 调查情境在发送支持心理健康短信中的作用。
Pub Date : 2023-04-01 Epub Date: 2023-04-19 DOI: 10.1145/3544548.3580774
Ananya Bhattacharjee, Joseph Jay Williams, Jonah Meyerhoff, Harsh Kumar, Alex Mariakakis, Rachel Kornfield

Without a nuanced understanding of users' perspectives and contexts, text messaging tools for supporting psychological wellbeing risk delivering interventions that are mismatched to users' dynamic needs. We investigated the contextual factors that influence young adults' day-to-day experiences when interacting with such tools. Through interviews and focus group discussions with 36 participants, we identified that people's daily schedules and affective states were dominant factors that shape their messaging preferences. We developed two messaging dialogues centered around these factors, which we deployed to 42 participants to test and extend our initial understanding of users' needs. Across both studies, participants provided diverse opinions of how they could be best supported by messages, particularly around when to engage users in more passive versus active ways. They also proposed ways of adjusting message length and content during periods of low mood. Our findings provide design implications and opportunities for context-aware mental health management systems.

如果对用户的观点和背景缺乏细致入微的了解,用于支持心理健康的短信工具就有可能提供与用户动态需求不匹配的干预措施。我们调查了影响年轻人与此类工具互动时的日常体验的背景因素。通过对 36 名参与者进行访谈和焦点小组讨论,我们发现人们的日常日程安排和情绪状态是影响其信息偏好的主要因素。我们围绕这些因素开发了两个信息对话,并向 42 名参与者进行了传播,以检验和扩展我们对用户需求的初步理解。在这两项研究中,参与者就如何通过信息为他们提供最佳支持提出了不同的意见,特别是关于何时以更被动或更主动的方式吸引用户。他们还提出了在情绪低落时调整信息长度和内容的方法。我们的研究结果为情境感知心理健康管理系统的设计提供了启示和机会。
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引用次数: 0
Meeting Users Where They Are: User-centered Design of an Automated Text Messaging Tool to Support the Mental Health of Young Adults. 满足用户需求:以用户为中心设计自动短信工具,为年轻人的心理健康提供支持。
Pub Date : 2022-04-01 Epub Date: 2022-04-29 DOI: 10.1145/3491102.3502046
Rachel Kornfield, Jonah Meyerhoff, Hannah Studd, Ananya Bhattacharjee, Joseph J Williams, Madhu Reddy, David C Mohr

Young adults have high rates of mental health conditions, but most do not want or cannot access formal treatment. We therefore recruited young adults with depression or anxiety symptoms to co-design a digital tool for self-managing their mental health concerns. Through study activities-consisting of an online discussion group and a series of design workshops-participants highlighted the importance of easy-to-use digital tools that allow them to exercise independence in their self-management. They described ways that an automated messaging tool might benefit them by: facilitating experimentation with diverse concepts and experiences; allowing variable depth of engagement based on preferences, availability, and mood; and collecting feedback to personalize the tool. While participants wanted to feel supported by an automated tool, they cautioned against incorporating an overtly human-like motivational tone. We discuss ways to apply these findings to improve the design and dissemination of digital mental health tools for young adults.

年轻人的心理健康问题发病率很高,但大多数人不愿意或无法接受正规治疗。因此,我们招募了有抑郁或焦虑症状的年轻人,共同设计了一款用于自我管理心理健康问题的数字工具。通过研究活动--包括在线讨论组和一系列设计研讨会--参与者强调了易于使用的数字工具的重要性,这些工具可以让他们在自我管理中发挥独立性。他们描述了自动信息传递工具可能使他们受益的方式:促进对不同概念和体验的尝试;允许根据喜好、时间和心情进行不同深度的参与;以及收集反馈以个性化工具。虽然参与者希望感受到自动化工具的支持,但他们提醒不要使用明显类似人类的激励语气。我们将讨论如何应用这些发现来改进面向年轻人的数字心理健康工具的设计和传播。
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引用次数: 0
Designing Flexible Longitudinal Regimens: Supporting Clinician Planning for Discontinuation of Psychiatric Drugs. 设计灵活的纵向方案:支持临床医生计划停用精神科药物。
Pub Date : 2022-04-01 Epub Date: 2022-04-29 DOI: 10.1145/3491102.3502206
Eunkyung Jo, Myeonghan Ryu, Georgia Kenderova, Samuel So, Bryan Shapiro, Alexandra Papoutsaki, Daniel A Epstein

Clinical decision support tools have typically focused on one-time support for diagnosis or prognosis, but have the ability to support providers in longitudinal planning of patient care regimens amidst infrastructural challenges. We explore an opportunity for technology support for discontinuing antidepressants, where clinical guidelines increasingly recommend gradual discontinuation over abruptly stopping to avoid withdrawal symptoms, but providers have varying levels of experience and diverse strategies for supporting patients through discontinuation. We conducted two studies with 12 providers, identifying providers' needs in developing discontinuation plans and deriving design guidelines. We then iteratively designed and implemented AT Planner, instantiating the guidelines by projecting taper schedules and providing flexibility for adjustment. Provider feedback on AT Planner highlighted that discontinuation plans required balancing interpersonal and infrastructural constraints and surfaced the need for different technological support based on clinical experience. We discuss the benefits and challenges of incorporating flexibility and advice into clinical planning tools.

临床决策支持工具通常侧重于对诊断或预后的一次性支持,但在基础设施面临挑战的情况下,有能力支持提供者对患者护理方案进行纵向规划。我们探索技术支持停药的机会,临床指南越来越多地建议逐渐停药,而不是突然停药,以避免戒断症状,但提供者有不同的经验水平和不同的策略来支持患者停药。我们对12家供应商进行了两项研究,确定供应商在制定停药计划和制定设计指南方面的需求。然后,我们迭代地设计和实现了AT Planner,通过投射锥度时间表来实例化指导方针,并提供调整的灵活性。供应商对AT Planner的反馈强调,终止计划需要平衡人际关系和基础设施的限制,并提出了基于临床经验的不同技术支持的需求。我们讨论将灵活性和建议纳入临床计划工具的好处和挑战。
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引用次数: 3
Innovating Novel Online Social Spaces with Diverse Middle School Girls: Ideation and Collaboration in a Synchronous Virtual Design Workshop. 与多元化的初中女生一起创新新颖的在线社交空间:同步虚拟设计工作坊中的构思与合作。
Pub Date : 2022-04-01 Epub Date: 2022-04-29 DOI: 10.1145/3491102.3517576
Catherine Grevet Delcourt, Linda Charmaraman, Sidrah Durrani, Quan Gu, Le Fan Xiao

Leveraging social media as a domain of high relevance in the lives of most young adolescents, we led a synchronous virtual design workshop with 17 ethnically diverse, and geographically-dispersed middle school girls (aged 11-14) to co-create novel ICT experiences. Our participatory workshop centered on social media innovation, collaboration, and computational design. We present the culminating design ideas of novel online social spaces, focused on positive experiences for adolescent girls, produced in small-groups, and a thematic analysis of the idea generation and collaboration processes. We reflect on the strengths of utilizing social media as a domain for computing exploration with diverse adolescent girls, the role of facilitators in a synchronous virtual design workshop, and the technical infrastructure that can enable age-appropriate scaffolding for active participation and use of participatory design principles embedded within educational workshops with this population.

社交媒体与大多数青少年的生活息息相关,我们利用社交媒体,与 17 名不同种族、不同地域的初中女生(11-14 岁)开展了同步虚拟设计工作坊,共同创造新颖的信息和通信技术体验。我们的参与式工作坊以社交媒体创新、协作和计算设计为中心。我们介绍了新颖的在线社交空间的最终设计理念,这些理念侧重于为青春期女孩提供积极的体验,以小组形式产生,并对理念的产生和协作过程进行了专题分析。我们反思了利用社交媒体作为与不同青春期女孩进行计算探索的领域的优势、促进者在同步虚拟设计工作坊中的作用,以及技术基础设施,这些基础设施可以为这些群体的积极参与和使用教育工作坊中嵌入的参与式设计原则提供适合其年龄的支架。
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引用次数: 0
Barriers to Online Dementia Information and Mitigation. 在线痴呆症信息和缓解的障碍。
Pub Date : 2022-04-01 Epub Date: 2022-04-29 DOI: 10.1145/3491102.3517554
Emma Dixon, Jesse Anderson, Diana Blackwelder, Mary Radnofsky, Amanda Lazar

There is growing interest in HCI to study ways to support access to accurate, accessible, relevant online health information for different populations. Yet, there remains a need to understand the barriers that are posed by the way our platforms are designed as well as how we might overcome these barriers for people with dementia. To address this, we conducted sixteen interviews and observation sessions with people with mild to moderate dementia. Our analysis uncovered four barriers to online health information and corresponding mitigation strategies that participants employed. We discuss how HCI researchers may apply these findings towards new technical approaches and standards concerning information accessibility and credibility for neurodiverse populations. Finally, we broaden the scope of HCI research to include investigations of the accessibility and credibility of online information for people with age-related cognitive impairment independent of proxies.

人们越来越有兴趣研究如何支持不同人群获得准确、可获取和相关的在线卫生信息。然而,我们仍然需要了解我们平台的设计方式所造成的障碍,以及我们如何为痴呆症患者克服这些障碍。为了解决这个问题,我们对轻度到中度痴呆症患者进行了16次访谈和观察。我们的分析揭示了在线健康信息的四个障碍以及参与者采用的相应缓解策略。我们讨论了HCI研究人员如何将这些发现应用于神经多样性人群的信息可访问性和可信度的新技术方法和标准。最后,我们扩大了HCI研究的范围,包括调查与年龄相关的认知障碍患者的在线信息的可及性和可信度。
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引用次数: 8
Examining AI Methods for Micro-Coaching Dialogs. 研究微教练对话的AI方法。
Pub Date : 2022-04-01 Epub Date: 2022-04-29 DOI: 10.1145/3491102.3501886
Elliot G Mitchell, Noémie Elhadad, Lena Mamykina

Conversational interaction, for example through chatbots, is well-suited to enable automated health coaching tools to support self-management and prevention of chronic diseases. However, chatbots in health are predominantly scripted or rule-based, which can result in a stagnant and repetitive user experience in contrast with more dynamic, data-driven chatbots in other domains. Consequently, little is known about the tradeoffs of pursuing data-driven approaches for health chatbots. We examined multiple artificial intelligence (AI) approaches to enable micro-coaching dialogs in nutrition - brief coaching conversations related to specific meals, to support achievement of nutrition goals - and compared, reinforcement learning (RL), rule-based, and scripted approaches for dialog management. While the data-driven RL chatbot succeeded in shorter, more efficient dialogs, surprisingly the simplest, scripted chatbot was rated as higher quality, despite not fulfilling its task as consistently. These results highlight tensions between scripted and more complex, data-driven approaches for chatbots in health.

会话互动,例如通过聊天机器人,非常适合启用自动化健康指导工具,以支持自我管理和预防慢性疾病。然而,医疗领域的聊天机器人主要是基于脚本或规则的,这可能导致停滞和重复的用户体验,而其他领域的聊天机器人则更动态,更受数据驱动。因此,人们对健康聊天机器人采用数据驱动方法的权衡知之甚少。我们研究了多种人工智能(AI)方法来实现营养中的微指导对话——与特定膳食相关的简短指导对话,以支持营养目标的实现——并比较了强化学习(RL)、基于规则的和脚本化的对话管理方法。虽然数据驱动的强化学习聊天机器人在更短、更有效的对话中取得了成功,但令人惊讶的是,最简单的脚本聊天机器人被评为质量更高,尽管它没有始终如一地完成任务。这些结果突显了医疗领域聊天机器人脚本化和更复杂、数据驱动的方法之间的紧张关系。
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引用次数: 5
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Proceedings of the SIGCHI conference on human factors in computing systems. CHI Conference
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