Medical use cases for machine learning (ML) are growing exponentially. The first hospitals are already using ML systems as decision support systems in their daily routine. At the same time, most ML systems are still opaque and it is not clear how these systems arrive at their predictions. In this paper, we provide a brief overview of the taxonomy of explainability methods and review popular methods. In addition, we conduct a systematic literature search on PubMed to investigate which explainable artificial intelligence (XAI) methods are used in 450 specific medical supervised ML use cases, how the use of XAI methods has emerged recently, and how the precision of describing ML pipelines has evolved over the past 20 years. A large fraction of publications with ML use cases do not use XAI methods at all to explain ML predictions. However, when XAI methods are used, open-source and model-agnostic explanation methods are more commonly used, with SHapley Additive exPlanations (SHAP) and Gradient Class Activation Mapping (Grad-CAM) for tabular and image data leading the way. ML pipelines have been described in increasing detail and uniformity in recent years. However, the willingness to share data and code has stagnated at about one-quarter. XAI methods are mainly used when their application requires little effort. The homogenization of reports in ML use cases facilitates the comparability of work and should be advanced in the coming years. Experts who can mediate between the worlds of informatics and medicine will become more and more in demand when using ML systems due to the high complexity of the domain.
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.
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.
With about 300 million affected people, major depressive disorder (MDD) is one of the most common diseases worldwide. During the COVID-19 pandemic, the number of cases increased even further, by 28%. Many factors may be correlated with MDD, including the excessive use of social media apps. In this paper, we investigated the relationship between the use of social media and communication apps and depressive symptoms during the COVID-19 pandemic. The pandemic and social distancing like lockdowns probably changed smartphone usage times and usage patterns. While previous studies have shown an association between depression and social media usage, we report about the situation during these special circumstances. We employed a log-linear regression to examine the association of social media and communication app usage and depression. To quantify the usage, we applied the total usage time in hours of social media apps (e.g., WhatsApp, Facebook) as well as communication apps (Phone and Messaging) within one week. To measure depressive symptoms, we used the PHQ-9 score. We discovered a significant association between the usage time and the PHQ-9 score (beta=0.0084, p-value=0.010). We conclude that social media usage is a robust marker for depression severity and future research should focus on a better understanding of the underlying causality and potential counter-measures.
Notifications are an essential part of the user experience on smart mobile devices. While some apps have to notify users immediately after an event occurs, others can schedule notifications strategically to notify them only on opportune moments. This tailoring allows apps to shorten the users’ interaction delay. In this paper, we present the results of a comprehensive study that identified the factors that influence users’ interaction delay to their smartphone notifications. We analyzed almost 10 million notifications collected in-the-wild from 922 users and computed their response times with regard to their demographics, their Big Five personality trait scores and the device’s charging state. Depending on the app category, the following tendencies can be identified over the course of the day: Most notifications were logged in late morning and late afternoon. This number decreases in the evening, between 8 p.m. and 11 p.m., and at the same time exhibits the lowest average interaction delays at daytime. We also found that the user’s sex and age is significantly associated with the response time. Based on the results of our study, we encourage developers to incorporate more information on the user and the executing device in their notification strategy to notify users more effectively.
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 8 languages and attracted 7,290 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.