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Publications

October 28, 2019

A Research Roadmap: Connected Health as an Enabler of Cancer Patient Support

Signorelli GR, Lehocki F, Mora Fernández M, O'Neill G, O'Connor D, Brennan L, Monteiro-Guerra F, Rivero-Rodriguez A, Hors-Fraile S, Munoz-Penas J, Bonjorn Dalmau M, Mota J, Oliveira RB, Mrinakova B, Putekova S, Muro N, Zambrana F, Garcia-Gomez JM

ABSTRACT

 

The evidence that quality of life is a positive variable for the survival of cancer patients has prompted the interest of the health and pharmaceutical industry in considering that variable as a final clinical outcome. Sustained improvements in cancer care in recent years have resulted in increased numbers of people living with and beyond cancer, with increased attention being placed on improving quality of life for those individuals. Connected Health provides the foundations for the transformation of cancer care into a patient-centric model, focused on providing fully connected, personalized support and therapy for the unique needs of each patient. Connected Health creates an opportunity to overcome barriers to health care support among patients diagnosed with chronic conditions. This paper provides an overview of important areas for the foundations of the creation of a new Connected Health paradigm in cancer care. Here we discuss the capabilities of mobile and wearable technologies; we also discuss pervasive and persuasive strategies and device systems to provide multidisciplinary and inclusive approaches for cancer patients for mental well-being, physical activity promotion, and rehabilitation. Several examples already show that there is enthusiasm in strengthening the possibilities offered by Connected Health in persuasive and pervasive technology in cancer care. Developments harnessing the Internet of Things, personalization, patient-centered design, and artificial intelligence help to monitor and assess the health status of cancer patients. Furthermore, this paper analyses the data infrastructure ecosystem for Connected Health and its semantic interoperability with the Connected Health economy ecosystem and its associated barriers. Interoperability is essential when developing Connected Health solutions that integrate with health systems and electronic health records. Given the exponential business growth of the Connected Health economy, there is an urgent need to develop mHealth (mobile health) exponentially, making it both an attractive and challenging market. In conclusion, there is a need for user-centered and multidisciplinary standards of practice to the design, development, evaluation, and implementation of Connected Health interventions in cancer care to ensure their acceptability, practicality, feasibility, effectiveness, affordability, safety, and equity.

February 04, 2019

Smartphone Sensors for Monitoring Cancer-Related Quality of Life: App Design, EORTC QLQ-C30 Mapping and Feasibility Study in Healthy Subjects

Sabina Asensio-Cuesta, Ángel Sánchez-García, J. Alberto Conejero, Carlos Saez, Alejandro Rivero-Rodriguez and Juan M. García-Gómez

Abstract: Quality of life (QoL) indicators are now being adopted as clinical outcomes in clinical trials on cancer treatments. Technology-free daily monitoring of patients is complicated, time-consuming and expensive due to the need for vast amounts of resources and personnel. The alternative method of using the patients’ own phones could reduce the burden of continuous monitoring of cancer patients in clinical trials. This paper proposes monitoring the patients’ QoL by gathering data from their own phones. We considered that the continuous multiparametric acquisition of movement, location, phone calls, conversations and data use could be employed to simultaneously monitor their physical, psychological, social and environmental aspects. An open access phone app was developed (Human Dynamics Reporting Service (HDRS)) to implement this approach. We here propose a novel mapping between the standardized QoL items for these patients, the European Organization for the Research and Treatment of Cancer Quality of Life Questionnaire (EORTC QLQ-C30) and define HDRS monitoring indicators. A pilot study with university volunteers verified the plausibility of detecting human activity indicators directly related to QoL.

January 07, 2019

An Innovative, Information and Communication Technology Supported Approach, Towards Effective Chronic Pain Management

Haridimos Kondylakis, Santiago Hors-Fraile, Lefteris Koumakis, Angelina Kouroubali, George Notas, Alejandro Rivero-Rodriguez, Prodromos Sidiropoulos, Panagiotis Simos, and Dimitrios G. Katehakis.

Abstract

Chronic pain is one of the most common health problems affecting daily activity, employment, relationships and emotional functioning. Unfortunately, the lack of specialized health care personnel, and the high heterogeneity in terms of clinical manifestation and treatment results contribute in failure to manage efficiently and effectively pain. Information and communication technology (ICT) can be a valuable tool, enabling patients and healthcare professional empowerment and better self-management of pain. To this direction, this article reports on the design of a novel technical infrastructure to support effectively and efficiently chronic pain management, based on an Intelligent Personal Health Record platform on top of already available ICT tools. The designed platform targets, among others, at improving the knowledge on the patient data, effectiveness and adherence to treatment and providing effective communication channels between patients and healthcare professionals.

August 31, 2018

3MD for chronic conditions : a model for motivational mHealth design

Giunti, Guido - University of Oulu Graduate School, Salumedia Tecnologías

Abstract

Chronic conditions are the leading cause of death in the world. Major improvements in acute care and diagnostics have created a tendency towards the chronification of formerly terminal conditions, requiring people with these conditions to learn how to self-manage. Mobile technologies hold promise as self-management tools due to their ubiquity and cost-effectiveness.

The delivery of health-related services through the use of mobile technologies (mHealth) has grown exponentially in recent years. However, only a fraction of these solutions takes into consideration the views of relevant stakeholders like healthcare professionals or even patients. The use of behavioral change models (BCM) has proven important in developing successful health solutions, yet engaging patients remains a challenge. There is a trend in mHealth solutions called gamification that attempts to use game elements to drive user behavior and increase engagement. As it stands, designers of mHealth solutions for behavioral change in chronic conditions have no clear way of deciding what factors are relevant to consider.

This doctoral thesis is framed in Consumer Health Informatics within the field of Medical Informatics and Information Systems. The focus of this work was to discover factors for the design of mHealth solutions for chronic patients; to do so, negotiations between medical knowledge, BCM and gamification were explored through an embedded case study research methodology. The data obtained was thematically analyzed to create the Model for Motivational Mobile-health Design for Chronic conditions (3MD).

August 23, 2018

3MD for Chronic Conditions, a Model for Motivational mHealth Design: Embedded Case Study

Guido Giunti

ABSTRACT:

Background: Chronic conditions are the leading cause of death in the world. Major improvements in acute care and diagnostics have created a tendency toward the chronification of formerly terminal conditions, requiring people with these conditions to learn how to self-manage. Mobile technologies hold promise as self-management tools due to their ubiquity and cost-effectiveness. The delivery of health-related services through mobile technologies (mobile health, mHealth) has grown exponentially in recent years. However, only a fraction of these solutions take into consideration the views of relevant stakeholders such as health care professionals or even patients. 

June 24, 2018

Designing a Novel Technical Infrastructure for Chronic Pain Self-Management.

Kondylakis H, Kouroubali A, Koumakis L, Rivero-Rodriguez A, Hors-Fraile S, Katehakis D.

ABSTRACT

Chronic pain is one of the most common health problems affecting daily activity, employment, relationships and emotional functioning. Unfortunately, limited access to pain experts, the high heterogeneity in terms of clinical manifestation and treatment results, contribute in failure to manage efficiently and effectively pain. Information and Communication Technology (ICT) can be a valuable tool, enabling better self-management and self-empowerment of pain.

May 22, 2018

Supply and Demand in mHealth Apps for Persons With Multiple Sclerosis: Systematic Search in App Stores and Scoping Literature Review

Guido Giunti; Estefanía Guisado Fernández; Enrique Dorronzoro Zubiete; Octavio Rivera Romero

ABSTRACT

Background: Multiple sclerosis (MS) is a non-curable chronic inflammatory disease of the central nervous system that affects more than 2 million people worldwide. MS-related symptoms impact negatively on the quality of life of persons with MS, who need to be active in the management of their health. mHealth apps could support these patient groups by offering useful tools, providing reliable information, and monitoring symptoms. A previous study from this group identified needs, barriers, and facilitators for the use of mHealth solutions among persons with MS. It is unknown how commercially available health apps meet these needs.

February 28, 2018

More Stamina, a Gamified mHealth Solution for Persons with Multiple Sclerosis: Research Through Design

Guido Giunti; Vasiliki Mylonopoulou; Octavio Rivera Romero

ABSTRACT

Background: Multiple sclerosis (MS) is one of the world’s most common neurologic disorders. Fatigue is one of most common symptoms that persons with MS experience, having significant impact on their quality of life and limiting their activity levels. Self-management strategies are used to support them in the care of their health. Mobile health (mHealth) solutions are a way to offer persons with chronic conditions tools to successfully manage their symptoms and problems. Gamification is a current trend among mHealth apps used to create engaging user experiences and is suggested to be effective for behavioral change. To be effective, mHealth solutions need to be designed to specifically meet the intended audience needs. User-centered design (UCD) is a design philosophy that proposes placing end users’ needs and characteristics in the center of design and development, involving users early in the different phases of the software life cycle. There is a current gap in mHealth apps for persons with MS, which presents an interesting area to explore.

January 31, 2018

Exploring the Specific Needs of Persons with Multiple Sclerosis for mHealth Solutions for Physical Activity: Mixed-Methods Study

Guido Giunti; Jan Kool; Octavio Rivera Romero; Enrique Dorronzoro Zubiete

ABSTRACT

Background: Multiple sclerosis (MS) is one of the world’s most common neurologic disorders, with symptoms such as fatigue, cognitive problems, and issues with mobility. Evidence suggests that physical activity (PA) helps people with MS reduce fatigue and improve quality of life. The use of mobile technologies for health has grown in recent years with little involvement from relevant stakeholders. User-centered design (UCD) is a design philosophy with the goal of creating solutions specific to the needs and tasks of the intended users. UCD involves stakeholders early and often in the design process. In a preliminary study, we assessed the landscape of commercially available MS mobile health (mHealth) apps; to our knowledge, no study has explored what persons with MS and their formal care providers think of mHealth solutions for PA.

January 31, 2018

A biopsy of Breast Cancer mobile applications: state of the practice review

Guido Giunti; Diego H. Giunta; Estefania Guisado-Fernandez; Jackie L. Bender; Luis Fernandez-Luque

Abstract

Background

Breast cancer is the most common cancer in women. The use of mobile software applications for health and wellbeing promotion has grown exponentially in recent years. We systematically reviewed the breast cancer apps available in today’s leading smartphone application stores and characterized them based on their features, evidence base and target audiences.

December 31, 2017

Activating Technology for Connected Health in Cancer: Protocol for a Research and Training Program

Nicola Mountford; Enrique Dorronzoro Zubiete; Threase Kessie; Begonya Garcia-Zapirain; Roberto Nuño-Solinís; David Coyle; Kristin B Munksgaard; Luis Fernandez-Luque; Octavio Rivera Romero; Matilde Mora Fernandez; Pedro Valero Jimenez; Ailish Daly; Ruth Whelan; Brian Caulfield

ABSTRACT

Background: As cancer survival rates increase, the challenge of ensuring that cancer survivors reclaim their quality of life (QoL) becomes more important. This paper outlines the research element of a research and training program that is designed to do just that.

November 30, 2017

Mobile Phone Apps for Quality of Life and Well-Being Assessment in Breast and Prostate Cancer Patients: Systematic Review

Esther Rincon; Francisco Monteiro-Guerra; Octavio Rivera-Romero; Enrique Dorronzoro-Zubiete; Carlos Luis Sanchez-Bocanegra; Elia Gabarron

ABSTRACT

Background: Mobile phone health apps are increasingly gaining attention in oncological care as potential tools for supporting cancer patients. Although the number of publications and health apps focusing on cancer is increasing, there are still few specifically designed for the most prevalent cancers diagnosed: breast and prostate cancers. There is a need to review the effect of these apps on breast and prostate cancer patients’ quality of life (QoL) and well-being.

October 31, 2017

The Design of a Mobile App for Promotion of Physical Activity and Self-Management in Prostate Cancer Survivors: Personas, Feature Ideation and Low-Fidelity Prototyping

Francisco Monteiro-Guerra; Octavio Rivera-Romero; Vasiliki Mylonopoulou; Gabriel R. Signorelli; Francisco Zambrana; Luis Fernandez-Luque

Most prostate cancer survivors are confronted with disease-related and treatment-related side effects that impact their quality of life. A tool that combines specific physical activity coaching with the promotion of a healthy lifestyle and self-management guidance might be a successful method to enhance a lifestyle change in these patients. As a prerequisite for useful health technology, it is important to consider a design process centred in the patients. The aim of this study was to investigate the context of the problem and the user needs to support the ideation of a low-fidelity prototype of a tool to promote a healthy lifestyle among early-stage prostate cancer survivors.

June 30, 2017

Designers are from Mars, Physicians are from Venus: challenges on integrating HCI and IS perspectives into Healthcare

Guido Giunti

 

The ubiquity of information and communication technologies (ICTs) can’t be challenged in today’s world. The current global use of smartphones has reached 2.6 billion (Ericsson 2017) and this is without counting other type of devices like personal computers or tablets. It is a surprise to no one that the underlying Information Systems (IS) have permeated other fields and disciplines, changing and redefining them. What is surprising, however, is its relatively slow adoption in healthcare and medicine. There are several factors at play that can explain this situation.

June 23, 2017

Connected Health in Multiple Sclerosis: A Mobile Applications Review

Guido Giunti; Estefania Guisado-Fernandez; Brian Caulfield

Abstract:

Multiple Sclerosis (MS) is an unpredictable, often disabling disease that can adversely affect any body function; this often requires persons with MS to be active patients who are able to self-manage. There are currently thousands of health applications available but it is unknown how many concern MS. We conducted a systematic review of all MS apps present in the most popular app stores (iTunes and Google Play store) on June 2016 to identify all relevant MS apps. After discarding non-MS related apps and duplicates, only a total of 25 MS apps were identified. App description contents and features were explored to assess target audience, functionalities, and developing entities. The vast majority of apps were focused on disease and treatment information with disease management being a close second. This is the first study that reviews MS apps and it highlights an interesting gap in the current repertoire of MS mHealth resources.

June 23, 2017

Detecting Gamification in Breast Cancer Apps: An Automatic Methodology for Screening Purposes

Guido Giunti; Diego H. Giunta; Santiago Hors-Fraile; Minna Isomursu; Diana Karosevičiūtė

Abstract:

Breast cancer is the most common cancer in women both in developed and developing countries. More than half of all cancer mobile application concern breast cancer. Gamification is widely used in mobile software applications created for health-related services. Current prevalence of gamification in breast cancer apps is unknown and detection must be manually performed. The purpose of this study is to describe and produce a tool allowing automatic detection of apps which contain gamification elements and thus empowering researchers to study gamification using large data samples. Predictive logistic regression model was designed on data extracted from breast cancer apps title and description text available in app stores. Model was validated comparing estimated and benchmark values, observed by gamification specialists. Studys outcome can be applied as a screening tool to efficiently identify gamification presence in breast cancer apps for further research.

September 30, 2016

Design of two combined health recommender systems for tailoring messages in a smoking cessation app

Santiago Hors-Fraile; Francisco J Núñez Benjumea; Laura Carrasco Hernández; Francisco Ortega Ruiz; Luis Fernandez-Luque

In this article, we describe the design of two recommender systems (RS) designed to support the smoking cessation process through a mobile application. We plan to use a hybrid RS (content-based, utility-based, and demographic filtering) to tailor health recommendation messages, and a content-based RS to schedule a timely delivery of the message. We also define metrics that we will use to assess their performance, helping people quit smoking when we run the pilot.

June 30, 2016

Gamified Design for Health Workshop

Guido Giunti

Abstract

Increasing lifespans for chronic disease sufferers means a population of young patients who require lifestyle intervention from an early age. For multiple sclerosis (MS) patients, social problems begin with the decline of cognitive skills and their quality of life is affected.

In this workshop, organizers will propose participants to work on different gamification design approachs to solve MS patients' engagement problem. Participants will obtain skills that can be extrapolated to other conditions that require patients change to adopt a different behavior.

At the end, participants will present their proposed gamification design and discuss and comment each solution, assessing potential unintended outcomes and advantages.

November 30, 2014

Play as a prevention strategy: Using a web app to teach youth about STDs

Elia Gabarron; J.Artur Serrano; Thomas R.  Schopf; Luis Fernandez-Luque; Rolf Wynn

Introduction Chlamydia is the most common sexually transmitted disease (STD) in Norway; and 85,7% of reported chlamydia cases are found in persons below 29 years of age.

1. Methods The web app sjekkdeg.no aims at providing information for Norwegian secondary school students about the prevention of STDs. The development of the app was based on a constructivist learning theory using text, multimedia, and interactive game-like applications. We examined the use of the various sections of the web app by Google Analytics statistics. The web app was also evaluated by students using questionnaires and by interviewing nurses engaged in teaching secondary school students.

November 30, 2013

Gamification Strategy on Prevention of STDs for Youth

Elia Gabarron; Thomas Schopf; J. Artur Serrano; Luis Fernández Luque; Enrique Dorronzoro Zubiete

Sexually transmitted diseases (STDs) and especially chlamydia is a worrying problem among North-Norwegian youngsters. Gamified web applications should be valued for sexual health education, and thus STDs prevention, for their potential to get users engaged and involved with their healthcare. Aiming to achieve that youngsters become more aware of STDs we have developed “sjekkdeg.no”, a gamified web application focused on sexual health targeting North-Norwegian youngsters.  

July 31, 2013

Evaluation of sensors for inputting data in exergames for the elderly.

Santiago Hors-Fraile; James Browne; Ellen Brox; Gunn Evertsen

Abstract

We aim to solve which off-the-shelf motion sensor device is the most suitable for extensive usage in PC open-source exergames for the elderly. To solve this problem, we studied the specifications of the market-available sensors to reduce the initial, broad set of sensors to only two candidates: the Nintendo Wii controllers and the Microsoft© Kinect™ camera. The capabilities of these two are tested with a demo implementation. We take into account both the accuracy in the movement-detection of the sensors, and the software-related issues. Our outcome indicates that the Microsoft© Kinect™ camera is the option that currently provides the best solution for our purpose. This study can be helpful for researchers to choose the device that suits their project needs better, removing the sensor-choosing task time from their schedule.

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