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Mobile apps are increasingly utilized to gather data for various healthcare aspects. Furthermore, mobile apps are used to administer interventions (e.g., breathing exercises) to individuals. In this context, mobile crowdsensing constitutes a technology, which is used to gather valuable medical data based on the power of the crowd and the offered computational capabilities of mobile devices. Notably, collecting data with mobile crowdsensing solutions has several advantages compared to traditional assessment methods when gathering data over time. For example, data is gathered with high ecological validity, since smartphones can be unobtrusively used in everyday life. Existing approaches have shown that based on these advantages new medical insights, for example, for the tinnitus disease, can be revealed. In the work at hand, data of a developed mHealth crowdsensing platform that assesses the stress level and fluctuations of the platform users in daily life was investigated. More specifically, data of 1797 daily measurements on GPS and stress-related data in 77 users were analyzed. Using this data source, machine learning algorithms have been applied with the goal to predict stress-related parameters based on the GPS data of the platform users. Results show that predictions become possible that (1) enable meaningful interpretations as well as (2) indicate the directions for further investigations. In essence, the findings revealed first insights into the stress situation of individuals over time in order to improve their quality of life. Altogether, the work at hand shows that mobile crowdsensing can be valuably utilized in the context of stress on one hand. On the other, machine learning algorithms are able to utilize geospatial data of stress measurements that was gathered by a crowdsensing platform with the goal to improve the quality of life of its participating crowd users.

Smart devices and low-powered sensors are becoming increasingly ubiquitous and nowadays almost all of these devices are connected, which is a promising foundation for crowdsensing of data related to various environmental phenomena. Resulting data is especially meaningful when it is related to time and location. Interestingly, many existing approaches built their solution on monolithic backends that process data on a per-request basis. However, for many scenarios, such technical setting is not suitable for managing data requests of a large crowd. For example, when dealing with millions of data points, still many challenges arise for modern smartphones if calculations or advanced visualization features must be accomplished directly on the smartphone. Therefore, the work at hand proposes an architectural design for managing geospatial data of tinnitus patients, which combines a cloudnative approach with Big Data concepts used in the Internet of Things. The presented architectural design shall serve as a generic foundation to implement (1) a scalable backend for a platform that covers the aforementioned crowdsensing requirements as well as to provide (2) a sophisticated stream processing concept to calculate and pre-aggregate incoming measurement data of tinnitus patients. Following this, this paper presents a visualization feature to provide users with a comprehensive overview of noise levels in their environment based on noise measurements. This shall help tinnitus or hearing-impaired patients to avoid locations with a burdensome sound level.

Presently, mHealth technology is often applied in the context of chronic diseases to gather data that may lead to new and valuable medical insights. As many aspects of chronic diseases are not completely understood, new data sources might be promising. mHealth technology may help in this context as it can be easily used in everyday life. Moreover, the bring your own device principle encourages many patients to use their smartphone to learn more about their disease. The less is known about a disorder (e.g., tinnitus), the more patients crave for new insights and opportunities. Despite the fact that existing mHealth technology like mobile crowdsensing has already gathered data that may help patients, in general, less is known whether and how data gathered with different mobile technologies may differ. In this context, one relevant aspect is the contribution of the mobile operating system itself. For example, are there differences between Android and iOS users that utilize the same mHealth technology for a disease. In the TrackYourTinnitus project, a mobile crowdsensing mHealth platform was developed to gather data for tinnitus patients in order to reveal new insights on this disorder with high economic and patient-related burdens. As many data sets were gathered during the last years that enable us to compare Android and iOS users, the work at hand compares characteristics of these users. Interesting insights like the one that Android users with tinnitus are significantly older than iOS users could be revealed by our study. However, more evaluations are necessary for TrackYourTinnitus in particular and mHealth technology in general to understand how smartphones affect the gathering of data on chronic diseases when using them in the large.

Many studies have revealed that therapeutic homework is beneficial for the efficacy of therapies. Interestingly, the latter have been less supported by IT systems so far and, hence, therapeutic opportunities have been neglected. For example, mobile devices can be used to notify patients about assigned homework and help them to accomplish it in a timely manner. In general, the use of mobile devices as well as their sensors seem to be promising for the support of remote therapeutic interventions. In the Albatros project, we have been developing a framework that enables domain experts to flexibly define the homework required in the context of a remote therapeutic intervention. More precisely, the various tasks of a homework can be specified as a mobile process, which is then run on the mobile device of the respective patient. To realize this vision, a configurator component using a model-driven approach was developed. In particular, the Albatros configurator shall relieve domain experts from complex technical issues when defining a homework. The study presented in this paper investigates whether domain experts are actually able to use the configurator component. In particular, the study revealed three insights. First, basic interventions can be easily defined with an acceptable number of errors. Second, for defining complex interventions (e.g., using a sensor when performing an exercise) several issues could be identified that will contribute to improve the Albatros configurator. Third, additional studies are needed to evaluate the overall mental effort of domain experts when using the configurator. Altogether, the Albatros framework may be a reasonable alley to empower domain experts in creating homework in the context of remote therapeutic interventions.

Treatment of patients with tinnitus is mainly pursued on the basis of screening data, encompassing answers to questionnaires or audiological examinations. Since tinnitus affects the quality of life of patients and is associated with comorbidities like depression, the screening step involves the acquisition of extensive amounts of information, which may contribute to the design of a personalized treatment. Often times, it can be observed that patients give up their treatment before completion (i.e., they constitute “dropout” cases). In this study, we investigate how multi-target classification on the screening data can contribute to characterize patients that will drop out of the study. For our analysis, we base or considerations on the target variable “tinnitus loudness”, i.e. the subjectively perceived loudness of the phantom signal. Following this, we attempt to identify variables that explain the tinnitus loudness together with the likelihood of interrupting the treatment. To be more precise, we report on results from gathered data of 1419 tinnitus patients from the University Hospital of Regensburg.

The identification of subpopulations with particular characteristics with respect to a disease is important for personalized diagnostics and therapy design. For some diseases, the outcome is described by more than one target variable. An example is tinnitus: the perceived loudness of the phantom signal and the level of distress caused by it are both relevant targets for diagnosis and therapy. In this work, we study the potential of multi-target classification for the identification of those screening variables, which separate best among the different subpopulations of patients, paying particular attention to subpopulations with discordant value combinations of loudness and distress. We analyse the screening data of 1344 tinnitus patients from the University Hospital Regensburg, including questions from 7 questionnaires, and report on the performance of our workflow in target separation and in ranking the questionnaires variables on their discriminative power.

The development of information systems, which support homework in the context of therapeutic interventions, has not been sufficiently addressed so far. However, both therapists and patients crave for a mobile assistance managing complex homework procedures. For example, smart mobile devices can automatically inform therapists about corresbonding outcomes, giving them the opportunity to timely adjust homework if required. When realizing information systems that integrate smart mobile devices, the common procedure of therapeutic interventions in general and homework in particular must be carefully captured by the system. Therefore, relevant requirements were elicitated in real-world projects. Based on these requirements, we realized the Albatros platform enabling therapists to manage therapeutic interventions remotely. Using the platform, homework can be created with a web-based component and be performed by patients with the help of smart mobile devices. In this paper, elicitated requirements for realizing the platform as well as its features and architecture are presented. Altogether, the Albatros platform enables therapists as well as patients to manage therapeutic interventions and homework more efficiently.

Assessment of chronic disorders requires new ways of data collection compared to the traditional pen & paper based approaches. For example, tinnitus, the phantom sensation of sound, is a highly prevalent disorder that is difficult to treat, i.e., available treatments are only effective for patient subgroups. In most individuals with tinnitus, loudness and annoyance of tinnitus varies over time. Currently, established assessment methods of tinnitus neither systematically assess this moment-to-moment variability nor environmental factors having an effect on tinnitus loudness and distress. However, information of individual fluctuations and the effect of environmental factors on the tinnitus might represent important information for tinnitus subtyping and for individualized treatment. In this context, a promising approach for collecting ecological valid longitudinal datasets at rather low costs is mobile crowdsensing. In the TrackYourTinnitus project, we developed an advanced mobile crowdsensing platform to reveal more detailed information about the course of tinnitus over time. In this paper, the patient mobile feedback service as a particular component of the platform is presented. It was developed to provide patients with aggregated information about the variation of their tinnitus over time. This mobile feedback service shall help a patient to demystify the tinnitus and to get better control of it, which should facilitate coping with this chronic health condition. As the basic principles and design of this mobile services are also applicable to other chronic disorders, promising perspectives for disorder management and clinical research arise.

Many symptoms of neuropsychiatric disorders such as tinnitus are subjective and vary over time. Usually, in interviews or self-report questionnaires, patients are asked to report symptoms as well as their severity and duration retrospectively. However, only little is known to what degree such retrospective reports reflect the symptoms experienced in daily life some time ago. Mobile technologies can help to bridge this gap: mobile self-help services allow patients to record their symptoms prospectively when (or shortly after) they occur in daily life. In this study, we present results that we obtained with the mobile crowdsensing platform TrackYourTinnitus to show that there is a discrepancy between the prospective assessment of symptom variability and the retrospective report thereof. To be more precise, we evaluated the real-time entries provided to the platform by individuals experiencing tinnitus. The results indicate that mobile technologies like the TrackYourTinnitus crowdsensing platform may go beyond the role of an assistive service for patients by contributing to more accurate diagnosis and, hence, to a more elaborated treatment.

Smart mobile devices are variously used in the health sector. Some mobile applications empower patients to better understand their health problems, others guide them in health behavior. Moreover, smart mobile devices can be used in clinical research. Mobile crowd sensing has proven high usefulness for collecting health data with high ecological validity in this context. As the core idea, individually recorded health data are evaluated and fed back to individuals to better control their symptoms. For this purpose, the Track-YourTinnitus mobile crowd sensing platform was developed to empower patients to cope better with their tinnitus. So far, the platform has solely gathered patient data based on mobile questionnaires. When filling in a questionnaire, however, the analysis of the heartrate might provide novel information to medical experts. As monitoring the heartrate with smart mobile devices is costly, the trend towards wearables offers promising perspectives. Using smartwatches instead of smartphones in TrackYourTinnitus, however, requires questionnaire management on smartwatches. This work presents results of a prestudy related to the feasibility of sophisticated questionnaires on smartwatches. A prototype was developed and evaluated with 24 subjects. The obtained results are promising regarding the use of smartwatches for mobile crowd sensing in the context of chronic disorders.

Tinnitus ("ringing in the ear") is characterized by the perception of a sound in the absence of a corresponding acoustic stimulus. While many affected people habituate to the phantom sound, others are severely bothered and impaired in their quality of life. It is assumed that the latter group is characterized by a deficient noise cancelling mechanism in the brain. To train tinnitus patients to focus on target sounds and hence to suppress irrelevant background sounds, we developed a mobile serious game application, which is presented in this paper. The application runs on three mobile operating systems. We describe its goals and architecture as well as results from an evaluation study. Study results indicate that the gaming approach is feasible for training affected patients in focusing on directional hearing and, thereby, to suppress their tinnitus. Compared to traditional hearing training, advances of this approach are anytime availability, higher enjoyment, immediate feedback, and the option to stepwise increase game difficulty. From this, we expected an increased patient motivation and adherence as well as improved training and learning effects.

Many highly prevalent diseases (e.g., tinnitus, migraine, chronic pain) are difficult to treat and universally effective treatments are missing. Available treatments are only effective in patient subgroups, i.e., medical doctors and patients have to figure out which therapy might be helpful in the patient's situation. Sufficiently large and qualitative longitudinal data sets, however, would be desirable to facilitate evidence-based treatment decisions for individual patients. On one hand, traditional sensing techniques (i.e., clinical trials) have many merits enabling evidence-based medicine. On the other, they have inherent limitations. First, clinical trials are very cost- and labour-intensive. Second, the traditional approach aims at reducing ecological heterogeneity to enable the investigation of homogeneous subsamples. Recently, a new paradigm emerged that offers promising perspectives for collecting large amounts of longitudinal patient data -- Mobile Crowd Sensing. By utilizing smart mobile devices of a large number of patients, health information can be gathered from large patient collections as well as at many different time points and in various real life environmental situations. In the Track Your Tinnitus project, we implemented such a mobile crowd sensing platform to reveal new medical aspects about tinnitus with a particular focus on the variability of tinnitus over time depending on the environmental situation. In this paper, the current project status as well as first lessons learned from running the mobile application for twelve months are presented. In turn, the lessons learned are discussed in the context of the new perspectives offered by mobile crowd sensing in the medical field.

Tinnitus, the phantom sensation of sound, is a highly prevalent disorder that is difficult to treat, i.e., Available treatments are only effective for patient subgroups. Sufficiently large and qualitative longitudinal data sets, which aggregate the individuals' demographic and clinical characteristics, together with their response to specific therapeutic interventions, would therefore facilitate evidence-based treatment suggestions for individual patients. Currently, clinical trials are the standard instrument for realizing evidence-based medicine. However, the related information gathering is limited. For example, clinical trials try to reduce the complexity of the individual case by generating homogeneous groups to obtain significant results. From the latter, individual treatment decisions are inferred. A complementary approach would be to assess the effect of specific interventions in large samples considering the individual peculiarity of each subject. This allows providing individualized treatment decisions. Recently, mobile crowd sensing emerged as an approach for collecting large and ecological valid datasets at rather low costs. By providing mobile crowd sensing services to large numbers of patients, large datasets can be gathered cheaply on a daily basis. In the Track Your Tinnitus project, we implemented a mobile crowd sensing platform to reveal new medical aspects on tinnitus and its treatment. Additionally, we work on mobile services exploring approaches for understanding tinnitus and for improving its diagnostic and therapeutic management. We present the Track Your Tinnitus platform as well as its goals, architecture and preliminary results. Overall, the platform and its mobile services offer promising perspectives for tinnitus research and treatment.