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Aim: To non-invasively detect hypoglycemia in individuals with type 1 diabetes (T1D) based on gaze behavior while driving. Methods: Controlled hypoglycemia was induced in 19 individuals (12 males, age 32 ± 7.1 yrs) with T1D (HbA1c 7.1 ± 0.6% [54 ± 6 mmol/mol]) using an adapted hypoglycemic clamp protocol. Gaze and blood glucose (BG) data were gathered while driving in a simulator during three 18 min sessions: session 1 (BG 90-144 mg/dL), session 2 (BG declining from 72 to 45 mg/dL), and session 3 (BG 36-45 mg/dL). A gradient-boosting machine learning (ML) model was built for hypoglycemia (BG Results: Mean venous BG was 105.4 ± 11.4 mg/dL during session 1, declined from 61.4 ± 6.1 mg/dL to 47.2 ± 8.5 mg/dL during session 2, and was 42.7 ± 4.1 mg/dL during session 3, respectively. Gaze analysis provided 29,968 data samples (1,577.5 ± 52 per subject, 10,041 euglycemia, 19,927 hypoglycemia). Overall, ML achieved an area under the receiver-operating-characteristics curve of 0.83 ± 0.09 for hypoglycemia detection with leave-one-subject-out cross-validation. Conclusion: ML-based gaze analysis shows high accuracy in non-invasive hypoglycemia detection while driving. Our approach offers promising potential in various settings where cameras are available. Disclosure V. Lehmann: None. E. Fleisch: Research Support; Self; CSS Health Insurance, Switzerland, Stock/Shareholder; Self; Pathmate-Technologies AG, Switzerland. F. Wortmann: None. C. Stettler: None. M. Maritsch: None. T. Zueger: None. A. Marxer: None. C. Berube: None. M. Kraus: None. C. Albrecht: None. S. Feuerriegel: None. T. Kowatsch: Advisory Panel; Self; Pathmate Technologies AG, Switzerland and Germany, Stock/Shareholder; Self; Pathmate Technologies AG, Switzerland and Germany. Funding Swiss National Science Foundation (SNF CRSII5_183569); Insel Group; Diabetes Center Berne

Background: Chronic and mental health conditions are increasingly prevalent worldwide. As devices in our everyday lives offer more and more voice-based self-service, voice-based conversational agents (VCAs) have the potential to support the prevention and management of these conditions in a scalable manner. However, evidence on VCAs dedicated to the prevention and management of chronic and mental health conditions is unclear. Objective: This study provides a better understanding of the current methods used in the evaluation of health interventions for the prevention and management of chronic and mental health conditions delivered through VCAs. Methods: We conducted a systematic literature review using PubMed MEDLINE, Embase, PsycINFO, Scopus, and Web of Science databases. We included primary research involving the prevention or management of chronic or mental health conditions through a VCA and reporting an empirical evaluation of the system either in terms of system accuracy, technology acceptance, or both. A total of 2 independent reviewers conducted the screening and data extraction, and agreement between them was measured using Cohen kappa. A narrative approach was used to synthesize the selected records. Results: Of 7170 prescreened papers, 12 met the inclusion criteria. All studies were nonexperimental. The VCAs provided behavioral support (n=5), health monitoring services (n=3), or both (n=4). The interventions were delivered via smartphones (n=5), tablets (n=2), or smart speakers (n=3). In 2 cases, no device was specified. A total of 3 VCAs targeted cancer, whereas 2 VCAs targeted diabetes and heart failure. The other VCAs targeted hearing impairment, asthma, Parkinson disease, dementia, autism, intellectual disability, and depression. The majority of the studies (n=7) assessed technology acceptance, but only few studies (n=3) used validated instruments. Half of the studies (n=6) reported either performance measures on speech recognition or on the ability of VCAs to respond to health-related queries. Only a minority of the studies (n=2) reported behavioral measures or a measure of attitudes toward intervention-targeted health behavior. Moreover, only a minority of studies (n=4) reported controlling for participants’ previous experience with technology. Finally, risk bias varied markedly. Conclusions: The heterogeneity in the methods, the limited number of studies identified, and the high risk of bias show that research on VCAs for chronic and mental health conditions is still in its infancy. Although the results of system accuracy and technology acceptance are encouraging, there is still a need to establish more conclusive evidence on the efficacy of VCAs for the prevention and management of chronic and mental health conditions, both in absolute terms and in comparison with standard health care., Journal of Medical Internet Research, 23 (3), ISSN:1438-8871

CHI EA '20: Extended Abstracts of the 2020 CHI Conference on Human Factors in Computing Systems, ISBN:978-1-4503-6819-3

The reactions of the human body to physical exercise, psychophysiological stress and heart diseases are reflected in heart rate variability (HRV). Thus, continuous monitoring of HRV can contribute to determining and predicting issues in well-being and mental health. HRV can be measured in everyday life by consumer wearable devices such as smartwatches which are easily accessible and affordable. However, they are arguably accurate due to the stability of the sensor. We hypothesize a systematic error which is related to the wearer movement. Our evidence builds upon explanatory and predictive modeling: we find a statistically significant correlation between error in HRV measurements and the wearer movement. We show that this error can be minimized by bringing into context additional available sensor information, such as accelerometer data. This work demonstrates our research-in-progress on how neural learning can minimize the error of such smartwatch HRV measurements., Comment: Adjunct Proceedings of the 2019 ACM International Joint Conference on Pervasive and Ubiquitous Computing and the 2019 International Symposium on Wearable Computers