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Author Archives: Ernesto Ramirez
Numbers From Around the Web: Round 7
Where are you? A pretty easy question to answer. But, what about, “Where was I?” Not so easy to answer, especially when we start talking about periods of time more than a few days or weeks. Sure, we all have GPS running on our phones now. We can check in with Foursquare/Facebook/Path etc. to keep a log of locations, but that data is fragmented and only represents certain specific locations. What about paths? What would we learn if we knew more about how we traveled about our world?
Aaron Pareki is one of the founders of Geoloqi, a location-based services platform. He has also been tracking his location every 6 seconds for the last four years and he has created some amazing visualizations to better understand his movement:
You may think this is just a boring old map with some travel data layered on top, but what makes this map special is that there is no underlying geospatial data. The lines you see above are Aaron’s actual travel paths from his GPS data. Using this information you can easily see the well traveled roadways by finding the thicker lines. You can even quickly pick out freeways and interstates due to their high speed.
Here you see Aaron’s data for the last four years (again, there are only the GPS traces). You can see he’s color-coded the data ro represent different years in order to see where he spends his time.
Aaron has a lot more visualizations of his GPS traces, but I’ll leave you with this neat video showing a timelapse of his minute-by-minute movement:
Every few weeks be on the lookout for new posts profiling interesting individuals and their data. If you have an interesting story or link to share leave a comment or contact the author here.
QS 101: The Science of Self Experimentation
This special guest post in our ongoing QS 101 series comes to us from Dan Gartenberg, our great QS-Washington DC meetup organizer, and his fellow graduate students in the Human Factors and Applied Cognition program at George Mason University.
Turning Scientific Concerns into Strengths for Quantified Self Experimentation
By Dan Gartenberg, Ewart de Visser, and Jonathan Strohl

Quantified Self and Science are not oil and water. They are intertwined with one another and have a long history together. Though some scientists may not hold QS in high regard, and have the following claims:
“these studies lack validity!”
“a study of a single individual will not generalize to the broader population”
“the possibility of experimenter bias makes your findings highly suspicious and inconclusive.”
“is your effect even real?”
While these are legitimate concerns, QS is science. And if we keep in mind the scientific method when conducting QS research, this strengthens the validity of our QS projects.
History speaks for itself. QS studies are actually in line with an age-old scientific tradition: The n=1 study. Back in the day, scientists did not have large labs and took to experimenting on themselves. For example, Hermann Ebbinghaus, one of the first cognitive psychologists, conducted experiments on himself to reveal the process of learning and forgetting. As a scientist he used a level of rigor that was expected of scientists at the time, and more importantly, Eddinghaus contemplated reasonable mechanisms that explained his results. Science gives us the tools to make precise measurements, and QS, with its emphasis on improvement of the self, provides a social framework for people to discuss novel phenomena. In this article we demonstrate how science lends itself to QS and how the scientific method provides us with useful tools for self-discovery. We first recommend a framework for conducting QS experiments and then discuss the scientific methods to keep in mind.
1) Achieve your goal: Unlike most experimental research, in QS our main objective is more often than not self improvement. A frequently used approach to improve yourself is by throwing the kitchen sink at the problem until you get the sought after effect. When we make this process social, we can then discuss with others what they are doing and how they think they are being affected by what they are doing. Based on this information, we get a better understanding of how to most effectively modify our behaviors for the desired outcome.
2) Use a simple design. When presenting your data the scientific establishment might criticize your conclusions because it was not the gold standard “double blind randomized control trial.” But running the right type of design isn’t the be-all-end-all of good science. If you see a difference and have a reasonable mechanism that explains the difference, with no viable alternative explanations – you are solid.
3) Stats don’t matter as much. Just graph it! One of the biggest sources of confusion is how to analyze QS data and knowing the right stats to run. But statistics are only really useful when predicting small effects or for more complex prediction models. In QS, any change is usually meaningful. For example, if you are tracking your mood and you see a small improvement it is likely meaningful to you. So don’t worry too much about statistics.
To discuss the roles of QS and science, we’ll use a dataset that we generated as a case study. After reading the 4 Hour Body by Tim Ferris, three friends all had the same goal of losing weight. None of us were extremely overweight at the time, but we could all stand to lose about 10-pounds. This inspired us to create the 10-Pound Challenge, where we competed to lose weight and either did a slow carb diet or a low carb diet. We then weighed ourselves every morning.
Quantified Friends: The 10-Pound Challenge:
Here are some issues and concepts that you should consider when making sense of your findings and how Science and QS can benefit one another:
| Threat to validity | Definition | 10-pound application |
| Mortality | When your manipulation affects the likelihood of whether or not you respond to the measure of interest (i.e. you don’t respond to a survey out of embarrassment). | There are almost no skipped days over the course of our study. This demonstrates how QS can be used as a way to address the problem of mortality by making data collection more social. This makes people more accountable and motivated to input their data. |
| History | When external events from the environment impact the variables of interest. | The diet was made social when we shared our progress with one another. This socialization, where we competed to lose weight, may explain our progress. We knew that this resulted in alternative explanations, but it didn’t matter because we simply wanted to lose weight and were pulling out all the stops to help us reach our goal. |
| Maturation | When over the course of a study you have changed in other ways that have confounded the impact of the variables in your experiment. | In QS our goal is to actually change and mature. In our QS project the intention was to lose weight and the mechanism was only as important as it was necessary to understand and use in order to promote our increased weight loss. |
| Treatment Fidelity | In science we usually compare a treatment group to a control group, but what if the treatment is not much different from the control? (i.e. there is not a good counterfactual). | We administered relative treatments based on each of our unique situations (this is a common issue with QS). For example, one of us already had a relatively strict diet. He was able to make precise modifications to his diet in order to promote weight loss, whereas; the other two QSers made broader changes. This prevented us from making precise claims about how the diet affected weight loss. Though we still got the general idea that the diet worked. |
| Treatment Interaction | When the variable that you manipulate interacts with other variables that explain the outcome. | When undertaking the 10-pound challenge we frequently told people about the challenge. This in turn made us more accountable for what we consumed due to social pressure. In this example, the response to the treatment interacted with the social environment in a way that made us consume healthier meals and lose weight. Since in QS we are not as fixated on control, we can see how these interactions unfold in the environment and discuss them with others in order to confirm or deny our intuitions. This provides us with ways to explore new ideas and mechanisms. |
| Compensatory Rivalry | When the control group is aware that they are not getting the treatment and in turn seeks out other alternatives. | In the case of the 10-pound challenge, there was no control group. Control groups do not play a large role in QS because of the focus on self-improvement. This is an issue that can be addressed by the scientific method of an A-B-A design where the QSer acts as their own control group. |
| Regression Towards the Mean | This intuitive premise from science is the basic idea that at the extremes of a behavior you are increasingly likely to gravitate towards the mean. | QSers should be particularly sensitive to this because people frequently try to improve on a behavior when they are at an all time low or an all time high. |
| Reactivity | When your response is affected by external factors, for example, social desirability. | In QS, reactivity can actually be used to improve upon outcomes. In our example, there was a social desirability to discuss what was and was not working. At one point the team members independently agreed that eating too many slow-carbs (legumes) was hindering their progress. We then made the appropriate changes to our behaviors and found increased improvements. |
And these are just some of the threats to validity that QSers can consider to improve their projects. So look out for more to come!
We would like to thank Dr. Patrick McKnight and the MRES group (http://mres.gmu.edu) for providing helpful insights on our QS project.
May QS Newsletter
As we wrap up a wonderful April we here at QS Labs wanted to create something to let you all know what’s going with Quantified Self. Thanks to some prompting from our wonderful worldwide meetup organizers we decided to create the QS Newsletter.
Inside you’ll find a variety of information we hope you enjoy:
- A nice article about active moderating from our very own Gary Wolf
- The current May schedule for QS Meetups
- Recent pictures from QS Meetups around the world
- A profile of Ciaran Lyons, the meetup organizer for QS Singapore
- Links to top videos and posts from quantifiedself.com
- 2012 QS Conference information
Download your copy of the May 2012 QS Newsletter here. Copy it, share it, and let us know what you think!
Numbers From Around the Web: Round 6
There is something really magical about taking data and turning it into a compelling visual image. Even though I’ve already written a bit about the importance of making data visual, I am consistently amazed at how data can be made more appealing and informative by creating eye-popping graphics. Today we are devoting this NFATW post to some amazing projects with beautiful data.
Tom MacWright is an engineer for MapBox and Development Seed and spends his time creating and using amazing visual representations of his data. Here are just two of many wonderful projects.
A New Running Map
Tom wasn’t happy with the data visualization he was getting from his Garmin GPS and heart rate watch so he decided to build his own using tools he works with every day. What came out was a really interesting interactive website that visualizes his running routes along with his heart rate. Click on the image above to play around with him data.
He’s also created a unique representation of the same time of running data (GPS + HR) that anyone can play with called Ventricle. Ventricle allows you to plot your own running data if you have .gpx files.
Minute
I’ve had a long standing interest in how I spend my time interacting with my computer. As a long time RescueTime user I’ve gotten used to having something watching my computer use and informing me about my habits. Tom was also interested in his computer use, but wanted something that had less functionality while still giving him information that was important. So, he developed Minute, a keystroke counter and visualization system that constantly records and displays the keystroke frequency over time.
By using a heat map he is able to better understand the pattern of his technology usage. Interestingly, he is also able to make inferences about his sleep and leisure time as he treats them as the inverse of his keystroke time:
Minute is an open-source application hosted on github so if you’re interested in understanding your own computer use or want to contribute to the project go take a look at the source code.
We’ll wrap up today with a quote from Tom’s post on what he learned from developing and using Minute:
Tracking nearly anything you do is alarming and humbling. The aggregates of our actions are lost on us: we can watch hundreds of hours of television and write it off as a small time commitment. How much is too much? It’s hard to make pretty charts without learning something and thinking about what they should look like.
Every few weeks be on the lookout for new posts profiling interesting individuals and their data. If you have an interesting story or link to share leave a comment or contact the author here.
Numbers From Around the Web: Round 5
Today’s NFATW post comes from Martin Sona, a QS friend and organizer for the QS Aachen/Maastricht meetup group, who pointed out this fascinating project on the QS Facebook group.
Dale Lane is a software developer for IBM living and working in Hampshire and he has been developing neat personal tools for his self tracking for the last few years. Let’s take a look at a few of them.
Tracking TV Watching
Inspired by the background data collection offered by last.fm designed to capture music listening habits Dale set out to create his own “scrobbler” to better understand his TV viewing habits. What he came up with is amazing:
Using a bit of code running on his media PC he is able to track a number of variables including time of day, what program he’s watching, his most watched channels, and many many more. Take a bit of time to check out his comprehensive blog post about the project and the TV Scrobbling project page.
Smile!
Not satisfied while merely understanding what he was watching on TV, Dale took it upon himself to better understand how we was reacting to what he was watching. Using a webcam and a bit more code he was able to piece together a program that snaps a picture and then uses the Face.com API to determine interesting characteristics about the picture. The Face.com API enables him to see if he’s smiling as well as estimating his mood based on the facial characteristics that show up in the webcam shot. This little program has enabled him to find out some really interesting things such as:
He was also able to track his estimated emotional state while gaming and found some interesting insights:
This shows my facial expressions while playing Modern Warfare 3 last night. Mostly “sad”, as I kept getting shot in the head. With occasional moments where something made me smile or laugh, presumably when something went well.
These are really interesting and unique methods for understanding ourselves and our behavior. Dale’s work on self-tracking is fascinating and is an inspiration to those of us looking to expand our understanding of ourselves and how we interact and react with the digital world. Be sure to check out his blog for more self-tracking projects and interesting tools!
Every few weeks be on the lookout for new posts profiling interesting individuals and their data. If you have an interesting story or link to share leave a comment or contact the author here.
James Stout on Diabetes, Exercise, and QS
James Stout is a professional cyclist. He also has Type 1 Diabetes. In this Show & Tell, James explains how self-tracking has empowered him to understand himself and be a role model for others. Truly inspiring. (Filmed by the San Diego QS Show&Tell meetup group.)
QS San Diego: James Stout – Diabetes, Exercise, and Quantified Self from Ernesto Ramirez on Vimeo.
Talking Data With Your Doc: The Doctors
One day you decide to lead a data-driven life and naturally data collection seeps into the realm of health. Maybe you buy a Zeo to better understand your sleep patterns. Or maybe you decide to start tracking your blood pressure with one of the various new connected tools. Heck, maybe you’re just tracking your daily pain symptoms using plain old paper and pencil. Whatever it is you’re tracking, most likely you have the urge, the need, to take it to your physician or medical provider. That data represents you, the whole you, not just the you that sits on that sterile paper that’s rolled onto the examination bed in the cramped room with the poor lighting and six-month old issue of Time magazine.
Last week we discussed how you could present that information, your health data, to your doctor. The wonderful Katie McCurdy helped us understand the power of simple visualizations for her ongoing care and her own personal health knowledge. The patient perspective is incredibly important, as they say, “everyone is a patient at some point.” But, not everyone sits on the other end of the table, not everyone is a doctor. So what do physicians think about patient data? What do they see happening in their practices? Today, we’re lucky to have two wonderful physicians join us to offer their insights into those questions and more.
Dr. Eric Topol is an innovator and pioneer in the fields of wireless medicine and genomics. He is the Director of the Scripps Translational Science Institute, a National Institute of Health funded program of the Clinical and Translational Science Award Consortium. He is also Professor of Genomics at The Scripps Research Institute; Chief Academic Officer and holder of the Gary and Mary West Chair of Innovative Medicine at Scripps Health; and, a Senior Consultant cardiologist practitioner at Scripps Clinic. He is also the author of the recently released book, Creative Destruction of Medicine.
Dr. Larry Chu is a practicing anesthesiologist and an Assistant Professor of Anesthesia at Stanford Medical School. He also directs two separate research labs at Stanford – the Opioid Physiology Lab and the Anesthesia Informatics Lab. In his spare time (the man doesn’t sleep!) he directs the efforts for the upcoming MedicineX conference: a showcase of academic research, new technology, and patient stories designed to help guide the future of healthcare. I highly recommend watching their newly released e-patient videos that highlight two QS community members – Sean Ahrens and Hugo Campos.
Both Dr. Topol and Dr. Chu were kind enough to lend some of their time to answer a few of our questions. I hope you enjoy their thoughtful answers as much as I did.
QS: We keep hearing horror stories about doctors reacting negatively to patients who bring in their own health data. Why do you think that is?
Dr. Eric Topol: It reflects “old medicine” which is the current standard of care, characterized by paternalism, the “medical priesthood” and “Doctor Knows Best.” This will change and desperately needs to change to a participatory partnership of the patient and physician.
Dr. Larry Chu: I’m not sure that I can speak for other doctors, but I can tell you that I not only encourage my patients to self-track, but that I actually use those information streams every day to make decisions about each patient’s care. I treat patients with chronic pain. I have my assistants call my patients each day to get their pain scores, and ratings of medication side effects. I also ask my patients to keep daily diaries of their pain scores, side effects, and ratings of their ability to do activities of daily living. Working together, we use this information to tailor daily adjustments to their medications that I think not only improves their overall care but makes us better partners in a process that aims reduce pain while minimizing medication side-effects. Self-tracking brings me new data about each of my patients on a daily basis, which gives me new information and ideas on how to continually improve their care.
QS: How can a patient more appropriately create a dialog about their self-tracking and health data with their health provider(s)?
ET: By simply collecting the data and finding a receptive physician. Most doctors are data-driven and many would be enthusiastically supportive.
LC: I think it starts with sharing data that helps doctors understand what they want to know. Your doctor might ask you, “How’s your back pain been since I saw you last?” That might be the perfect opportunity to share pain diaries (or even a visualization of pain scores over time) to help your physician understand trends in symptoms and how they are affected by medications and other factors such as activity and exercise.
Data overload is a concern, so a focus on presenting concise data relevant to your physician’s interest might be a good way to start introducing self-tracking data into your physician visits.
QS: You illustrate a lot of examples of how the digital revolution is foundation of the Creative Destruction of Medicine in your book. What are a few fundamental shifts you see happening in the near future (1y? 5yrs?)
ET: 1 yr-the introduction of a large number of biosensors and “adds” that are smartphone centered and measure most physiologic metrics, or perform medical diagnostic tests like skin scan, refracting the eyes for glasses, and so many more; rapid sequencing for rare conditions, cancer at the time of initial diagnosis for genomically guided thearpy.
5 yr—marked change in the basic structure of the office visit with more Skype, Facetime, video chatting and less need of hospital beds except intensive care units—with the marked reliance on remote monitoring; routine genotyping before many drugs are given to avoid serious side effects and assure the drug will indeed be effective
QS: Do you think doctors are more receptive to the visual translation of data rather than the raw numbers that are commonly associated with health data?
ET: Yes, without question, anything that makes it more reductionist, simple, and less time consumptive.
LC: Absolutely. Physiologic processes have natural variability between patients and when tracked prospectively over time. Very rarely in my practice do I treat a “number”. I find that trends in data over time are the most useful in helping me understand physiologic processes in order to provide a diagnosis and therapeutic care plan for my patients.
QS: I’ve been thinking about the doc-patient relationship a lot lately. It seems the walls of authority are crumbling as we speak and we’re moving from a “You do this” or “You listen to me” type of authoritative approach to medicine to more conversational. How do you see data and visualizations helping to start and possibly support those conversations.
ET: There will be a Darwinian selection process for the “digital doctors” who have the plasticity to engage with patients in this way.
LC: Paternalism in medicine will hopefully diminish as physicians see that patients not only prefer but demand to participate and engage in their own care and that this engagement leads to better partnerships that produce better health outcomes. Self-tracking data and visualizations can help support that process. One example is medication compliance in my area of pain management. The very term “compliance” is a bit paternalistic because it implies that patients are expected to “comply” with a physician’s “orders”. If Mrs. Jones has been “non-compliant” with her medications, the reason might be more complicated than a simple failure to follow directions. Self-tracking allows me to see what happened: nausea and itching were out-of-control and limited her ability to increase her dose, or she had several high-activity days that exacerbated her pain. Self-tracking data, especially real-time streams that are passively collected with high resolution and granularity, have the potential to disrupt the paternalistic view of the patient-physician relationship. To me, that’s very exciting.
QS: Katie McCurdy mentions in her post that the reception from patients and caregivers has been really positive, how would do we help make it a positive and rewarding experience for the providers as well?
ET: Her remarkably careful and detailed self-assessment of her myasthenia gravis condition is prototypic of how data can be displayed. Our big mission is to reduce the work involved in capturing and graphing the data, but instead to have this done seamlessly. No question that data are good for one’s health. It’s the kind of data we did not have access to before in treating patients. Sensors, apps, and add-ons to smartphones will help to streamline this process.
LC: Make providers part of the process. Give us an opportunity to let you know what data we would love to see you track. Help us understand your concerns and how we can help you achieve your health goals.
QS: What tips or advice would you give to someone who is taking their data to their doc for the first time?
ET: Go for it! Don’t be shy. It’s your data, your body, your health. You are the most vested and important individual for the future of your health!
LC: Start with a picture, something simple, that helps your doctor better understand your body in relation to the reason for your visit. Data overload is a concern. Start by turning the spigot on slowly.
QS: How do you think self-tracking and data communication with physicians can support patient-initiated health experimentation?
ET: It will be the N of 1 story to find the right drug for conditions like high blood pressure or diabetes (Type 2, non-immune) and many other conditions. Moreover it will be invaluable for prevention, for which we will have a marked enabling capacity once we integrate genomics, sensors, health IT, the digital infrastructure and N of 1 —what I call Homo digitus–data!
LC: I think self-tracking can provide real-time physiologic and symptom data to physicians to aid them in interpreting the success of patient-initiated health experiments. I use self-tracking to study physician-initiated health experiments in my NIH-funded clinical research lab at Stanford. I don’t see a reason why the tables can’t be turned.
We also have some questions from Susannah Fox, who was kind enough contribute her thoughts and insights to this piece:
SF: True or false: There have always been patients like Katie, who try to figure out what’s going on with their health. It’s just now that they have tools to polish up and express their observations in engaging ways. It’s just now that clinicians are ready to listen to and even welcome such patients.
ET: True for many conditions.
LC: True. We have been self-tracking even before there was the term. I got to mark my height on my door frame every birthday growing up: I was a self-tracker at age five! There is a temptation to focus on technologies and tools in self-tracking, but they are not a necessity for the process. A pen and paper will suffice. What I see today is an explosion of consumer-facing devices, some of which passively collect high-resolution and finely granular datasets. This may add to the data streams we can collect, but analysis and synthesis of the data into meaningful conclusions is a growing challenge.
SF: If you are observing a shift, in yourself or in your colleagues, why do you think that is?
ET: I have shifted my practice, but unfortunately I have not seen a significant shift in many others yet. That’s why I wrote the book—to educate, activate consumers to catalyze “new medicine” They need to drive this—it is their medical information, their DNA, their tissue, their smartphone, and their social networks. Never before were we so well positioned for a consumer health care revolution as now. A veritable Kairos.
LC: I think mobile computing and wireless mobile devices have exposed physicians to many of the same consumer-facing self-tracking applications that their patients use. As patients ourselves, many physicians see the potential for self-tracking to impact our own health and lives.
Having read through these answers again and again I can safely say there are some major themes that are starting to creep up. Partnerships, excitement, mHealth – each of these concepts were mentioned on more than one occasion by these two amazing members of the medical establishment. Hopefully their insights will help give you the small push to begin speaking to your medical provider about your health data. The data you collect. The data that represents you.
Again, this is part two in a three-part series on the data centric conversation we engage in with the medical community. Look for our next part with insights from Susannah Fox next Thursday. If you have questions of comments feel free to discuss on Facebook, Twitter, and here in our comments.
Talking Data With Your Doc : The Patient
Data.
Health.
Communication.
In our daily lives, we are keenly aware of the power of each of these individual concepts. However taken together, their influence on our wellbeing, to borrow a phrase from my friend Karen Herzog, “our wholeness”, is exponentially influential. So why do they seem to rarely coalesce during our conversations, discussions, and interactions with the individuals and institutions tasked with tracking, diagnosing, and treating the cracks and fissures in our wholeness?
This is the first in a three-part series about the data we produce about our health and how we communicate that information to the medical system, specifically the providers of care. We’re starting from the perspective of the patient because we’ve all been there. Whether it was a routine check up or a 3AM visit to the emergency room, we’ve all had to relay information to a medical provider about out health. So what happens when we’ve collected, stored, and tried to understand our own health information in preparation for those visits?
Our guide today for the patient perspective of health data communication is Katie McCurdy. Katie is a user experience designer and researcher living and working in New York. She is also living with Myasthenia gravis, an autoimmune disease that causes muscle weakness in voluntary muscles. Like many individuals with autoimmune diseases, Katie spend a lot of time communicating and working with the medical system. These visits, although regular, were a point of contention between Katieand the individuals entrusted with her care. So when she was going to see a new physician for the first time she decided to apply her interaction design knowledge and skill. She’s talked about this on her blog and on the e-patients.net blog so I’ll let here words speak for themselves:
As I was getting ready to see a new doctor, I realized that the best way to tell my story would be to create a medical “life story” timeline that reflected:
- The course of my autoimmune disease
- Severity of my gastrointestinal problems
- Key moments in time when I started and stopped certain medications or took antibiotics
- Any significant dietary changes
I sketched out the two timelines (autoimmune and gastrointestinal) separately, and then created them electronically using Adobe Illustrator. (I’m an interaction designer by day, so fortunately I had the skills/know-how to create a somewhat legible artifact.) I used a peach color to represent gastrointestinal wellness/symptoms, and a blue color for Myasthenia Gravis.
Katie was kind enough to answer a few questions and we’re grateful to be able to share her responses here with you today.
QS: Why visualize? Do you think doctors are more receptive to the visual translation of data rather than the raw numbers that are commonly associated with health data?
KM: For me it’s about creating a representation of my history and my health that can be communicated most efficiently. I believe in the power of visualization to help tell stories that wouldn’t be possible with raw data alone. Knowing I would be ‘on the spot’ during my doctor visit put the pressure on to make something that would help me tell my story as succinctly as possible. Also…because I was not tracking my data (it’s all from memory) I didn’t have the raw data to share anyway!
QS: I’ve been thinking about the doc-patient relationship a lot lately. It seems the walls of authority are crumbling as we speak and we’re moving from a “You do this” or “You listen to me” type of authoritative approach to medicine to more conversational. How do you see data and visualizations helping to start and possibly support those conversations.
KM: I see it as, like you said, changing the dynamics of the relationship so that the patient is more of a partner in care. By tracking data, the patient can provide a more refined and nuanced picture of what is really going on with them. By visualizing that data, the patient is helping the doctor absorb the information more painlessly. The patient is providing contextual information about his or her OWN situation that compliments the doctor’s past experience, expertise, and test results.
QS: You mention in your post that the reception from patients and caregivers has been really positive, how would do we help make it a positive and rewarding experience for the providers as well?
KM: I think that giving patients tools to create simple, clean, and attractive visualizations could help make the experience better for doctors. If doctors are presented with high-quality visualizations that tell a coherent story, it may make office visits more efficient. Imagine if the doctor could work with the patient and suggest a type of graph or visualization that would be most helpful.
QS: What tips or advice would you give to someone who is taking their data to their doc for the first time?
KM: I suggest using the data as a storytelling tool. Bring a printed artifact or something on a tablet to refer to, and point out the highlights as you talk about what’s been going on with you. Don’t be disappointed if they don’t comment on your beautiful data and all of the work you put into it. Ask if there is anything you can do to to make the data more legible/easy to understand for the doc.
QS: You mention that self-tracking has given you better insights into your own health and that you’re even trying some self-experimentation like a no-carb diet. How do you think self-tracking and data communication with physicians can support patient-initiated health experimentation?
KM: Ah, I think self-tracking and visualization can help increase patient compliance! My low-carb diet was actually prescribed by my doctor. When I saw on the timeline that my diet changes were strongly correlated with my gastro symptoms improving, it was very reinforcing of my diet behavior. I mentioned antibiotics in my post. Now, if I even think of asking for antibiotics, all I can see in my mind is the number of antibiotics I took as my stomach issues got worse and worse. That is a big change in my outlook that resulted from internalizing the data I was seeing on the timeline.
QS: Who are your design/data viz heros? Anyone who really inspires you in your health visualizations?
KM: I have a few data viz heros! Jer Thorpe, of the new york times, makes beautiful interactive data visualizations and is one of the best speakers I have ever seen. Nicholas Felton, of Feltron and now a designer at Facebook, is a compulsive self-tracker who releases a gorgeous printed yearly report. I love Mortiz Stefaner’s work as well. I am really inspired by the natural world and the work of 19th century plant and wildlife documentor Ernst Haekel. I am also inspired by the awesome patients I’ve met and the folks on e-patients.net who remind me that patients need to be their own advocates.
We also have some questions from Susannah Fox, who was kind enough contribute her thoughts and insights to this piece:
SF: Would Katie care to comment on that from her own experience? That is, is it only recently that she has both found the right tools and that her own clinicians are interested? Had she attempted something earlier, with pencil & paper? What has made the difference?
KM: I never did anything before this apart from bringing notes to my doctor visits – things to remember to say. I literally had a realization one day at work and wrote an email to my personal account with the subject: ‘very important idea.’ :) I think the idea had to incubate for a few years before it bubbled up.last fall.
My goal is to keep pursuing this idea and work toward creating a tool for patients so they can at least assemble their own health timeline, and perhaps even track their data more regularly. I am holding interviews with patients, patient caregivers (or parents), and people who are active self-trackers; if you are interested in donating about 30 minutes of your time, email me at kathryn.mccurdy at gmail.com.
Again, this is part one in a three-part series on the data centric conversation we engage in with the medical community. Look for our next part with insights from Dr. Eric Topol and Dr. Larry Chu next Thursday. If you have questions of comments feel free to discuss on Facebook, Twitter, and here in our comments.
#qschat Number 1
On Tuesday March 12, Nick Dawson asked if there was a Quantified Self Twitter Chat. Lots of interest followed so we decided to make it happen. We had the very first #qschat twitter chat last Thursday and it was a lot of fun. I learned a lot about what people are thinking and doing in the Quantified Self space and in their daily lives. I’ve included some highlights from the chat below, but you can always just search Twitter for #qschat for the full list of tweets.
We’re going to try our best to make this happen every Thursday night at 6PM PST. Just follow the Quantified Self Twitter account to join in!
Our three questions for tonight (3/22/12) will be:
- What is one thing you’ve learned from your self-tracking and Quantified Self practice?
- Have you ever shared your experiments and results with anyone? If so how did it go. If not, why not?
- Health is an obvious Quantified Self area of interest. What other areas have you applied, or want to apply, Quantified Self to?
Again, join us at 6 PM PST to talk about these three questions and more!
Read more to see some selected tweets from our first chat last Thursday!
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The Computational Quantified Self: A Q&A with Stephen Wolfram
On March 8th, 2012 Stephen Wolfram opened the curtains and gave the world a glimpse of his own self-tracking and personal analytics practice. It was jaw-dropping. It was dense. It was beautiful. And, it might have shown us the future of what the Quantified Self could become. We were lucky enough to have Dr. Wolfram answer a few questions about his data, his personal insights, and the future of personal analytics.
First, some background. Stephen Wolfram is a no ordinary self-tracker. Reading through his biography has honestly given me a case of the envies. First published scientific paper by age 15. Five years later a PhD from CalTech in theoretical physics. He then went on to study and develop the field of scientific computing. This led him on a path towards trying to understand the underlying principles that drive the complex systems we often observe in nature. Of course he also had to invent his own computational engine to help discover those principles and in 1988 Wolfram Research released Mathematica. Not one to rest on his laurels he then set out to develop pioneering projects and in 2009 oversaw the release of Wolfram|Alpha, a new kind of computational knowledge engine.
During this time he also set up some really neat systems to store, process, and analyze different streams of data that make up his day-to-day life. I’ll just go over a few here that I found particularly interesting.
Phone Calls. Throughout all the development of his groundbreaking work and running a successful company, he has managed to operate as a remote CEO. So this means a lot of time on the phone. A lot.
We can clearly see that when you examine the available data Stephen spends more than 4 hours per day on the phone. But suppose you need to speak to him. When is the time he’s already most likely on the phone?
Probably best to call him between 11 AM and 6 PM. Although, maybe the weekend evenings would also be good. Personally I found this really interesting that his weekend and weekday evening phone use probabilities were so closely matched.
Steps. If you know me you know how much time I spend thinking about steps. I’m an avid Fitbit user and really believe in the power of subtle passive data tracking for physical activity. Stephen has been wearing a digital pedometer for a few years and has kept some amazing records of his daily activity:
And, I’ll be completely honest here. I was a little beside myself to learn that Stephen and I are kindred spirits when it comes to our use of treadmill desks:
There’s no mystery to this: years ago I decided I should take some exercise each day, so I set up a computer and phone to use while walking on a treadmill. (Yes, with the correct ergonomic arrangement one can type and use a mouse just fine while walking on a treadmill, at least up to—for me—a speed of about 2.5 mph.)
Those are just a few of the numbers and analyses he described in his fascinating blog post. Be sure to give it a read, but before you do read below for our interview with Stephen and a summary of thoughts on what a computational quantified self might become.
Q: There has been a lot of reaction around the internet regarding your post with many people astounded at how much data you’ve collected. In your estimation how much of that data is passively collected/recorded versus actively collected/recorded?
Stephen Wolfram: It’s essentially all passive. I’ve had systems set up at different times, then I’ve just let the systems run. And after a decade or two they’ve accumulated a lot of data.
I should say that quite a few of the systems are set up to send me mail each day with a report on the previous day (how much I typed; how many steps I took; etc.). I find this a useful form of self-awareness and self-management. But it has the side effect that it checks that the systems are still running. Systems that aren’t checked “on“ have a nasty habit of decaying and failing.
About active data collection: I’m frankly too busy (and perhaps too lazy) for that. Last year I decided to record everything I ate. I kept it up for the whole year, but it was a pain. I decided I’d wait for that data until it could be more automated (which it will be soon).
Q: The main point of contention that many people are making after learning about your data collection and analysis is along the the line of “Who has the time for that?” How would you answer that question and where do you see the field of personal informatics and analysis going to meet the needs of people who just don’t have the time?
SW: It has taken only a tiny amount of my time over the last 20 years or so! It did take time to set up the systems. But not to run them.
The analysis now has taken time too. And there’s lots more that should be done as well.
Both the systems and the analysis were made vastly easier by the fact that we used Mathematica for all of them. I’m hoping that we can set up systems that let other people use what we’ve built to do their own personal analytics–with essentially no expenditure of time.
Q: You’ve obviously spent a lot of time with your personal data, and mention that you have even more in reserve that you didn’t expand upon. What was the most surprising thing you’ve learned in so far in your exploration?
SW: I wish I’d had more time to spend with my data. The blog post and the data behind it are really only scratching the surface. Almost every plot we made, I said, “Hmmm … that’s interesting.” Often it was just confirming some impression about my life that I already had. But sometimes I learned things. An example that surprised me a bit was that so much of my email I end up processing late at night; I thought I was keeping up better during the day. I’d been thinking of going to sleep earlier … but I’d clearly have to find another scheme for my email then….
Q: Have there been or did you experience any negative effects from either tracking or analyzing your data? Where there any surprises about yourself that you weren’t expecting that weren’t positive?
SW: Not really. My children sometimes tease me about my obsessive data keeping, but that’s about it. I had thought perhaps I might be able to see some kind of degradation in my performance over the past 20 years, which would have been sobering … but there’s nothing that I’ve found so far. Quite to the contrary, in fact: it seems, for example, that I’m getting more done than I did 20 years ago.
Now, there are pieces of tracking that would be nice to do, but that I don’t feel comfortable doing. An example is keeping an image stream. I have a camera to wear around my neck, but it would be too weird for me in social situations to have it be there, so I have essentially never used it.
Q: Now that you’ve looked at such a large portion of your longitudinal personal data I wonder if you’ve changed your behavior in any way. Was there any point during the analysis, or possibly during previous analyses of this or other data that helped you decide to change something in your life, and if yes, what was it?
SW: About 10 years ago I did some analysis of my email flow, and concluded that it was better to wait awhile before responding to internal emails, because they tended to be on threads that “resolved themselves”, so I didn’t need to spend time.
There are lots of details that I’ve changed. An example is making sure spelling mistakes, especially in people’s names, get immediately resolved in e.g. calendar entries … because if they’re not, it becomes hopeless to search for them later.
A bigger thing some time ago from personal analytics is that I discovered that whenever I took a trip, my work was perturbed for quite awhile afterwards. That made me take fewer trips. Though recently my children have got me to take more trips … and I’m happy to find that technology has advanced to the point where I can avoid getting so behind as a result of them ….
Q: A majority of your post really gets into the correlational structure of multiple data sets. One would say that this is the epitome of post-hoc analysis. How do you think you could use the information you’re collecting now to help you make real-time decisions about your life and your behavior? What kind of system or data would have to be in place to make that worthwhile?
SW: As I’ve mentioned, I do have daily email sent to me, with data on quite a few things. I find that somewhat useful in regulating my behavior (“I didn’t get enough done yesterday; I’d better be more focused today”, etc.). Also, I think it always puts me in a good mood when I see that the previous day was very productive, and it helps me be more productive then.
I’ve thought about having some real-time displays. An example I recently set up is a count-up timer (really it’s just an iPad looking at a web page) that tells me how long I’ve been asleep. I also quite often look at my digital pedometer to see if I’ve walked enough steps yet in a day.
Q: Something that keeps popping up in my exploration of Quantified Self and people who use personal data tracking devices and services is the issue of “getting credit”. You yourself express regret over not having more information from earlier in your life. Some might argue that this dependence borders on the obsessive or unhealthy. That we are offloading our human intuition to these data capture systems. How do you balance your intuition and instinct with what you learn and access through your personal data collection and analysis?
SW: I am spoiled by personally having a rather good memory, especially for facts, names, etc. So I’ve always had the issue of remembering a lot about what happened in the past. Of course, with actual data I continually learn how sparse my memory is.
I’ve been fortunate enough to have all sorts of experiences in my life, and I’ve learned a lot from them. And the more I can remember the experiences, the better I can make use of what I learned from them. And the more I am able to repeat my successes, and avoid repeating my mistakes.
I’m definitely a person who likes to do things, not just contemplate my past life. But I like to build on my past life to continually be able to do more things, and have more personal satisfaction.
Q: Lastly, this post has been a big inspiration to a lot of people and has been shared and passed around by many. Are there any last insights or thoughts you’ld like to share with our community?
SW: I think it’s great that your community is working in these directions. There’s a lot of “best practices” to figure out, that will probably affect our lives a lot in the future. I’m looking forward to seeing what your community figures out!
So there you have it. Some very insightful words from the man behind the numbers. Now that I’ve read through his wonderful answers to my overly wordy questions, spent some time watching his wonderful TED talk, and doing some late night thinking, I’m starting to wonder about how his process and systems might be a window into our quantified futures.
The reason this post is entitled, The Computational Quantified Self, is because I think that Stephen is onto to something brilliant here with his process of having Wolfram|Alpha Pro handle all of the processing for him. One of the things that I hear time and time again from individuals who are either interested in or just starting their own self-tracking practice is, “What next?” That is to say, there are a lot of people out there who either do not have the skills, knowledge, or time to handle the analysis needed to make sense of the large data sets they’re creating. So what happens when there is a system to do that work for you? Maybe that system is something from Wolfram Research, or Google, or some new startup we don’t even know about yet. But surely there will be people who embrace those systems to help them make decisions. Better decisions. Informed decisions. Personalized data driven decisions that enhance and improve their lives.
That sounds like a pretty amazing world to live in.
Special thanks to Stephen Wolfram for taking time out of his busy schedule to answer our questions and to his staff for making this possible. This was a special edition of our regular Numbers from Around the Web series. If you have data you’ld like to have featured in the series you can contact the author here.
































