Making Data Usable: 2014 presentation at Datapalooza

The Science of User-Centered Data Tools

June 2, 2014

Bradford W. Hesse, PhDChief, Health Communication and InformaticsNational Cancer InstituteMonday, June 2, 14

What behavioral intervention was credited with saving 58,000 injuries

per year, & saving $655,000,000 per year?

Question: American Psychological Association (2004)

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Question: American Psychological Association (2004)

Monday, June 2, 14

Human Factors research focused squarely on user’s perspective: Cognitive & perceptual demands

Intervention based on human-system integration

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4.3% in rear end collisions

92,000 crashes / year

58,000 injuries / year

$655,000,000 in property damage

Return on Investment(ROI)

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“Travel agents selected flight on first line

more than half the time”

American Airlines Sabre System

Data design effects

November Line of Sale Analysis, memo to R. E. Murray from S. D. Nason, American Airlines, Dec. 3, 1981.

Monday, June 2, 14

Website designs reshape travel & other industries

Sabre system becomes Travelocity

Data design effects

November Line of Sale Analysis, memo to R. E. Murray from S. D. Nason, American Airlines, Dec. 3, 1981.

CONSUMER ACCESS SHIFTS MARKET

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Interface wars part of new business

Microsoft DOS

Graphical User Interface

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Targets in Medicine?

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Nudging Best Practice:HITECH & Behavior

Source: Hesse, Bradford W., Ahern, David K., & Woods, Susan S. (2011). Nudging best practice: the HITECH act and behavioral medicine Translational Behavioral Medicine, 1(1), 175-181.

• Incentives• Understand Mental Maps• Defaults• Give feedback• Expect error• Structure decisions

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Stakes are high

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Stakes are high

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Data smog

• Decisional paralysis

• Confusion

• Risky behaviors

• Frequent errors

• Avoidance

Source: Shenk, David. (1997). Data smog : surviving the information glut (1st ed.). San Francisco, Calif.: Harper Edge.

Consequences

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The case of Hugo Campos

Source: Dave deBronkart, through ONC (http://www.healthit.gov/)Monday, June 2, 14

ROI will go to best design

for each user niche

Interfaces across ecosystem

Source: Hesse BW, Hansen D, Finholt T, Munson S, Kellogg W, Thomas JC. Social Participation in Health 2.0. IEEE Computer. 2010;43(11):45-52.Monday, June 2, 14

Human System Integration

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History: Bad Design Led to Catastrophic Error

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Mechanistic World View• Actors: Engineers, biological scientists• Question: How can we create new

technologies?• Focus: Physical Object

Humanistic World View• Actors: Social scientists, physicians• Question: How can we create new

people?• Focus: Person

Competing World Views

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Source: Vicente, Kim J. (2003). The human factor : revolutionizing the way people live with technology (1st ed.). New York: Taylor and Francis Books.

Human System Integration

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Knowledge in the Head*

Knowledge in The World*

Task Relevant Schemata

General model

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Computer Human Interaction

Don Norman, 1988

Jakob Nilsen: 1993, 1999

Shneiderman & Plaisant: 2010 edition

DHHS: 2004

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• Strive for consistency

Eight Golden Rules

See: www.usability.gov

Consistency within application

Consistency across product line

Predictable Controls

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• Cater to universal usability*

Eight Golden Rules

Sir Jonathan Ive

*universal across experience, literacy, physical ability, profession

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• Cater to universal usability

• Offer informative feedback

Eight Golden Rules

Shneiderman & Plaisant: 2010 editionSeriously?!

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Eight Golden Rules

Good design: sequence, progress, action all indicated

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• Design dialogs to yield closure

Eight Golden Rules

user goal

Deep Support

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• Prevent errors

Eight Golden Rules

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• Prevent errors

• Permit easy reversal of actions

Eight Golden Rules

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• Prevent errors

• Permit easy reversal of actions

• Support internal locus of control

Eight Golden Rules

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Wrong Question:

X What can the computer do?

X How do we automate cognition?

X What is the transactional gain?

X How do we get users to conform?

Better Questions:

✓ What can humans do?

✓ How do we augment cognition?

✓ What is the relational gain?

✓ How do we optimizesociotechnical balance?

Source: Hesse BW, Shneiderman B. eHealth research from the user's perspective. Am J Prev Med 2007;32(5 Suppl):S97-103.

Asking the Right Question in H.I.T.

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STOP asking the wrong question

Wrong Question:

Better Questions:

“Expert systems in medicine turned out to be brittle, impracticable, and nontransparent. In short, they turned out to be bad medicine.”

Source: Hesse BW, Shneiderman B. eHealth research from the user's perspective. Am J Prev Med 2007;32(5 Suppl):S97-103.

Monday, June 2, 14

START Answering Right Question

Wrong Question:

Better Questions:

David Brailer, First Na4onal Coordinator for Health IT

“Everyone thought Health I.T. was about computers, but we’ve refined that to say that IT is

about healthcare — it’s about the experience we really have.”

Source: 1. Brailer D. Ac/on through collabora/on: a conversa/on with David Brailer. The na/onal coordinator of HIT believes that facilita/on, not mandates, are the way to move the agenda forward. Interview by Robert Cunningham. Health Aff (Millwood) 2005;24(5):1150-‐7.

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Wrong Question:

Better Questions:

“Intelligent Agent” misfires

Root Cause: Over-‐Reliance on “Autopilot”

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Wrong Question:

Better Questions:

Reminder System

Source: Hesse BW. Enhancing Consumer Involvement in Health Care. In: Parker JC, Thornson E, editors. Health Communica/on in the New Media Landscape. New York, NY: Springer Publishing Company; 2008. p. 119-‐149.

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Wrong Question:

Better Questions:

*Zuboff S, Maxmin J. The support economy: why corporations are failing individuals and the next episode of capitalism. New York: Viking; 2002.

Monday, June 2, 14

Wrong Question:

Better Questions:

Source: Hesse BW. Harnessing the power of an intelligent health environment in cancer control. Stud Health Technol Inform 2005;118:159-‐76..Monday, June 2, 14

Wrong Question:

Better Questions:

*Zuboff S, Maxmin J. The support economy: why corporations are failing individuals and the next episode of capitalism. New York: Viking; 2002.

Monday, June 2, 14

Wrong Question:

Better Questions:

Charlie Chaplin in “Modern

Times” (1936)

Monday, June 2, 14

Wrong Question:

Better Questions:

HITECH Switches Emphasis to “Meaningful Use”

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Wrong Question:

Better Questions:

Source: Blumenthal, D. (2010). Guiding the health information technology agenda. Interviewed by David J. Brailer. Health Aff (Millwood), 29(4), 586-595.

David Blumenthal

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Research on Communicating Data

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Making Data Talk

Inform Support Decisions

Educate Persuade

Adapting to a World of Ubiquitous Data Systems

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Making Data Talk

Educate Persuade

Monday, June 2, 14

Making Data Talk

Educate Persuade

Monday, June 2, 14

Making Data Talk

Educate Persuade

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Chapter 4: Visual Displays

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SOURCE: http://alleydog.com/topics/sensation_and_perception.php

Perceptual Basics

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source: Carpenter PA, Shah P. A model of the perceptual and conceptual processes in graph comprehension. J Educ Psychol. 1999, 91(4): 690-702.

• Constructive process

• Gaze goes to center for pattern

• Contiguous labels for meaning

• Left to right tendency in western culture

• Perceptual rules guide meaning

Cognitive / Perceptual Research

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source: Carpenter PA, Shah P. A model of the perceptual and conceptual processes in graph comprehension. J Educ Psychol. 1999, 91(4): 690-702.

Visualizing Long Term Change

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Hans Rosling, BBC

Visualizing Change Dynamically

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Monitoring for Change in EHR Systems

Aging In Place, IntelRule of Thumb* for “Big Data” Systems

•Overview

•Zoom / filter

•Details on demand

*Ben Shneiderman

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Biases & Heuristics

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Overcome “small numbers” bias

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Exceptional Case

Fallacy of small numbers;Tversky & Kahneman, 1971

Illnesses322,000,000

Hospitalizations21,000,000

Prevented

Deaths732,000

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Improving Decision MakingProblem: Conditional (Bayesian) probabilities are counter-intuitive, arcane for practice.

source: Gigerenzer, Gerd, & Hoffrage, Ulrich. (1995). How to improve Bayesian Reasoning without Instruction: Frequency Formats. Psychological Review, 102(4), 684-704.

For example:

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95 out of 100 physicians estimated 70-80% instead

of a correct 7.8%

Improving Decision MakingProblem: Conditional (Bayesian) probabilities are counter-intuitive, arcane for practice.

For example:

Monday, June 2, 14

Natural frequencies work better

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See: Fagerlin, A., Ubel, P. A., Smith, D. M., & Zikmund-Fisher, B. J. (2007). Making numbers matter: present and future research in risk communication. Am J Health Behav, 31 Suppl 1, S47-56.

Icon arrays convey natural frequencies more effectively

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Portraying trends to policy makersChoropleth Maps: CDC Obesity Trends, BRFSS 1985

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Nonsegmented geographic data

Isopleth “Weather Maps,” HINTS

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Juxtaposing geographic distributions

Mortality Maps (SEER):Lung Cancer Mortality

For Example:Knowledge Maps (HINTS):Does Smoking Cause Cancer?

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Added User Controls14 datasets spanning 6 years

NSF, NIH Collaboration

Disolving Barriers Between Clinical and Community Health

Monday, June 2, 14

Added User Controls14 datasets spanning 6 years

NSF, NIH Collaboration

Disolving Barriers Between Clinical and Community Health

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Disparities Frame

Framing Effects

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Disparities Frame

Impact Frame

Framing Effects

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Disparities Frame

Impact Frame

Progress Frame

Framing Effects

Monday, June 2, 14

Disparities Frame

Impact Frame

Progress Frame

Framing Effects

Progress Impact Disparity

Low MistrustHigh Mistrust

Progress Impact Disparity

Low MistrustHigh Mistrust

I want to be screened for colon cancer? Framing X Medical Mistrust Questionnaire

Best influence on behavior

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Bottom Line

Monday, June 2, 14

Data: New “Intel Inside*”

Source: O'Reilly, Tim. (2005). What Is Web 2.0? Design Patterns and Business Models for the Next Generation of Software.

Tim O’Reilly

Monday, June 2, 14

Data = Power(by itself)

Monday, June 2, 14

Data = PowerUser Centered*

*i.e., made understandable, actionable, accessible Monday, June 2, 14

Research methods to address gap

See: Brinck, T., Gergle, D., & Wood, S. D. (2002). Designing Web sites that work : usability for the Web (1st ed.). San Francisco: Morgan Kaufmann Publishers.

Monday, June 2, 14

www.slideshare.net/BradfordHesse

http://cancercontrol.cancer.gov/brp/hcirb/

usability.gov

Guidelines

Grants

This slide deck

Thank you!

Monday, June 2, 14

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