How Companies Scour Our Digital Lives for Clues to Our Health - People touch phones 2,617 times -- per day!
How Companies Scour Our Digital Lives for Clues to Our
Health
An emerging field, digital phenotyping, tries to assess
people’s
well-being based on their interactions with digital
devices.
By NATASHA SINGER FEB. 25, 2018
Your digital footprint — how often you post on social
media, how quickly you scroll through your contacts, how frequently you check
your phone late at night — could hold clues to your physical and mental health.
That at least is the theory behind an emerging field,
digital phenotyping, that is trying to assess people’s well-being based on
their interactions with digital devices. Researchers and technology companies
are tracking users’ social media posts, calls, scrolls and clicks in search of
behavior changes that could correlate with disease symptoms. Some of these
services are opt-in. At least one is not.
People typically touch their phones 2,617 per day,
according to one study — leaving a particularly enticing trail of data to mine.
“Our interactions with the digital world could actually
unlock secrets of disease,” said Dr. Sachin H. Jain, chief executive of
CareMore Health, a health system, who has helped study Twitter posts for signs
of sleep problems. Similar approaches, he said, might someday help gauge
whether patients’ medicines are working.
“It could help with understanding the effectiveness of
treatments,” he said.
The field is so new and so little studied, however, that
even proponents warn that some digital phenotyping may be no better at
detecting health problems than a crystal ball.
If a sociable person suddenly stopped texting friends,
for instance, it might indicate that he or she had become depressed, said Dr.
Steve Steinhubl, director of digital medicine at the Scripps Translational
Science Institute in San Diego. Or “it could mean that somebody’s just going on
a camping trip and has changed their normal behavior,” he said.
“It’s this whole new potential for snake oil,” Dr.
Steinhubl said.
That is not stopping the rush into the field — by
start-ups and giants like Facebook — despite questions about efficacy and data
privacy.
Scanning for Suicidal Thoughts
One of the most ambitious efforts is being conducted by
Facebook.
The company recently announced that it was using
artificial intelligence to scan posts and live video streams on its social
network for signs of possible suicidal thoughts. If the system detects certain
language patterns — such as friends posting comments like “Can I help?” or “Are
you O.K.?” — it may assign a certain algorithmic score to the post and alert a
Facebook review team.
In some cases, Facebook sends users a supportive notice
with suggestions like “Call a helpline.” In urgent cases, Facebook has worked
with local authorities to dispatch help to the user’s location. The company
said that, over a month, its response team had worked with emergency workers
more than 100 times.
Some health researchers applauded Facebook’s effort,
which wades into the complex and fraught realm of mental health, as well
intentioned. But they also raised concerns. For one thing, Facebook has not
published a study of the system’s accuracy and potential risks, such as
inadvertently increasing user distress.
“It’s a great idea and a huge unmet need,” Dr. Steinhubl
said. Even so, he added, Facebook is “certainly right up to that line of
practicing medicine not only without a license, but maybe without proof that
what they are doing provides more benefit that harm.”
For another thing, Facebook is scanning user posts in the
United States and some other countries for signs of possible suicidal thoughts
without giving users a choice of opting out of the scans.
“Once you are characterized as suicidal, is that forever
associated with your name?” said Frank Pasquale, a law professor at the
University of Maryland who studies emerging health technologies. “Who has
access to that information?”
Will Nevius, a Facebook spokesman, said Facebook deleted
the algorithmic scores associated with posts after 30 days. The cases involving
emergency responders are kept in a separate system that is not tied to users’
profiles, he said.
Facebook said it had worked with suicide prevention
groups when developing the effort. Mr. Nevius added that publishing a useful
study would be complex because of the difficulty in removing personal data and
“the delicate nature of the posts.”
Detecting Depression in Clicks
Therapists traditionally diagnose depression by observing
patients and asking them how they feel. Mindstrong Health, a mental health
start-up in Palo Alto, Calif., is observing people’s smartphone use.
The company has developed a research platform to continuously
monitor users’ phone habits, looking at changes in taps and clicks for hints
about mood and memory changes associated with depression.
“We are building digital smoke alarms for people with
mental illness,” said Dr. Thomas R. Insel, a Mindstrong co-founder and a former
director of the National Institute of Mental Health.
Mindstrong’s research app tracks 1,000 smartphone-related
data points — like how long it takes someone to scroll through a contact list
and click on a name. The start-up recruited 200 volunteers to participate in
pilot studies. Dr. Insel said a few of the signals, like changes in users’
keyboard accuracy and speed, correlated with similar motor skills changes that
researchers could measure in lab tests.
Now the company is participating in a large
government-funded study of trauma patients. Part of it involves using the
Mindstrong platform to study whether patients who go on to develop
post-traumatic stress disorder also develop corresponding changes in their
smartphone use.
“We’ve got these really interesting statistical signals
with very high correlations,” Dr. Insel said. “But whether that’s going to work
in the real world of clinical care is something we’re looking at right now.”
He added that Mindstrong had tapped law and ethics
experts to help examine the implications of its technology and develop ethical
frameworks for using it.
“You want to think through all the unintended
consequences early on,” Dr. Insel said, “so they don’t come back to bite you.”
Vetting Calls for Signs of Stress
The traditional use of a phone — talking — is also being
examined for health clues. Sharecare, a digital health company based in
Atlanta, offers a wellness app with an optional feature that analyzes users’
stress levels during phone calls.
The system uses pattern recognition technology to
categorize users’ speech, the company said. After each call, the system
delivers reports like “you seemed anxious” or “you seemed balanced.” It also
characterizes users’ relationships with the people they call in terms of
attitudes like “dominance” or “affection.”
Jeff Arnold, a co-founder of Sharecare, described the
voice scan as “an emotional selfie.”
“If I can tell you your stress level in real time, it
will in itself change your behavior,” said Mr. Arnold, who previously founded
WebMD.
Health insurers and self-insured companies use Sharecare
to promote wellness and manage health care costs. Sharecare is working with the
Georgia Institute of Technology to study the effectiveness of its voice
analysis service.
Jiten Chhabra, a health tech researcher at the
university’s Interactive Media Technology Center, said volunteers who tried the
voice-scanning feature reported feeling less stressed afterward. But he said it
was too soon to tell whether the stress analysis itself directly caused the
change — or whether volunteers had simply become more relaxed in their daily
lives.
The company does not record the content of the calls it
scans, it said. But the app did collect phone numbers for people on the other
side of calls from Sharecare users, according to an analysis by The New York
Times. The service did not inform people on the phone with Sharecare users that
their relationships were being analyzed.
Jennifer Martin Hall, a spokeswoman for Sharecare, said
the way the company protected data “makes it practically impossible for any
Sharecare employees to access a phone number in the call information.” She
added that characterizing users’ voice “analysis in terms of ‘relationships’
helps contextualize the relevance of their stress and enables them to be more
mindful day to day.”
Sharecare says its voice analysis feature does not record
users’ phone calls, but it sends a notice after every call analyzing Sharecare
users’ relationships — without informing people on the other end of the call
that the app is doing so.
Other researchers said such pervasive scanning could also
have the opposite effect — increasing stress on otherwise healthy people.
“It’s like we’re in school forever,” Professor Pasquale
said, “and we’re being graded in all these ways forever by all the companies
that have the most data about us.”
Aaron Krolik contributed reporting.
A version of this article appears in print on February
26, 2018, on Page B1 of the New York edition with the headline: Scouring Our
Clicks For Clues To Our Health.
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