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      Data Mining of a Remote Behavioral Tracking System for Type 2 Diabetes Patients: A Prospective Cohort Study

      research-article
      , PhD, RKin 1 , , PhD 2 , , PhD 2 , , B BSc (Hons), RKin 1 , , PhD (CPsych) 3 , , PhD 4 , 5 , , PhD (CPsych) 1 ,
      (Reviewer), (Reviewer), (Reviewer)
      JMIR Diabetes
      JMIR Publications
      diabetes mellitus, type 2, health coaching, mhealth, telehealth, data mining

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          Abstract

          Background

          Complications from type 2 diabetes mellitus can be prevented when patients perform health behaviors such as vigorous exercise and glucose-regulated diet. The use of smartphones for tracking such behaviors has demonstrated success in type 2 diabetes management while generating repositories of analyzable digital data, which, when better understood, may help improve care. Data mining methods were used in this study to better understand self-monitoring patterns using smartphone tracking software.

          Objective

          Associations were evaluated between the smartphone monitoring of health behaviors and HbA1c reductions in a patient subsample with type 2 diabetes who demonstrated clinically significant benefits after participation in a randomized controlled trial.

          Methods

          A priori association-rule algorithms, implemented in the C language, were applied to app-discretized use data involving three primary health behavior trackers (exercise, diet, and glucose monitoring) from 29 participants who achieved clinically significant HbA1c reductions. Use was evaluated in relation to improved HbA1c outcomes.

          Results

          Analyses indicated that nearly a third (9/29, 31%) of participants used a single tracker, half (14/29, 48%) used two primary trackers, and the remainder (6/29, 21%) of the participants used three primary trackers. Decreases in HbA1c were observed across all groups (0.97-1.95%), but clinically significant reductions were more likely with use of one or two trackers rather than use of three trackers (OR 0.18, P=.04).

          Conclusions

          Data mining techniques can reveal relevant coherent behavior patterns useful in guiding future intervention structure. It appears that focusing on using one or two trackers, in a symbolic function, was more effective (in this sample) than regular use of all three trackers.

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          Most cited references14

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          The inevitable application of big data to health care.

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            Canadian Diabetes Association 2013 clinical practice guidelines for the prevention and management of diabetes in Canada. Introduction.

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              Data mining in healthcare and biomedicine: a survey of the literature.

              As a new concept that emerged in the middle of 1990's, data mining can help researchers gain both novel and deep insights and can facilitate unprecedented understanding of large biomedical datasets. Data mining can uncover new biomedical and healthcare knowledge for clinical and administrative decision making as well as generate scientific hypotheses from large experimental data, clinical databases, and/or biomedical literature. This review first introduces data mining in general (e.g., the background, definition, and process of data mining), discusses the major differences between statistics and data mining and then speaks to the uniqueness of data mining in the biomedical and healthcare fields. A brief summarization of various data mining algorithms used for classification, clustering, and association as well as their respective advantages and drawbacks is also presented. Suggested guidelines on how to use data mining algorithms in each area of classification, clustering, and association are offered along with three examples of how data mining has been used in the healthcare industry. Given the successful application of data mining by health related organizations that has helped to predict health insurance fraud and under-diagnosed patients, and identify and classify at-risk people in terms of health with the goal of reducing healthcare cost, we introduce how data mining technologies (in each area of classification, clustering, and association) have been used for a multitude of purposes, including research in the biomedical and healthcare fields. A discussion of the technologies available to enable the prediction of healthcare costs (including length of hospital stay), disease diagnosis and prognosis, and the discovery of hidden biomedical and healthcare patterns from related databases is offered along with a discussion of the use of data mining to discover such relationships as those between health conditions and a disease, relationships among diseases, and relationships among drugs. The article concludes with a discussion of the problems that hamper the clinical use of data mining by health professionals.
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                Author and article information

                Contributors
                Journal
                JMIR Diabetes
                JMIR Diabetes
                JD
                JMIR Diabetes
                JMIR Publications (Toronto, Canada )
                2371-4379
                Jan-Jun 2016
                06 April 2016
                : 1
                : 1
                : e1
                Affiliations
                [1 ] Health Behaviour Change Lab School of Kinesiology & Health Science York University Toronto, ON Canada
                [2 ] Data Mining Lab Lassonde School of Engineering York University Toronto, ON Canada
                [3 ] Pain Mechanisms Lab Department of Psychology York University Toronto, ON Canada
                [4 ] Division of Biostatistics Dalla Lana School of Public Health University of Toronto Toronto, ON Canada
                [5 ] Analytics and Informatics Prevention and Cancer Control Cancer Care Ontario Toronto, ON Canada
                Author notes
                Corresponding Author: Paul Ritvo pritvo@ 123456yorku.ca
                Author information
                http://orcid.org/0000-0002-8513-3616
                http://orcid.org/0000-0001-7360-9720
                http://orcid.org/0000-0003-3581-3346
                http://orcid.org/0000-0002-8686-447X
                http://orcid.org/0000-0003-2541-3744
                http://orcid.org/0000-0003-1141-0083
                Article
                v1i1e1
                10.2196/diabetes.4506
                6238830
                30291054
                55a126d6-4564-475c-88ed-dca38984c958
                ©Noah Wayne, Nick Cercone, Jiye Li, Ariel Zohar, Joel Katz, Patrick Brown, Paul Ritvo. Originally published in JMIR Diabetes (http://diabetes.jmir.org), 06.04.2016.

                This is an open-access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Diabetes, is properly cited. The complete bibliographic information, a link to the original publication on http://diabetes.jmir.org/.as well as this copyright and license information must be included.

                History
                : 6 April 2015
                : 29 July 2015
                : 28 October 2015
                : 8 January 2016
                Categories
                Original Paper
                Original Paper

                diabetes mellitus, type 2,health coaching,mhealth,telehealth,data mining

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