title: Data-driven health management: reasoning about personally generated data in diabetes with information technologies.
abstract: To investigate how individuals with diabetes and diabetes educators reason about data collected through self-monitoring and to draw implications for the design of data-driven self-management technologies.
  
  
  
  Ten individuals with diabetes (six type 1 and four type 2) and 2 experienced diabetes educators were presented with a set of self-monitoring data captured by an individual with type 2 diabetes. The set included digital images of meals and their textual descriptions, and blood glucose (BG) readings captured before and after these meals. The participants were asked to review a set of meals and associated BG readings, explain differences in postprandial BG levels for these meals, and predict postprandial BG levels for the same individual for a different set of meals. Researchers compared conclusions and predictions reached by the participants with those arrived at by quantitative analysis of the collected data.
  
  
  
  The participants used both macronutrient composition of meals, most notably the inclusion of carbohydrates, and names of dishes and ingredients to reason about changes in postprandial BG levels. Both individuals with diabetes and diabetes educators reported difficulties in generating predictions of postprandial BG; their predictions varied in their correlations with the actual captured readings from r = 0.008 to r = 0.75.
  
  
  
  Overall, the study showed that identifying trends in the data collected with self-monitoring is a complex process, and that conclusions reached by both individuals with diabetes and diabetes educators are not always reliable. This suggests the need for new ways to facilitate individuals' reasoning with informatics interventions.
authors.affiliation: Department of Biomedical Informatics, Columbia University lena.mamykina@dbmi.columbia.edu.
authors.forename: Lena
authors.initials: L
authors.lastname: Mamykina
authors.affiliation: Department of Biomedical Informatics, Columbia University.
authors.forename: Matthew E
authors.initials: ME
authors.lastname: Levine
authors.affiliation: West Chester University, West Chester, Pennsylvania.
authors.forename: Patricia G
authors.initials: PG
authors.lastname: Davidson
authors.affiliation: School of Nursing, Columbia University.
authors.forename: Arlene M
authors.initials: AM
authors.lastname: Smaldone
authors.affiliation: Department of Biomedical Informatics, Columbia University.
authors.forename: Noemie
authors.initials: N
authors.lastname: Elhadad
authors.affiliation: Department of Biomedical Informatics, Columbia University.
authors.forename: David J
authors.initials: DJ
authors.lastname: Albers
mesh_terms: D001786:Blood Glucose / Q000032:analysis*; D003920:Diabetes Mellitus / Q000097:blood / Q000628:therapy*; D015930:Diet Records; D040441:Health Educators; D006801:Humans; D062407:Meals; D008991:Monitoring, Physiologic / Q000379:methods; D000076206:Patient Generated Health Data / Q000295:instrumentation / Q000379:methods*; D012648:Self Care
chemical_list: D001786:Blood Glucose
keywords: chronic disease; self-care