Posted Jan 21 , 2019 02:41 AM

Personal discovery in diabetes self-management: Discovering cause and effect using self-monitoring data

Mamykina L, et a. J. Biomedical Informatics 2017 December 76:1-8

What were the findings (excerpted from the Abstract)?

The objective of this study was to outline new design directions for informatics solutions that facilitate personal discovery with self-monitoring data. The authors investigated this question in the context of chronic disease self-management with the focus on type 2 diabetes. They conducted an observational qualitative study of discovery with personal data among adults attending a diabetes self-management education (DSME) program that utilized a discovery-based curriculum. The study included observations of class sessions, and interviews and focus groups with the educator and attendees of the program (n = 14). The main discovery in diabetes self-management evolved around discovering patterns of association between characteristics of individuals’ activities and changes in their blood glucose levels that the participants referred to as “cause and effect.” This discovery empowered individuals to actively engage in self-management and provided a desired flexibility in selection of personalized self-management strategies. They showed that discovery of cause and effect involves four essential phases: (1) feature selection, (2) hypothesis generation, (3) feature evaluation, and (4) goal specification. Further, they identified opportunities to support discovery at each stage with informatics and data visualization solutions by providing assistance with: (1) active manipulation of collected data (e.g., grouping, filtering and side-by-side inspection), (2) hypotheses formulation (e.g., using natural language statements or constructing visual queries), (3) inference evaluation (e.g., through aggregation and visual comparison, and statistical analysis of associations), and (4) translation of discoveries into actionable goals (e.g., tailored selection from computable knowledge sources of effective diabetes self-management behaviors). This study suggests that discovery of cause and effect in diabetes can be a powerful approach to helping individuals to improve their self-management strategies, and that self-monitoring data can serve as a driving engine for personal discovery that may lead to sustainable behavior changes.

Why is this important?

Enabling personal discovery is an important approach to enhancing chronic disease self-management with informatics interventions. Unfortunately, this avenue of diabetes education through personal discovery was first documented nearly 15 years ago (Brackenridge B, and Swenson K . The British Journal of Diabetes & Vascular Disease 2004;4:117-120) and yet the principles are practiced inconsistently by many diabetes education programs. When we learned facts in our education, we often asked for the relevance of these facts. When patients learn things about their diabetes through the use of self-monitoring of blood glucose, the relevance is automatic. While this is a small observational study, it’s findings support the use of SMBG-based discovery as an educational tool in all diabetes educational programs.
Do you use SMBG as a discovery tool? Do you reinforce learnings during your DSME program?

Read the Abstract: