Quantified Self Fourth Person Perspective and Self 2.0

Quantified self trackers¹ are having an increasingly intimate relationship with technology and data flow in mediating their experience of reality. Technology effectively opens up a new perspective (as vaunted by Nietzsche), a fourth person perspective – a new and objective view of the self, possibly on the road to creating the overself (self 2.0). An important and radical aspect of quantified self (QS) activity is its inherent linkage of the former binary of quantified and qualified in three important ways:

1) The QS Act Itself 
The very act of QS’ing fundamentally includes both the collection of objective metrics data and the subjective experience of the impact of these data

2) QS’ing the Qualitative 
QS methods are now being applied to the tracking of (formerly objectively inaccessible) qualitative phenomena such as mood (e.g.; tracking qualitative word descriptors or mapping subjective experience onto quantitative scales)

3) Quant-Qual are part of a Larger Phenomenon 
To understand QS’ing is to see that it is part of a larger more complex process in which the quantified data collection and the qualitative experience of the data are nodes in feedback loops for behavior change. Data, information, understanding, and action are constituent parts of the looping process

¹Quantified self activity: the self-tracking of any kind of biological, physical, behavioral, or environmental information, often with a proactive stance towards action

The Evolution of the Quantified Self into the Qualified Self and the Extended Exoself

The Quantified Self is a fast-growing movement of individuals who are interested in personalized knowledge through self-tracking. So far, 5,000 QS’ers have come together at 70 worldwide meetup groups to share the details of their projects, discussing what they did, how they did it, and what they learned. Three areas were thematized at the group’s third conference held at Stanford University, September 15-16, 2012:

• The need for a data commons where participants may contribute personalized self-tracking data streams 
• Improving quality of life by tracking impact rather than actions in areas such as mood, happiness, productivity, well-being, and goal-achievement 
• The notion of current QS activities being an intermediary step towards the development of an extended self with exosenses like augmented reality vision overlays and haptic data that can be perceived as a sensation

The Quantified Self becomes the Qualified Self and the Exoself

Quotable quotes from the third Quantified Self conference held at Stanford University September 15-16, 2012. 

• Can I query my shirt or am I limited to consuming the querying that comes packaged in my shirt?
• Quantified Self enables the constant creation of this thing called the self
• We think more about our cats/dogs than we do our real pets, our microbiome
• Information conveyance, not dataviz
• Quantified emotion and data sensation (haptics)
• Display of numerical data and graphs are the interface
• Quantifying is the intermediary step...exosenses (haptics, wearable electronic senses) is really what we want
• Perpetual data explosion
• Our mission as Quantified Selves is to discover our mission

Figure 1. Word Cloud Visualization of Agenda Topics at the third Quantified Self Conference.

Behavior change through information availability and financial incentives

The presence of the big data era is increasingly difficult to ignore, but what is its influence exactly? Even if big data results in some beneficial outcomes, are humans being enslaved or empowered?

One example of behavior change through the availability of big data is personal power consumption. Home electricity consumption was reduced when individuals were able to self-monitor and obtain feedback on their resource use. There were 7-10% reductions with data and feedback [1,2], and a 32% reduction with data and feedback plus incentives [3].

It is a subtle line between the coercion of social pressure and other invisible influences and the ability to make a truly self-empowered choice whilst living in society. One answer philosophers have had to this question is that at least awareness of the issue helps. Irrespective of the source of motivations, the fact that responsibility-taking through greater awareness and access to information has been demonstrated could possibly be extended to have a similarly transformative impact on health and other sectors.

References
[1] Wood G, Newborough M. Dynamic energy-consumption indicators for domestic appliances: environment, behaviour and design. Energy and Buildings 2003 Sep;35(8);821-41.
[2] Parker DS. Pilot Evaluation of Energy Savings from Residential Energy Demand Feedback Devices. Solar Energy 2008 Jan; 13.
[3] Petersen JE, Shunturov V, Janda K, Platt G, Weinberger K. Dormitory residents reduce electricity consumption when exposed to real-time visual feedback and incentives. International Journal of Sustainability in Higher Education 2007;8(1);16-33.

Citizen scientists innovate research model

It is clear that quantified self-tracking, preventive medicine, and community-based research conducted by citizen scientists could be a huge new industry. The coming era of very large data sets and continuously collected information with algorithmic tools for signal-to-noise interpretation could significantly shift how the baseline measures of health are defined and managed. Citizen science is re-innovating the model for conducting science at every level.

In the traditional research model (Figure 1), there is a principal investigator at an institution, conducting research on subjects, under the purview of an Institutional Review Board, supported by grant funding and publishing results in journals.

Figure 1. Traditional Science Research Model

(source: DIYgenomics - an open platform for citizen science research)

The citizen science model (Figure 2) is different as there is no distinction between investigator and subject, everyone is an investigator and participant; therefore the analog to the IRB is different, perhaps there are citizen ethicists, or a list of FAQs. Funding could come from patient advocacy groups, innovative research foundations, social venture capital, and crowd-sourcing; and research results could be self-published on the web.

Figure 2. Citizen Science Research Model
(source: DIYgenomics - an open platform for citizen science research)

Health Literacy Toolkit

With one key life sciences focus shifting to health as opposed to healthcare (as HealthCamp founder Mark Scrimshire exhorts) and to preventive, predictive health management as opposed to therapy and treatment, there should be the concept of a health literacy toolkit that would be a component of standardized knowledge, such as how to write, drive or get a job.

Definition of health literacy
Surprising but emblematic of the traditional health mentality (e.g.; treat illness) is the prevailing definition of health literacy…”a patient’s ability to acquire and understand information about a condition and options once diagnosed…” Moving into the preventive era, the definition of health literacy needs to shift from being backward-looking to forward-looking. Having health knowledge ahead of time could inform behaviors to prevent, slow or lessen the development of disease. Health literacy should be a general set of knowledge for everyone to know, not related to a condition once a patient has it.

Gap between health literacy and demand for health information
A U.S. Department of Health and Human Services (HHS) study finds that only 12% of adults have proficient health literacy (p. 26); that nearly 9 out of 10 adults may lack the skills needed to manage their health and prevent disease.

The biggest reason for low health literacy could be a lack of appropriately accessible and presented health information.

A Pew Internet Study “The Social Life of Health Information” in June 2009 finds that 61% of U.S. adults are looking for health information online. The gap between health literacy and the demand for health information suggests that there is a substantial opportunity for a range of health information services and management tools, many of which could be fee-based such as the LIVESTRONG nutrition and exercise management program.

Health literacy toolkit
What should be the components of a standard health literacy toolkit? Many professionals (e.g.; physicians, academicians, etc.) believe that even HDL/LDL cholesterol information is too complicated for the lay public, but this just cannot be correct. When simple numeric information is presented clearly, people of any background and capability are often quite able to understand it and take action. For example, when utility bills started to provide straightforward quantitative data regarding power consumption, including day/night usage and costs, many people shifted their behavior in a positive informed way.

Figure 1: Ongoing Total Cholesterol readings for one individual

Figure 1 illustrates an example individual’s ongoing total cholesterol readings presented in a clear and informative way. Anyone inspecting the chart can easily identify the overall trend, down, which is good, wonder about the range of numeric measurements (157-185) vs. the average and how this translates into good or bad health tiers (e.g.; under 200 is generally good, but a rising trend that is still under 200 could be an indication of arising health issues for that individual), and inquisitively wonder about the peaks. The next level of information would be HDL and LDL readings, small lipids as is now de rigueur and triglycerides, but even this simple plot of total cholesterol measures is understandable, useful and potentially actionable. It is also the perfect level of information for individuals who are interested in being responsible for self-managing their health but from an efficient, easily-actionable level that does not require deep engagement of time or knowledge acquistion.

Some of the most obvious aspects to include in a health literacy toolkit would be nutritional information and its interpretation, caloric consumption and expenditure and ongoing quantitative measures of health from blood analysis and other tests (e.g.; blood pressure, glucose, cholesterol, BMI, weight, VO2 max, etc.). The data can be summarized (with detail available) and directly linked to actionable explanatory information (e.g.; measures may go up or down if they were not measured at the same time or situation, for example if a meal had been eaten before some but not all of the measurements). Other components of a standard health literacy toolkit could include where and how to obtain information and tools for self-tracking, how to integrate multiple data sources into a unified view, and how and what to expect when interacting with the medical community. Genomics is already part of the health literacy toolkit for early adopters and could become a standard toolkit component for everyone within five years, already helpful Genetics 101 sites are emerging.

Automated health monitoring tools
Health-self management in large quadrants of the population could accelerate with the advent of automated health monitoring tools that would capture frequent datapoints and aggregate the information into easily viewable web-based charts. Many devices such as blood pressure monitors, heart monitors and scales are now battery-intensive Bluetooth-enabled which is a nice intermediate step but what is really needed is for all of these monitoring devices to be directly on home WiFi networks. Where possible, having the monitoring applications directly on the smartphone is another obvious step rather than having separate devices. There are some WiFi-enabled devices, for example the FitBit calorimeter, which has been delayed in launching, and glucose monitors such as the GlucoMON, however its $75/month subscription fee appears exorbitant.

Personal environmental measurement

Quantified self-tracking is the regular collection of any data that can be measured about the self such as biological, physical, behavioral or environmental information. Additional steps may include the graphical display of the data and a feedback loop of introspection and self-experimentation.

So far a lot of quantified self-tracking has focused on measuring personal biomarkers (genomic and other biological data such as cholesterol, blood pressure, hormone levels, etc.) and behavior (exercise, calorie expenditure, sleep, weight, nutritional intake, time management, memory improvement systems, sexual activity, baby kicks from the womb, etc.). In addition to measuring these biomarkers and behaviors, another important area to evaluate is one’s environment, trying to answer…how toxic is my environment and what can I do about it? What is the quality of the general indoor and outdoor area around me and how are the specific products I use impacting me?

1) Measuring one’s personal environment
Two key personal environmental monitoring efforts are the UCLA Center for Embedded Networked Sensing’s participatory urban sensing project which uploads location data from GPS-enabled mobile phones to a central repository and generates Personal Environmental Impact Reports. A second effort is OpenSpime’s Internet-connected geosensors, being developed to capture ongoing real-time readings of pollution and other air quality indicators and automatically log the information to a collective display built on Google Maps.

2) Measuring one’s chemical body burden
Assessing body burden, or chemical body load counts is measuring the cumulative impact of exposure to toxic substances in the environment. Personalized chemical testing services generally focus on pollutants, evaluating the levels of selected pesticides, flame retardants, PCBs, dioxins and other substances. One example is the environmental scan conducted by Axys Analytical Services for David Duncan in the ExperimentalMan project. Environmental screening may also be conducted by hair analysis tests that assess exposure to toxic substances and perform nutritional analysis.

3) Measuring the toxicity of one’s personal care products
The toxicity level of personal care products such as soap, shampoo and cosmetics can be queried from the Environmental Working Group's Skin Deep Cosmetic Safety Database.