WatchGuardian: Enabling User-Defined Personalized Just-in-Time Intervention on Smartwatch

While just-in-time interventions (JITIs) have effectively targeted common health behaviors, individuals often have unique needs to intervene in personal undesirable actions that can negatively affect physical, mental, and social well-being. We present WatchGuardian, a smartwatch-based JITI system that empowers users to define custom interventions for these personal actions with a small number of samples. For the model to detect new actions based on limited new data samples, we developed a few-shot learning pipeline that finetuned a pre-trained inertial measurement unit (IMU) model on public hand-gesture datasets. We then designed a data augmentation and synthesis process to train additional classification layers for customization. Our offline evaluation with 26 participants showed that with three, five, and ten examples, our approach achieved an average accuracy of 76.8%, 84.7%, and 87.7%, and an F1 score of 74.8%, 84.2%, and 87.2% We then conducted a four-hour intervention study to compare WatchGuardian against a rule-based intervention. Our results demonstrated that our system led to a significant reduction by 64.0 +- 22.6% in undesirable actions, substantially outperforming the baseline by 29.0%. Our findings underscore the effectiveness of a customizable, AI-driven JITI system for individuals in need of behavioral intervention in personal undesirable actions. We envision that our work can inspire broader applications of user-defined personalized intervention with advanced AI solutions.

RECOVER: Designing a Large Language Model-based Remote Patient Monitoring System for Postoperative Gastrointestinal Cancer Care

Cancer surgery is a key treatment for gastrointestinal (GI) cancers, a group of cancers that account for more than 35% of cancer-related deaths worldwide, but postoperative complications are unpredictable and can be life-threatening. In this paper, we investigate how recent advancements in large language models (LLMs) can benefit remote patient monitoring (RPM) systems through clinical integration by designing RECOVER, an LLM-powered RPM system for postoperative GI cancer care. To closely engage stakeholders in the design process, we first conducted seven participatory design sessions with five clinical staff and interviewed five cancer patients to derive six major design strategies for integrating clinical guidelines and information needs into LLM-based RPM systems. We then designed and implemented RECOVER, which features an LLM-powered conversational agent for cancer patients and an interactive dashboard for clinical staff to enable efficient postoperative RPM. Finally, we used RECOVER as a pilot system to assess the implementation of our design strategies with four clinical staff and five patients, providing design implications by identifying crucial design elements, offering insights on responsible AI, and outlining opportunities for future LLM-powered RPM systems.

"It Felt Like I Was Left in the Dark": Exploring Information Needs and Design Opportunities for Family Caregivers of Older Adult Patients in Critical Care Settings

Older adult patients constitute a rapidly growing subgroup of Intensive Care Unit (ICU) patients. In these situations, their family caregivers are expected to represent the unconscious patients to access and interpret patients' medical information. However, caregivers currently have to rely on overloaded clinicians for information updates and typically lack the health literacy to understand complex medical information. Our project aims to explore the information needs of caregivers of ICU older adult patients, from which we can propose design opportunities to guide future AI systems. The project begins with formative interviews with 11 caregivers to identify their challenges in accessing and interpreting medical information; From these findings, we then synthesize design requirements and propose an AI system prototype to cope with caregivers' challenges. The system prototype has two key features: a timeline visualization to show the AI extracted and summarized older adult patients' key medical events; and an LLM-based chatbot to provide context-aware informational support. We conclude our paper by reporting on the follow-up user evaluation of the system and discussing future AI-based systems for ICU caregivers of older adults.

Zero-shot Large Language Models for Long Clinical Text Summarization with Temporal Reasoning

Recent advancements in large language models (LLMs) have shown potential for transforming data processing in healthcare, particularly in understanding complex clinical narratives. This study evaluates the efficacy of zero-shot LLMs in summarizing long clinical texts that require temporal reasoning, a critical aspect for comprehensively capturing patient histories and treatment trajectories. We applied a series of advanced zero-shot LLMs to extensive clinical documents, assessing their ability to integrate and accurately reflect temporal dynamics without prior task-specific training. While the models efficiently identified key temporal events, they struggled with chronological coherence over prolonged narratives. The evaluation, combining quantitative and qualitative methods, highlights the strengths and limitations of zero-shot LLMs in clinical text summarization. The results suggest that while promising, zero-shot LLMs require further refinement to effectively support clinical decision-making processes, underscoring the need for enhanced model training approaches that better capture the nuances of temporal information in long context medical documents.

SepsisCalc: Integrating Clinical Calculators into Early Sepsis Prediction via Dynamic Temporal Graph Construction

Sepsis is an organ dysfunction caused by a deregulated immune response to an infection. Early sepsis prediction and identification allow for timely intervention, leading to improved clinical outcomes. Clinical calculators (e.g., the six-organ dysfunction assessment of SOFA) play a vital role in sepsis identification within clinicians' workflow, providing evidence-based risk assessments essential for sepsis diagnosis. However, artificial intelligence (AI) sepsis prediction models typically generate a single sepsis risk score without incorporating clinical calculators for assessing organ dysfunctions, making the models less convincing and transparent to clinicians. To bridge the gap, we propose to mimic clinicians' workflow with a novel framework SepsisCalc to integrate clinical calculators into the predictive model, yielding a clinically transparent and precise model for utilization in clinical settings. Practically, clinical calculators usually combine information from multiple component variables in Electronic Health Records (EHR), and might not be applicable when the variables are (partially) missing. We mitigate this issue by representing EHRs as temporal graphs and integrating a learning module to dynamically add the accurately estimated calculator to the graphs. Experimental results on real-world datasets show that the proposed model outperforms state-of-the-art methods on sepsis prediction tasks. Moreover, we developed a system to identify organ dysfunctions and potential sepsis risks, providing a human-AI interaction tool for deployment, which can help clinicians understand the prediction outputs and prepare timely interventions for the corresponding dysfunctions, paving the way for actionable clinical decision-making support for early intervention.

Vital Insight: Assisting Experts' Sensemaking Process of Multi-modal Personal Tracking Data Using Visualization and LLM

Researchers have long recognized the socio-technical gaps in personal tracking research, where machines can never fully model the complexity of human behavior, making it only able to produce basic rule-based outputs or "black-box" results that lack clear explanations. Real-world deployments rely on experts for this complex translation from sparse data to meaningful insights. In this study, we consider this translation process from data to insights by experts as "sensemaking" and explore how HCI researchers can support it through Vital Insight, an evidence-based 'sensemaking' system that combines direct representation and indirect inference through visualization and Large Language Models. We evaluate Vital Insight in user testing sessions with 14 experts in multi-modal tracking, synthesize design implications, and develop an expert sensemaking model where they iteratively move between direct data representations and AI-supported inferences to explore, retrieve, question, and validate insights.

Secret Use of Large Language Models

The advancements of Large Language Models (LLMs) have decentralized the responsibility for the transparency of AI usage. Specifically, LLM users are now encouraged or required to disclose the use of LLM-generated content for varied types of real-world tasks. However, an emerging phenomenon, users' secret use of LLM, raises challenges in ensuring end users adhere to the transparency requirement. Our study used mixed-methods with an exploratory survey (125 real-world secret use cases reported) and a controlled experiment among 300 users to investigate the contexts and causes behind the secret use of LLMs. We found that such secretive behavior is often triggered by certain tasks, transcending demographic and personality differences among users. Task types were found to affect users' intentions to use secretive behavior, primarily through influencing perceived external judgment regarding LLM usage. Our results yield important insights for future work on designing interventions to encourage more transparent disclosure of the use of LLMs or other AI technologies.

Mutual Theory of Mind in Human-AI Collaboration: An Empirical Study with LLM-driven AI Agents in a Real-time Shared Workspace Task

Theory of Mind (ToM) significantly impacts human collaboration and communication as a crucial capability to understand others. When AI agents with ToM capability collaborate with humans, Mutual Theory of Mind (MToM) arises in such human-AI teams (HATs). The MToM process, which involves interactive communication and ToM-based strategy adjustment, affects the team's performance and collaboration process. To explore the MToM process, we conducted a mixed-design experiment using a large language model-driven AI agent with ToM and communication modules in a real-time shared-workspace task. We find that the agent's ToM capability does not significantly impact team performance but enhances human understanding of the agent and the feeling of being understood. Most participants in our study believe verbal communication increases human burden, and the results show that bidirectional communication leads to lower HAT performance. We discuss the results' implications for designing AI agents that collaborate with humans in real-time shared workspace tasks.

SepsisLab: Early Sepsis Prediction with Uncertainty Quantification and Active Sensing

Sepsis is the leading cause of in-hospital mortality in the USA. Early sepsis onset prediction and diagnosis could significantly improve the survival of sepsis patients. Existing predictive models are usually trained on high-quality data with few missing information, while missing values widely exist in real-world clinical scenarios (especially in the first hours of admissions to the hospital), which causes a significant decrease in accuracy and an increase in uncertainty for the predictive models. The common method to handle missing values is imputation, which replaces the unavailable variables with estimates from the observed data. The uncertainty of imputation results can be propagated to the sepsis prediction outputs, which have not been studied in existing works on either sepsis prediction or uncertainty quantification. In this study, we first define such propagated uncertainty as the variance of prediction output and then introduce uncertainty propagation methods to quantify the propagated uncertainty. Moreover, for the potential high-risk patients with low confidence due to limited observations, we propose a robust active sensing algorithm to increase confidence by actively recommending clinicians to observe the most informative variables. We validate the proposed models in both publicly available data (i.e., MIMIC-III and AmsterdamUMCdb) and proprietary data in The Ohio State University Wexner Medical Center (OSUWMC). The experimental results show that the propagated uncertainty is dominant at the beginning of admissions to hospitals and the proposed algorithm outperforms state-of-the-art active sensing methods. Finally, we implement a SepsisLab system for early sepsis prediction and active sensing based on our pre-trained models. Clinicians and potential sepsis patients can benefit from the system in early prediction and diagnosis of sepsis.

Sunnie: An Anthropomorphic LLM-Based Conversational Agent for Mental Well-Being Activity Recommendation

A longstanding challenge in mental well-being support is the reluctance of people to adopt psychologically beneficial activities, often due to a lack of motivation, low perceived trustworthiness, and limited personalization of recommendations. Chatbots have shown promise in promoting positive mental health practices, yet their rigid interaction flows and less human-like conversational experiences present significant limitations. In this work, we explore whether the anthropomorphic design (both LLM's persona design and conversational experience design) can enhance users' perception of the system and their willingness to adopt mental well-being activity recommendations. To this end, we introduce Sunnie, an anthropomorphic LLM-based conversational agent designed to offer personalized guidance for mental well-being support through multi-turn conversation and activity recommendations based on positive psychological theory. An empirical user study comparing the user experience with Sunnie and with a traditional survey-based activity recommendation system suggests that the anthropomorphic characteristics of Sunnie significantly enhance users' perception of the system and the overall usability; nevertheless, users' willingness to adopt activity recommendations did not change significantly.