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Institute
- Hasso-Plattner-Institut für Digital Engineering GmbH (127) (remove)
Digitale Technologien bieten erhebliche politische, wirtschaftliche und gesellschaftliche Chancen. Zugleich ist der Begriff digitale Souveränität zu einem Leitmotiv im deutschen Diskurs über digitale Technologien geworden: das heißt, die Fähigkeit des Staates, seine Verantwortung wahrzunehmen und die Befähigung der Gesellschaft – und des Einzelnen – sicherzustellen, die digitale Transformation selbstbestimmt zu gestalten. Exemplarisch für die Herausforderung in Deutschland und Europa, die Vorteile digitaler Technologien zu nutzen und gleichzeitig Souveränitätsbedenken zu berücksichtigen, steht der Bildungssektor. Er umfasst Bildung als zentrales öffentliches Gut, ein schnell aufkommendes Geschäftsfeld und wachsende Bestände an hochsensiblen personenbezogenen Daten. Davon ausgehend beschreibt der Bericht Wege zur Entschärfung des Spannungsverhältnisses zwischen Digitalisierung und Souveränität auf drei verschiedenen Ebenen – Staat, Wirtschaft und Individuum – anhand konkreter technischer Projekte im Bildungsbereich: die HPI Schul-Cloud (staatliche Souveränität), die MERLOT-Datenräume (wirtschaftliche Souveränität) und die openHPI-Plattform (individuelle Souveränität).
Economic evaluation of digital therapeutic care apps for unsupervised treatment of low back pain
(2023)
Background:
Digital therapeutic care (DTC) programs are unsupervised app-based treatments that provide video exercises and educational material to patients with nonspecific low back pain during episodes of pain and functional disability. German statutory health insurance can reimburse DTC programs since 2019, but evidence on efficacy and reasonable pricing remains scarce. This paper presents a probabilistic sensitivity analysis (PSA) to evaluate the efficacy and cost-utility of a DTC app against treatment as usual (TAU) in Germany.
Objective:
The aim of this study was to perform a PSA in the form of a Monte Carlo simulation based on the deterministic base case analysis to account for model assumptions and parameter uncertainty. We also intend to explore to what extent the results in this probabilistic analysis differ from the results in the base case analysis and to what extent a shortage of outcome data concerning quality-of-life (QoL) metrics impacts the overall results.
Methods:
The PSA builds upon a state-transition Markov chain with a 4-week cycle length over a model time horizon of 3 years from a recently published deterministic cost-utility analysis. A Monte Carlo simulation with 10,000 iterations and a cohort size of 10,000 was employed to evaluate the cost-utility from a societal perspective. Quality-adjusted life years (QALYs) were derived from Veterans RAND 6-Dimension (VR-6D) and Short-Form 6-Dimension (SF-6D) single utility scores. Finally, we also simulated reducing the price for a 3-month app prescription to analyze at which price threshold DTC would result in being the dominant strategy over TAU in Germany.
Results:
The Monte Carlo simulation yielded on average a euro135.97 (a currency exchange rate of EUR euro1=US $1.069 is applicable) incremental cost and 0.004 incremental QALYs per person and year for the unsupervised DTC app strategy compared to in-person physiotherapy in Germany. The corresponding incremental cost-utility ratio (ICUR) amounts to an additional euro34,315.19 per additional QALY. DTC yielded more QALYs in 54.96% of the iterations. DTC dominates TAU in 24.04% of the iterations for QALYs. Reducing the app price in the simulation from currently euro239.96 to euro164.61 for a 3-month prescription could yield a negative ICUR and thus make DTC the dominant strategy, even though the estimated probability of DTC being more effective than TAU is only 54.96%.
Conclusions:
Decision-makers should be cautious when considering the reimbursement of DTC apps since no significant treatment effect was found, and the probability of cost-effectiveness remains below 60% even for an infinite willingness-to-pay threshold. More app-based studies involving the utilization of QoL outcome parameters are urgently needed to account for the low and limited precision of the available QoL input parameters, which are crucial to making profound recommendations concerning the cost-utility of novel apps.
Economic impact of clinical decision support interventions based on electronic health records
(2020)
Background
Unnecessary healthcare utilization, non-adherence to current clinical guidelines, or insufficient personalized care are perpetual challenges and remain potential major cost-drivers for healthcare systems around the world. Implementing decision support systems into clinical care is promised to improve quality of care and thereby yield substantial effects on reducing healthcare expenditure. In this article, we evaluate the economic impact of clinical decision support (CDS) interventions based on electronic health records (EHR).
Methods
We searched for studies published after 2014 using MEDLINE, CENTRAL, WEB OF SCIENCE, EBSCO, and TUFTS CEA registry databases that encompass an economic evaluation or consider cost outcome measures of EHR based CDS interventions. Thereupon, we identified best practice application areas and categorized the investigated interventions according to an existing taxonomy of front-end CDS tools.
Results and discussion
Twenty-seven studies are investigated in this review. Of those, twenty-two studies indicate a reduction of healthcare expenditure after implementing an EHR based CDS system, especially towards prevalent application areas, such as unnecessary laboratory testing, duplicate order entry, efficient transfusion practice, or reduction of antibiotic prescriptions. On the contrary, order facilitators and undiscovered malfunctions revealed to be threats and could lead to new cost drivers in healthcare. While high upfront and maintenance costs of CDS systems are a worldwide implementation barrier, most studies do not consider implementation cost. Finally, four included economic evaluation studies report mixed monetary outcome results and thus highlight the importance of further high-quality economic evaluations for these CDS systems.
Conclusion
Current research studies lack consideration of comparative cost-outcome metrics as well as detailed cost components in their analyses. Nonetheless, the positive economic impact of EHR based CDS interventions is highly promising, especially with regard to reducing waste in healthcare.
EMOOCs 2021
(2021)
From June 22 to June 24, 2021, Hasso Plattner Institute, Potsdam, hosted the seventh European MOOC Stakeholder Summit (EMOOCs 2021) together with the eighth ACM Learning@Scale Conference.
Due to the COVID-19 situation, the conference was held fully online.
The boost in digital education worldwide as a result of the pandemic was also one of the main topics of this year’s EMOOCs. All institutions of learning have been forced to transform and redesign their educational methods, moving from traditional models to hybrid or completely online models at scale. The learnings, derived from practical experience and research, have been explored in EMOOCs 2021 in six tracks and additional workshops, covering various aspects of this field. In this publication, we present papers from the conference’s Experience Track, the Policy Track, the Business Track, the International Track, and the Workshops.
EMOOCs 2023
(2023)
From June 14 to June 16, 2023, Hasso Plattner Institute, Potsdam, hosted the eighth European MOOC Stakeholder Summit (EMOOCs 2023).
The pandemic is fortunately over. It has once again shown how important digital education is. How well-prepared a country was could be seen in our schools, universities, and companies. In different countries, the problems manifested themselves differently. The measures and approaches to solving the problems varied accordingly. Digital education, whether micro-credentials, MOOCs, blended learning formats, or other e-learning tools, received a major boost.
EMOOCs 2023 focusses on the effects of this emergency situation. How has it affected the development and delivery of MOOCs and other e-learning offerings all over Europe? Which projects can serve as models for successful digital learning and teaching? Which roles can MOOCs and micro-credentials bear in the current business transformation? Is there a backlash to the routine we knew from pre-Corona times? Or have many things become firmly established in the meantime, e.g. remote work, hybrid conferences, etc.?
Furthermore, EMOOCs 2023 has a closer look at the development and formalization of digital learning. Micro-credentials are just the starting point. Further steps in this direction would be complete online study programs or full online universities.
Another main topic is the networking of learning offers and the standardization of formats and metadata. Examples of fruitful cooperations are the MOOChub, the European MOOC Consortium, and the Common Micro-Credential Framework.
The learnings, derived from practical experience and research, are explored in EMOOCs 2023 in four tracks and additional workshops, covering various aspects of this field. In this publication, we present papers from the conference’s Research & Experience Track, the Business Track and the International Track.
This paper aims to present the results of a higher education experience promoted by the research centres INTELLECT (University of Modena and Reggio Emilia) and CDM (University of Roma Tre), as part of difference master’s degrees programme of the academic years 2018/2019, 2019/2020, and 2020/2021. Through different online activities, 37 students attended and evaluated a MOOC on museum education content, such promoting their professionals and transverse skills, such as critical thinking, and developing their knowledge relative to OERs, within culture and heritage education contexts. Moreover, results from the online evaluation activities support the implementation of the MOOC in a collaborative way: during the academic years, evaluation data have been used by researcher to make changes to the course modules, thus realizing a more effective online path from and educational point of view.
Gait analysis is an important tool for the early detection of neurological diseases and for the assessment of risk of falling in elderly people. The availability of low-cost camera hardware on the market today and recent advances in Machine Learning enable a wide range of clinical and health-related applications, such as patient monitoring or exercise recognition at home. In this study, we evaluated the motion tracking performance of the latest generation of the Microsoft Kinect camera, Azure Kinect, compared to its predecessor Kinect v2 in terms of treadmill walking using a gold standard Vicon multi-camera motion capturing system and the 39 marker Plug-in Gait model. Five young and healthy subjects walked on a treadmill at three different velocities while data were recorded simultaneously with all three camera systems. An easy-to-administer camera calibration method developed here was used to spatially align the 3D skeleton data from both Kinect cameras and the Vicon system. With this calibration, the spatial agreement of joint positions between the two Kinect cameras and the reference system was evaluated. In addition, we compared the accuracy of certain spatio-temporal gait parameters, i.e., step length, step time, step width, and stride time calculated from the Kinect data, with the gold standard system. Our results showed that the improved hardware and the motion tracking algorithm of the Azure Kinect camera led to a significantly higher accuracy of the spatial gait parameters than the predecessor Kinect v2, while no significant differences were found between the temporal parameters. Furthermore, we explain in detail how this experimental setup could be used to continuously monitor the progress during gait rehabilitation in older people.
Fetal alcohol-spectrum disorder (FASD) is underdiagnosed and often misdiagnosed as attention-deficit/hyperactivity disorder (ADHD). Here, we develop a screening tool for FASD in youth with ADHD symptoms. To develop the prediction model, medical record data from a German University outpatient unit are assessed including 275 patients aged 0-19 years old with FASD with or without ADHD and 170 patients with ADHD without FASD aged 0-19 years old. We train 6 machine learning models based on 13 selected variables and evaluate their performance. Random forest models yield the best prediction models with a cross-validated AUC of 0.92 (95% confidence interval [0.84, 0.99]). Follow-up analyses indicate that a random forest model with 6 variables - body length and head circumference at birth, IQ, socially intrusive behaviour, poor memory and sleep disturbance - yields equivalent predictive accuracy. We implement the prediction model in a web-based app called FASDetect - a user-friendly, clinically scalable FASD risk calculator that is freely available at https://fasdetect.dhc-lab.hpi.de.
Language developers who design domain-specific languages or new language features need a way to make fast changes to language definitions. Those fast changes require immediate feedback. Also, it should be possible to parse the developed languages quickly to handle extensive sets of code.
Parsing expression grammars provides an easy to understand method for language definitions. Packrat parsing is a method to parse grammars of this kind, but this method is unable to handle left-recursion properly. Existing solutions either partially rewrite left-recursive rules and partly forbid them, or use complex extensions to packrat parsing that are hard to understand and cost-intensive. We investigated methods to make parsing as fast as possible, using easy to follow algorithms while not losing the ability to make fast changes to grammars.
We focused our efforts on two approaches.
One is to start from an existing technique for limited left-recursion rewriting and enhance it to work for general left-recursive grammars. The second approach is to design a grammar compilation process to find left-recursion before parsing, and in this way, reduce computational costs wherever possible and generate ready to use parser classes.
Rewriting parsing expression grammars is a task that, if done in a general way, unveils a large number of cases such that any rewriting algorithm surpasses the complexity of other left-recursive parsing algorithms. Lookahead operators introduce this complexity. However, most languages have only little portions that are left-recursive and in virtually all cases, have no indirect or hidden left-recursion. This means that the distinction of left-recursive parts of grammars from components that are non-left-recursive holds great improvement potential for existing parsers.
In this report, we list all the required steps for grammar rewriting to handle left-recursion, including grammar analysis, grammar rewriting itself, and syntax tree restructuring. Also, we describe the implementation of a parsing expression grammar framework in Squeak/Smalltalk and the possible interactions with the already existing parser Ohm/S. We quantitatively benchmarked this framework directing our focus on parsing time and the ability to use it in a live programming context. Compared with Ohm, we achieved massive parsing time improvements while preserving the ability to use our parser it as a live programming tool.
The work is essential because, for one, we outlined the difficulties and complexity that come with grammar rewriting. Also, we removed the existing limitations that came with left-recursion by eliminating them before parsing.
Psychology and nutritional science research has highlighted the impact of negative emotions and cognitive load on calorie consumption behaviour using subjective questionnaires. Isolated studies in other domains objectively assess cognitive load without considering its effects on eating behaviour. This study aims to explore the potential for developing an integrated eating behaviour assistant system that incorporates cognitive load factors. Two experimental sessions were conducted using custom-developed experimentation software to induce different stimuli. During these sessions, we collected 30 h of physiological, food consumption, and affective states questionnaires data to automatically detect cognitive load and analyse its effect on food choice. Utilising grid search optimisation and leave-one-subject-out cross-validation, a support vector machine model achieved a mean classification accuracy of 85.12% for the two cognitive load tasks using eight relevant features. Statistical analysis was performed on calorie consumption and questionnaire data. Furthermore, 75% of the subjects with higher negative affect significantly increased consumption of specific foods after high-cognitive-load tasks. These findings offer insights into the intricate relationship between cognitive load, affective states, and food choice, paving the way for an eating behaviour assistant system to manage food choices during cognitive load. Future research should enhance system capabilities and explore real-world applications.