Tiffany M. Driesse

Bio: Tiffany M. Driesse is an academic researcher from University of North Carolina at Chapel Hill. The author has contributed to research in topics: Computer science & Medicine. The author has co-authored 2 publications.

Privacy concerns of older adults using voice assistant systems

Abstract: 1. Divi C, Koss RG, Schmaltz SP, Loeb JM. Language proficiency and adverse events in US hospitals: a pilot study. International J Qual Health Care. 2007;19(2):60-67. doi:10.1093/intqhc/mzl069 2. Inouye SK, Leo-Summers L, Zhang Y, Bogardus ST Jr, Leslie DL, Agostini JV. A chart-based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method. J Am Geriatr Soc. 2005;53(2):312-318. doi:10. 1111/j.1532-5415.2005.53120.x 3. Rajaram A, Thomas D, Sallam F, Verma AA, Rawal S. Accuracy of the preferred language field in the electronic health records of two Canadian Hospitals. Appl Clin Inform. 2020; 11(4):644-649. doi:10.1055/s-0040-1715896 4. Escobar GJ, Greene JD, Scheirer P, Gardner MN, Draper D, Kipnis P. Risk-adjusting hospital inpatient mortality using automated inpatient, outpatient, and laboratory databases. Med Care. 2008;46(3):232-239. doi:10.1097/MLR.0b013e3181589bb6 5. Mohr WK, Petti TA, Mohr BD. Adverse effects associated with physical restraint. Can J Psychiatry. 2003;48(5):330-337. doi:10. 1177/070674370304800509 6. Herzig SJ, LaSalvia MT, Naidus E, et al. Antipsychotics and the risk of aspiration pneumonia in individuals hospitalized for nonpsychiatric conditions: a cohort study. J Am Geriatr Soc. 2017;65(12):2580-2586. doi:10.1111/jgs.15066 7. Ludolph P, Stoffers-Winterling J, Kunzler AM, et al. Nonpharmacologic multicomponent interventions preventing delirium in hospitalized people. J Am Geriatr Soc. 2020;68(8):18641871. doi:10.1111/jgs.16565 8. Mong J, Cram P, Syed K, Rawal S. Interpretation use for consent to hip fracture surgery in patients with limited English proficiency. J Am Geriatr Soc. 2021;69(8):2358-2361. doi:10. 1111/jgs.17157 9. Schiaffino MK, Nara A, Mao L. Language services in hospitals vary by ownership and location. Health Aff. 2016;35:1399-1403. doi:10.1377/hlthaff.2015.0955 10. Wong AH, Whitfill T, Ohuabunwa EC, et al. Association of race/ethnicity and other demographic characteristics with use of physical restraints in the emergency department. JAMA Netw Open. 2021;4(1):e2035241. doi:10.1001/jamanetworkopen. 2020.35241

Impact of whey protein supplementation in a weight-loss intervention in rural dwelling adults: A feasibility study.

Abstract: Summary Background & aims Weight loss in older adults enhances physical function, but may lead to sarcopenia and osteoporosis. Whey protein is a low cost rich source of essential amino acids, may improve physical function. We evaluated the feasibility and acceptability of consuming whey protein in the context of a weight-loss intervention in older adults with obesity. Methods A 12-week pilot feasibility, non-randomized weight loss study of 28 older adults was conducted, consisting of individualized, weekly dietitian visits with twice weekly physical therapist-led group strengthening classes. Half consumed whey protein, three times weekly, following exercise. Preliminary efficacy measures of body composition, sit-to-stand, 6-min walk and grip strength and subjective measures of self-reported health and function were also evaluated. Results Of the 37 enrolled, 28 completed the study (50 % in the protein group). Attendance rates for protein vs. non-protein groups were 89.9 ± 11.1 % vs. 95.6 ± 3.4 % (p = 0.08). Protein consumption was high in those attending classes (90.3 %) as was compliance at home (82.6 %). Whey was pleasant (67.3 ± 22.1, range 30–100, above average), had little aftertaste, and was neither salty or sticky. All were compliant (0.64 ± 0.84, range 0–5, low = higher compliance). Both groups lost significant weight (protein vs. no protein, −3.45 ± 2.86 vs. −5.79 ± 3.08, p = 0.47); Sit-to-stand, 6-min walk, and gait speed were no different, grip strength was improved in the protein compared to the non-protein group (−2.63 kg vs. 4.29 kg; p Conclusions Our results suggest that whey protein is a low-cost and readily available nutritional supplement that can be integrated into a weight loss intervention.

Patient perceptions of using voice-based dietary assessment tools among older adults

Abstract: Abstract Poor diet among older adults is a risk factor for developing multiple chronic diseases. Dietary recall comprises an important component in intervention research and clinical care. Commonly used tools include the web-based automated self-administered 24-hour assessment (ASA-24). Yet voice assistant (VAS) systems (i.e., Amazon Alexa) have not been developed for this purpose. Hence, we evaluated patient perceptions on performing a VAS-based dietary assessment among older adults. Community-dwelling adults (age 65+ years) participated in two virtual sessions who reported their past 24-hour intake, first using ASA-24, and then using a VAS. All completed a Likert questionnaire (binary, % strongly agree/strongly disagree reported) regarding the simplicity of using both systems, completion time, and user satisfaction. Semi-structured interviews allowed us to ask about technology use. Of the 40 participants (100% enrolled), mean age was 69±1.0 years (85% female, 100% white, 5% Latinx). Only 40% owned a VAS; 60% reported having VAS experience prior to the study. After completing both sessions, 80% preferred a VAS over the ASA-24. Participants reported that web-based recalls were unnecessarily complex (60%), time-consuming (50%), and 60% did not wish to use them. Comparatively, VAS recalls were intuitive (75%), easily reportable (85%), and there was willingness to report food while preparing meals (85%). In 16 participants, we evaluated themes of VAS use including easier navigation, less time, and ability to have a natural conversation. A VAS provides a more convenient, conversational, and computerless interaction to report meals over web-based solutions suggesting they hold promise for dietary recall in older adults.

Studying Exploration & Long-Term Use of Voice Assistants by Older Adults

Abstract: While past research has examined older adults’ voice assistant (VA) use, it is unclear whether VAs provide enough value to sustain use when compared to technologies such as smartphones. Research also suggests that barriers around structured command input may limit use. In order to investigate these gaps in adoption, we conducted interviews with ten older adults in a long-term care community who have adopted Alexa devices for at least one year. Participants learned to use Alexa through a training program that encouraged exploration. They used Alexa to complement their daily routines, improve their mood, engage in cognitively stimulating activities, and support socialization with others. We discuss our findings in the context of prior work, describe strategies to promote VA learning and adoption, and present design recommendations to support aging.

Evaluating the Performance of State-of-the-Art ASR Systems on Non-Native English using Corpora with Extensive Language Background Variation

Abstract: This investigation is an exploration into the performance of several different ASR systems in dealing with non-native English using corpora with extensive language background variation. This study takes two corpora amounting to 191 different native language (L1) backgrounds and looks at how these systems are able to process non-native English (L2) speech. A transformer based ASR system and a CRDNN architecture are both tested, trained on Librispeech [1] and Commonvoice [2] for a three way cross comparison. In addition Google’s Speech-to-Text API and AWS Transcribe were investigated in order to evaluate popular mainstream approaches given their current de-gree of impact in deployed systems. Experiments reveal deficits in the range of 10%-15% mean WER performance difference between L1 and L2 speech. Results indicate ASR systems trained on particular varieties of L2 speech may be effective in improving WERs with outcomes in this paper demonstrating several Google ASR models trained on varieties of African L2 English outperforming L1 trained ASR for under-represented dialect groups in the United Kingdom. Further research is pro-posed to explore the plausibility of this approach and to criti-cally approach WER as a metric for ASR evaluation, striving instead towards metrics with greater emphasis on evaluating language for communication.

Privacy concerns of older adults using voice assistant systems

Abstract: 1. Divi C, Koss RG, Schmaltz SP, Loeb JM. Language proficiency and adverse events in US hospitals: a pilot study. International J Qual Health Care. 2007;19(2):60-67. doi:10.1093/intqhc/mzl069 2. Inouye SK, Leo-Summers L, Zhang Y, Bogardus ST Jr, Leslie DL, Agostini JV. A chart-based method for identification of delirium: validation compared with interviewer ratings using the confusion assessment method. J Am Geriatr Soc. 2005;53(2):312-318. doi:10. 1111/j.1532-5415.2005.53120.x 3. Rajaram A, Thomas D, Sallam F, Verma AA, Rawal S. Accuracy of the preferred language field in the electronic health records of two Canadian Hospitals. Appl Clin Inform. 2020; 11(4):644-649. doi:10.1055/s-0040-1715896 4. Escobar GJ, Greene JD, Scheirer P, Gardner MN, Draper D, Kipnis P. Risk-adjusting hospital inpatient mortality using automated inpatient, outpatient, and laboratory databases. Med Care. 2008;46(3):232-239. doi:10.1097/MLR.0b013e3181589bb6 5. Mohr WK, Petti TA, Mohr BD. Adverse effects associated with physical restraint. Can J Psychiatry. 2003;48(5):330-337. doi:10. 1177/070674370304800509 6. Herzig SJ, LaSalvia MT, Naidus E, et al. Antipsychotics and the risk of aspiration pneumonia in individuals hospitalized for nonpsychiatric conditions: a cohort study. J Am Geriatr Soc. 2017;65(12):2580-2586. doi:10.1111/jgs.15066 7. Ludolph P, Stoffers-Winterling J, Kunzler AM, et al. Nonpharmacologic multicomponent interventions preventing delirium in hospitalized people. J Am Geriatr Soc. 2020;68(8):18641871. doi:10.1111/jgs.16565 8. Mong J, Cram P, Syed K, Rawal S. Interpretation use for consent to hip fracture surgery in patients with limited English proficiency. J Am Geriatr Soc. 2021;69(8):2358-2361. doi:10. 1111/jgs.17157 9. Schiaffino MK, Nara A, Mao L. Language services in hospitals vary by ownership and location. Health Aff. 2016;35:1399-1403. doi:10.1377/hlthaff.2015.0955 10. Wong AH, Whitfill T, Ohuabunwa EC, et al. Association of race/ethnicity and other demographic characteristics with use of physical restraints in the emergency department. JAMA Netw Open. 2021;4(1):e2035241. doi:10.1001/jamanetworkopen. 2020.35241

Natural language processing techniques for studying language in pathological ageing: A scoping review.

Abstract: BACKGROUND In the past few years there has been a growing interest in the employment of verbal productions as digital biomarkers, namely objective, quantifiable behavioural data that can be collected and measured by means of digital devices, allowing for a low-cost pathology detection, classification and monitoring. Numerous research papers have been published on the automatic detection of subtle verbal alteration, starting from written texts, raw speech recordings and transcripts, and such linguistic analysis has been singled out as a cost-effective method for diagnosing dementia and other medical conditions common among elderly patients (e.g., cognitive dysfunctions associated with metabolic disorders, dysarthria). AIMS To provide a critical appraisal and synthesis of evidence concerning the application of natural language processing (NLP) techniques for clinical purposes in the geriatric population. In particular, we discuss the state of the art on studying language in healthy and pathological ageing, focusing on the latest research efforts to build non-intrusive language-based tools for the early identification of cognitive frailty due to dementia. We also discuss some challenges and open problems raised by this approach. METHODS & PROCEDURES We performed a scoping review to examine emerging evidence about this novel domain. Potentially relevant studies published up to November 2021 were identified from the databases of MEDLINE, Cochrane and Web of Science. We also browsed the proceedings of leading international conferences (e.g., ACL, COLING, Interspeech, LREC) from 2017 to 2021, and checked the reference lists of relevant studies and reviews. MAIN CONTRIBUTION The paper provides an introductory, but complete, overview of the application of NLP techniques for studying language disruption due to dementia. We also suggest that this technique can be fruitfully applied to other medical conditions (e.g., cognitive dysfunctions associated with dysarthria, cerebrovascular disease and mood disorders). CONCLUSIONS & IMPLICATIONS Despite several critical points need to be addressed by the scientific community, a growing body of empirical evidence shows that NLP techniques can represent a promising tool for studying language changes in pathological aging, with a high potential to lead a significant shift in clinical practice. WHAT THIS PAPER ADDS What is already known on this subject Speech and languages abilities change due to non-pathological neurocognitive ageing and neurodegenerative processes. These subtle verbal modifications can be measured through NLP techniques and used as biomarkers for screening/diagnostic purposes in the geriatric population (i.e., digital linguistic biomarkers-DLBs). What this paper adds to existing knowledge The review shows that DLBs can represent a promising clinical tool, with a high potential to spark a major shift to dementia assessment in the elderly. Some challenges and open problems are also discussed. What are the potential or actual clinical implications of this work? This methodological review represents a starting point for clinicians approaching the DLB research field for studying language in healthy and pathological ageing. It summarizes the state of the art and future research directions of this novel approach.