Medical images taken with mobile phones by patients, i.e. medical selfies, allow screening, monitoring, and diagnosis of skin lesions. While mobile teledermatology can provide good diagnostic accuracy for skin tumours, there is little research about emotional and physical aspects when taking medical selfies of body parts. We conducted a survey with 100 participants and a qualitative study with twelve participants, in which they took images of eight body parts including intimate areas. Participants had difficulties taking medical selfies of their shoulder blades and buttocks. For the genitals, they prefer to visit a doctor rather than sending images. Taking the images triggered privacy concerns, memories of past experiences with body parts, and raised awareness of the bodily medical state. We present recommendations for the design of mobile apps to address the usability and emotional impacts of taking medical selfies.
• Human-centered computing → Human-computer interaction (HCI); Empirical studies in HCI; • Applied computing → Health care information systems; Consumer health; Health informatics.
Selfies, E-health, M-health, Telemedicine
The incidence of skin cancer has reached epidemic proportions in white populations and the trend is still rising . Currently, between 2 and 3 million non-melanoma skin cancers and 132,000, melanoma skin cancers occur globally each year. One in every three cancers diagnosed is skin cancer and, according to the Skin Cancer Foundation, one in every five Americans will develop skin cancer in their lifetime . Early detection and treatment are essential in reducing mortality. While the technical equipment commonly used in this context has previously comprised expensive stereomicroscopes and digital dermoscopy systems, teledermatology has shown to be more cost-effective [29, 30, 55] and at least as accurate in diagnosis [37, 58] compared to face-to-face consultations. Mobile teledermatology has good diagnostic accuracy for skin tumours [24–26]. Due to the low-cost infrastructure, it is a convenient tool, especially in resource-limited settings. Examples of the successful implementation of teledermatology services are reported from the Netherlands with 130531 consults between 2006 and 2015  and from the Brazilian state of Catarina with 83100 consults from 2014 to 2018 .
While technology has evolved rapidly , the emotional impacts of sharing medical photos between patients and doctors have not been considered in the literature to the same extent. Sending sensitive medical images through an abstract communication channel that is not as tangible as face-to-face communication requires patients to build a high level of trust in the technology. This has implications for the design of applications and systems through which patients collect and distribute sensitive medical photos, and potentially receive back life-changing diagnosis. In this context, we address the concept of affective atmospheres , whereby the combination of technology, spaces, and actors contribute to the overall effective experience of an individual using a system. When dealing with health and technology use, people can be vulnerable and are exposed to strong feelings.
When there is no physical presence of a doctor, sensory engagement with the patient, an essential part of developing trust, is lacking and has to be compensated for. Interactions between humans and digital devices can be personal and intimate experiences [20, 21, 56]. In the medical context, the visual, aural and haptic aspects of digital devices become increasingly important to support the emotional impacts of their use . Recent work exploring the use of digital resources for HIV, has identified that such considerations for providing emotional support are currently missing from online medical services . We propose that in situations where digital imaging for the purposes of disease detection takes place, a particular atmosphere is created that is dependent on, for example, the body parts being digitally documented by an individual for disease detection purposes; the current level of knowledge of the medical state of the particular body part being photographed for diagnosis; the existing relation with one’s body; the presence and form of a camera used to photograph one’s body; the presence or absence of other humans in the space; the familiarity or foreignness of the space and; the ways in which the images are to be forwarded to medical experts. Moreover, we propose a possibility that the usage of cameras of personal smartphones to take medical photographs of one’s own (private) body parts can create negative emotional states such as insecurity and discomfiture. This has a strong connection with the digital documenting of specific body parts that are considered as more sensitive, vulnerable or private to be taken pictures of.
The aim of our work is to explore the area of medical selfies, i.e. images taken of one’s self to record the state of a medical condition, in regards to their emotional impacts and practical challenges. We address the following research questions
• RQ 1: What are the emotional impacts associated with the process of taking medical selfies and how do they differ between body parts?
• RQ 2: What are the physical and practical challenges people face when taking medical selfies and how can mHealth apps be designed to overcome them?
The joint observation of the emotional together with the physical dimensions enables us to derive design guidelines specific to the intimate nature of medical selfies. In this paper, we report our findings from an online survey (n=100) and an in-depth user study (n=12) on how people experience taking medical images of their bodies. Survey respondents expressed that they mostly prefer to not send medical photos of intimate body parts but instead rather see a doctor. However, for other body parts and less severe skin conditions, such as rashes, respondents stated that selfie images were the preferred analysis mode. Participants in the user study found it physically challenging to take photos of their buttocks and shoulder blades and expressed most emotional discomfort with genital and buttock photos. Inspecting their bodies as part of the study procedure raised their awareness of skin features, e.g. dryness and moles. Self-examination made participants check on body parts they would not normally look at in their daily life. Participants were concerned about their appearance in medical selfies, even though they were aware of the sole medical purpose. We provide design guidelines (Table 6) that address practical challenges, e.g. correct device positioning and image acquisition, and emotional dimensions such as aesthetics and data privacy.
We collected two datasets, a survey (n=100) and an in-depth user study (n=12), exposing user perceptions of taking selfie photographs of skin conditions for diagnosis. When taking medical selfies of intimate body regions, people felt emotional discomfort and expressed data privacy concerns. For some participants, the aesthetics of the photos played an important role, even though they recognized their medical purpose. Participants faced practical problems with positioning to photograph their back and buttocks. Issues of lighting and camera focus were noted as challenges by participants. Our findings highlight the importance of addressing practical and usability issues as well as managing privacy in the user interface of e-health apps, building trust between users and the system. Methodologically, our approach of data collection, with participants recording their thinking aloud audio while capturing the medical selfies, and later video recordings provided a good trade-off between maintaining privacy and data quality.
The Kavian Scientific Research Association (KSRA) is a non-profit research organization to provide research / educational services in December 2013. The members of the community had formed a virtual group on the Viber social network. The core of the Kavian Scientific Association was formed with these members as founders. These individuals, led by Professor Siavosh Kaviani, decided to launch a scientific / research association with an emphasis on education.
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FULL Paper PDF file:Medical Selfies: Emotional Impacts and Practical Challenges
Medical Selfies: Emotional Impacts and Practical Challenges
MobileHCI 2020: Proceedings of the International Conference on Human-Computer Interaction with Mobile Devices and Service
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Professor Siavosh Kaviani was born in 1961 in Tehran. He had a professorship. He holds a Ph.D. in Software Engineering from the QL University of Software Development Methodology and an honorary Ph.D. from the University of Chelsea.