Thank You for referencing this work, if you find it useful! Citation of a related scientific paper: Manea, V., & Wac, K. (2020). Co-Calibrating Physical and Psychological Outcomes and Consumer Wearable Activity Outcomes in Older Adults: An Evaluation of the coQoL Method. Journal of Personalized Medicine, 10(4), 203. DOI https://doi.org/10.3390/jpm10040203

1. Co-calibrating Physical and Psychological Outcomes and
Consumer Wearable Activity Outcomes in Older Adults:
An Evaluation of the coQoL Method
Vlad Manea, Katarzyna Wac
manea@di.ku.dk, katarzyna.wac@unige.ch

2. Motivation

3. PROs
Visiting the Doctor’s Office
Mayo, N. E., et al. (2017). Montréal Accord on Patient-Reported Outcomes (PROs) use series–Paper 2:
Terminology proposed to measure what matters in health. Journal of clinical epidemiology 89: 119-124.

4. “During the past month,
How often have you had
trouble sleeping because you...”
wake up in the middle
of the night or early
In the morning?
Buysse, D. J., Reynolds III, C. F., Monk, T. H.,
Berman, S. R., & Kupfer, D. J. (1989).
The Pittsburgh Sleep Quality Index:
A new instrument for psychiatric practice
and research. Psychiatry Research, 28(2),
193-213.
Example: Sleep
Gold Standard

5. Wac, K. (2018). From Quantified Self to Quality of Life, Chapter in: Digital Health: Scaling Healthcare to the World, Series: Health Informatics, Springer Nature, Dordrecht.
Patient-Reported Outcomes: Shortcomings
Gold Standard

6. TechROs
Visiting the Doctor’s Office
PROs
Mayo, N. E., et al. (2017). Montréal Accord on Patient-Reported Outcomes (PROs) use series–Paper 2:
Terminology proposed to measure what matters in health. Journal of clinical epidemiology 89: 119-124.

7. Dey, A. K., Wac, K., Ferreira, D., Tassini, K., Hong, J. H., & Ramos, J. (2011). Getting closer: An Empirical
Investigation Of The Proximity Of User To Their Smart Phones. In Proceedings of the ACM UBICOMP.
Smartphones
88%
of the time next to us

8. Wac, K. (2018). From Quantified Self to Quality of Life, Chapter in: Digital Health: Scaling
Healthcare to the World, Series: Health Informatics, Springer Nature, Dordrecht, the
Netherlands. Annotated wearables dataset https://doi.org/10.6084/m9.figshare.9702122
Even closer
438 wearables (2018)
Wearables
Emerging

9. Wac, K. (2018). From Quantified Self to Quality of Life, Chapter in: Digital Health: Scaling Healthcare to the World, Series: Health Informatics, Springer Nature, Dordrecht.
*-Reported Outcomes: A New Paradigm
Gold Standard Emerging
+

10. Research Problem: Co-Calibration
TechROs
Emerging
?
Gold Standard
PROs

11. Context

12. Context
Research Project
● AAL “Caregiver and ME” (CoME, No. 14-7)
○ 2015-2019
● For seniors with MCI and their caregivers
○ In Spain or Hungary, who can use a smartphone
Goals
● Relieve caregiver pressure by monitoring seniors
● Increase seniors’ wellbeing and autonomy
● Lower risk of developing dementia long-term
Livingston, G. et al. Dementia prevention, intervention, and care. The Lancet 390.10113 (2017): 2673-2734.

13. Study
Goal
● Co-calibrate patient-reported outcomes (PROs)
with tech-reported outcomes (TechROs)
Objectives
1. Demonstrate that co-calibration is feasible
2. Assess the data quality for our study in the wild
3. Inform the design of personalized studies

14. Method

15. Method: Measured Outcomes

16. Measured Outcomes
Profile (PROs)
● Filled during the first visit at the study site
● Updated along the duration of the project
Measures
● Age, gender, ethnicity, profession, education, cohabitants,
height, weight, blood pressure, cholesterol, smoking status,
alcohol status, medication, mild disease status, etc.

17. Measured Outcomes
Self-Reported Measures (PROs)
● Filled during subsequent group visits (3 waves)
○ (1) Mid 2018, (2) End 2018-Start 2019, (3) Mid 2019
Measures (Validated Scale)
1. Physical Activity (IPAQ)
2. Social Support (MSPSS)
3. Anxiety/Depression (GADS)
4. Mediterranean Diet (PREDIMED)
5. Nutrition (SelfMNA)
6. Memory (MFE)
7. Sleep Quality (PSQI)
8. Health-Related Quality of Life (EQ5D3L)

18. Devices (TechROs)
● Fitbit Charge 2 consumer wearable for ownership
Measures (Daily)
● Energy expenditure
● Steps
● Distance
● Sedentary duration
● Physical activity durations (light, moderate, vigorous)
● Sleep duration
● Heart rate
Measured Outcomes

19. Method: coQoL
PRO-TechRO Co-Calibration

20. Interval durations
7, 14, 21, 28, 60, 120 days
1.1
Step 3A
Select PRO variables
- item
- sub-score
- score
7
Step 3B
Select TechRO variables
absolute:
- median
relative:
- geometric mean
of composition
For each interval duration
Use a leeway between:
- PRO administration date, and
- TechRO interval end date
Allow maximum 1 alignment per wave
Obtain max. 1 alignment / duration / participant / wave / leeway
Step 2 Align in time
PRO-TechRO Alignment
Using a leeway of 0, 7, 14, 21, 28, 60, 90, 120 days
•
• • • • •
• • • •
6 4 ... 2 7
Health outcomes (scale) PRO
Behavioural markers (Fitbit) TechRO
Statistical Correlations
e.g., Spearman rS
0.75
7 1.1
2.1
...
6.2
...
4
...
5
...
Set of Pairs
PRO-TechRO Pair
7
1.1
Patterns of Correlations
TechRO j TechRO k
PRO i 0.75
0.55
Participants
Construct
PRO-TechRO
bivariate sets
Step 1A Compute
PRO scores
Step 1B Select TechRO
aggregations
Step 4 Inference
statistical hypothesis testing
Step 5 Patterns
from correlations to patterns
4
2 1 ... 1 3
5 6 3 1
Sub-score Numeric
score
Categorical
score
Sub-score Sub-score
Metrics for patterns
1. Count significant correlations 0.5+
- For all PROs and TechROs
2. Contours of significant correlations 0.8+
- For all PROs but only ordered TechROs
Overview of coQoL

21. Contours of Correlations Metric (Examples)

22. Results

23. Results: Participation

24. Signed Up
● N = 42 (age 69.8 ± 7.4)
Qualified
● N = 39 (age 70.0 ± 7.2)
○ At least one PRO or TechRO
○ 28 healthy, 11 with mild disease
Participants (PRO)

25. Results: Data Quality

26. Data Quality (TechRO): Days of Monitoring

27. Data Quality (TechRO): Data Summary
Total Compliance
● Mean 295 ± SD 238 days monitored
● 50% over 224 days monitored
● Healthy > mild disease (+58 days)
● Hungary > Spain (+446 days)
Intraday Compliance
● 89 ± 89 days with 23+ hours
● 50% over 49 days over 21 hours
● Healthy > mild disease (+4 ratio to total)
● Hungary > Spain (13 ratio to total)

28. Results: Physical Activity
Co-Calibrations (IPAQ - Fitbit)

29. Physical Activity (IPAQ): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ domestic moderate (8)
○ domestic+garden total (8)
○ garden moderate (7)
○ leisure moderate (7)
● Healthy participants
○ Domestic moderate (11)
○ Garden moderate (10)
● Participants with mild disease
○ Garden vigorous (12)
○ Leisure vigorous (12)
○ Work vigorous (11)
○ Work moderate (10)

30. Physical Activity (IPAQ): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● All participants
○ Domestic moderate
● Participants with mild disease
○ Work walking
○ Work moderate
○ Work vigorous
○ Garden vigorous
○ Leisure vigorous
○ Leisure total

31. Results: Social Support
Co-Calibrations (MSPSS - Fitbit)

32. Social Support (MSPSS): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Q8 family talks about problems (10)
○ Q11 family willing to help decide (10)
● Healthy participants
○ Q3 family tries to help (14)
○ Q6 friends try to help (14)
○ Q9 friends share (13)
○ Q10 significant other cares (12)
○ Q12 friends talk problems (13)
○ Friends score (12)

33. Social Support (MSPSS): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● All participants
○ Significant other social support
● Healthy participants
○ Significant other social support
● Participants with mild disease
○ Family social support
○ Friends social support
○ Overall social support

34. Results: Anxiety / Depression
Co-Calibrations (GADS - Fitbit)

35. Anxiety / Depression (GADS): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Q6D lost weight due to poor appetite (12)
○ Q8A worried own health (10)
○ Q1D lacking energy (10)
● Healthy participants
○ Q2D lost interest in things (12)
● Participants with mild disease
○ Q2A worrying a lot (11)

36. Anxiety / Depression (GADS): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● All participants
○ Q5A Sleeping poorly
● Healthy participants
○ Q7A Trembling

37. Results: Mediterranean Diet
Co-Calibrations (PREDIMED - Fitbit)

38. Mediterranean Diet (PREDIMED): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Categorical score (10)
○ Numeric score (9)
○ Q12 nuts use (7)
○ Q14 sofrito use (7)
● Healthy participants
○ Q4 fruits use (7)
○ Categorical score (6)

39. Mediterranean Diet (PREDIMED): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● All participants
○ Q12 Nuts consumption
● Healthy participants
○ Q3 Vegetables consumption

40. Results: Nutrition Co-Calibrations
(SelfMNA - Fitbit)

41. Nutrition (SelfMNA): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Categorical score (6)
● Healthy participants
○ Categorical score (5)
● Participants with mild disease
○ Q2 weight lost (7)
○ Q1 food intake declined (6)

42. Nutrition (SelfMNA): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● Participants with mild disease
○ Q1 Food intake declined
○ Q2 Weight loss
○ Q4 Stressed or severely ill

43. Results: Memory Co-Calibrations
(MFE - Fitbit)

44. Memory (MFE): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Q12 having difficulty new skills (11)
○ Q14 forget to do planned things (10)
○ Q6 forgetting time of events (9)
● Healthy participants
○ Q6 forgetting time of events (14)
○ Q15 forget details of done things (13)
○ Q12 having difficulty new skills (12)
○ Q14 forget to do planned things (12)
● Participants with mild disease
○ Q13 word on tip of the tongue (13)
○ Q25 getting lost in often place (12)

45. Memory (MFE): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● All participants
○ Q24 Forgetting where things are kept
● Healthy participants
○ Q14 Forgetting to do planned things
● Participants with mild disease
○ Q18 Forgetting to tell somebody
something important

46. Results: Sleep Quality Co-Calibrations
(PSQI - Fitbit)

47. Sleep Quality (PSQI): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Q7 trouble awake while ADL (14)
○ Q4 duration of actual sleep (11)
○ Daily dysfunction score (10)
● Healthy participants
○ Q4 duration of actual sleep (11)
○ Q5C trouble sleeping bathroom (10)
○ Q7 trouble awake while ADL (10)
○ Daily dysfunction score (9)
● Participants with mild disease
○ Daily dysfunction score (7)
○ Q6 duration of actual sleep (6)

48. Sleep Quality (PSQI): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● All participants
○ Q5F trouble due to feeling cold
● Healthy participants
○ Q5C trouble due to use of the bathroom
● Participants with mild disease
○ Q4 duration of actual sleep

49. Results: Quality of Life
Co-Calibrations (EQ-5D-3L - Fitbit)

50. Quality of Life (EQ5D3L): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Q6 health state today (8)
○ Q4 pain / discomfort (6)
● Healthy participants
○ Q4 pain / discomfort (7)
● Participants with mild disease
○ Q5 weight lost (5)

51. Quality of Life (EQ5D3L): Co-Calibrations
Notable PROs (contours of correlations 0.8+)
● Participants with mild disease
○ Q5 Anxiety and depression

52. Discussion

53. Effects of Longitudinal Measurement
Durations of Monitoring
● We reported strong correlations for
○ all TechRO durations (7-120 days)
○ all leeway durations (0-120 days)
Example: MSPSS Q3 vs Relative Fair Activity
● A strong PRO-TechRO correlation (0.9)
○ “More family help ~ more fair activity”
○ PRO: MSPSS Q3 family trying to help
○ TechRO: relative fair physical activity
● Effect of interval and leeway on corrs.
○ correlates the highest at 28 days
○ increasing leeway, decreasing corrs.

54. Towards a Holistic Assessment
Example: Participant 169
● 69-year old female from Hungary
○ Mild disease, university education, partner,
non-smoking, drinking alcohol daily (PRO)
● Diligent responder
○ Answered the questionnaires three times
○ Wore the Fitbit 794 days (141 valid)
● Outcomes coincide across waves
○ First wave (Summer 2018): base
○ Second wave (winter 2018/2019): worse
○ Third wave (Summer 2019): better
PROs TechROs

55. coQoL: Methodological Quantitative Approach
Feasibility of coQoL in Quantifying PRO-TechRO
● Groups of relationships between PRO and TechRO
● Data quality and its effects on the relationships above
● Holistic view across PROs and TechROs for an individual
Primary Study Limitation
● Small sample restricting analysis complexity
○ Only rank correlations without adjustments for multiple tests
○ Guidance for future studies that can discard trivial effects
Towards Personalized Medicine
● Wearable monitoring of TechRO daily life behaviours in time and context
○ When the TechRO behaviour changes, trigger specific PRO (e.g., ESM/EMA)

56. Co-calibrating Physical and Psychological Outcomes and
Consumer Wearable Activity Outcomes in Older Adults:
An Evaluation of the coQoL Method
Vlad Manea, Katarzyna Wac (2020). Co-Calibrating Physical and Psychological Outcomes and Consumer Wearable Activity Outcomes in
Older Adults: An Evaluation of the coQoL Method, MDPI Journal of Personalized Medicine, 2020 (impact factor 4.433, rank 10/102 (Q1)
Health Care Sciences and Services). Paper: https://doi.org/10.3390/jpm10040203 Slides: https://lnkd.in/erHCkAz

57. Poster

58. Interval durations
7, 14, 21, 28, 60, 120 days
1.1
Step 3A
Select PRO variables
- item
- sub-score
- score
7
Step 3B
Select TechRO variables
absolute:
- median
relative:
- geometric mean
of composition
For each interval duration
Use a leeway between:
- PRO administration date, and
- TechRO interval end date
Allow maximum 1 alignment per wave
Obtain max. 1 alignment / duration / participant / wave / leeway
Step 2 Align in time
PRO-TechRO Alignment
Using a leeway of 0, 7, 14, 21, 28, 60, 90, 120 days
•
• • • • •
• • • •
6 4 ... 2 7
Health outcomes (scale) PRO
Behavioural markers (Fitbit) TechRO
Statistical Correlations
e.g., Spearman rS
0.75
7 1.1
2.1
...
6.2
...
4
...
5
...
Set of Pairs
PRO-TechRO Pair
7
1.1
Patterns of Correlations
TechRO j TechRO k
PRO i 0.75
0.55
Participants
N = 39 (age 70.0 ± 7.2)
Construct
PRO-TechRO
bivariate sets
Step 1A Compute
PRO scores
Step 1B Select TechRO
aggregations
Step 4 Inference
statistical hypothesis testing
Step 5 Patterns
from correlations to patterns
4
2 1 ... 1 3
5 6 3 1
Sub-score Numeric
score
Categorical
score
Sub-score Sub-score
Co-calibrating Physical and Psychological Outcomes (PRO) and Consumer Wearable Activity
Outcomes (TechRO) in Older Adults: An Evaluation of the coQoL Method
Vlad Manea, Katarzyna Wac. Journal of Personalized Medicine 2020, 10(4), 203.
coQoL is a part of the
Quality of Life Technologies Lab
Data Science in the Service of Life Quality
qualityoflifetechnologies.com CoME AAL-2014-7-127
WellCo H2020-769765
Guardian AAL-2019-6-120-CP

59. Appendix

60. Method: coQoL for PRO - TechRO
Co-Calibration in Depth

61. coQoL: PRO-TechRO Co-Calibration (overview)
coQoL
Step 1A: Compute PRO scores
Step 1B: Select TechRO aggregations
Step 2: Align PROs and TechROs in time Step 3A: Select PRO variables
Step 3B: Select TechRO variables
Step 4: Construct pairwise PRO-TechRO sets
Step 5: Co-calibrate (via correlation)

62. coQoL Step 1/4: Computation and Aggregation
PRO computation
● Computed scores directly
TechRO aggregation
● Different monitoring intervals
○ 7, 14, 28, 60, 90, 120 days
● Inclusion criteria
○ Having 70%+ days with 21+ hours

63. coQoL Step 2/4: Alignments and Leeways
Alignments
● Pairwise PRO-TechRO variables
○ Using TechRO interval end date and PRO
administration date as criterion
○ Restricting to one answer per participant
per wave (the last wave)
Leeways
● Allow days before the alignment
○ 0, 7, 14, 28, 60, 90, 120
○ Accommodates missing data

64. coQoL Step 3/4: Variables
PRO Variables
● Variables: self-reported items and scores
TechRO Variables
● Absolute amount
○ Raw behavioural markers: energy, steps,
heart rate
○ Processed behavioural markers: durations
of sedentary, light, fair, vigorous, sleep
○ Variable: interval median
● Relative amount
○ Behavioural Markers: sedentary, light, fair,
vigorous, and sleep durations
○ Per-day compositions: centered log ratios
○ Variable: interval geometric mean

65. coQoL Step 4/4: Co-Calibration
Qualitative Assessment
● See differences in PROs / TechROs
○ Used profile items as differentiators
○ Used health status (healthy or mild disease),
gender, and country
Quantitative Assessment
● Correlate pairs of PRO-TechRO vars
○ We used Spearman (rS
) correlation
○ Significant at p < 0.05, no adjustment
○ We only want to see patterns
● Use pattern metrics
○ Number of correlations above 0.5
○ Contours of correlations above 0.8

66. Results: Data Quality

67. Data Quality (PRO): Raw Data
Waves of Answers
● First wave
○ Mid 2018
● Second wave
○ End 2018
○ Start 2019
● Third wave
○ Mid 2019

68. Data Quality (TechRO): Raw Data
Days Collected
● N = 32 both PROs and TechROs
● Hungary > Spain
○ 6 / top 10 were Hungarian
○ Most days: 3 Hungarians
○ Most valid days: one Hungarian
● Longitudinal and reliable data
○ One third had less than 30 days
○ Half had less than 60 days
○ One person had 90 days
○ One third had more than 120 days

69. Data Quality (TechRO): Data Summary
Raw Variables
● Energy: 295 ± 238 days
● Steps: 276 ± 236 days
● Heart rate: 230 ± 214 days
Processed Variables
● Sedentary duration: 219 ± 203 days
● Light duration: 219 ± 202 days
● Fair duration: 165 ± 171 days
● Vigorous duration: 160 ± 168 days
● Sleep duration: 198 ± 194 days

70. Results: Behavioural Markers

71. Behavioural Markers (TechRO): Data Summary
Raw Behavioural Markers
● Energy expenditure
○ 2013 ± 487 kcal / day
○ Mild disease > healthy (+100 kcal)
○ Hungary > Spain (+223 kcal)
○ Male > female (+783 kcal)
● Step count
○ 8084 ± 3205 steps / day
○ Healthy > mild disease (+556)
○ Spain > Hungary (+1013)
○ Male > female (+1992)
● Heart rate
○ 61 ± 7 bpm / day
○ Spain > Hungary (+5 bpm)
○ Female > male (+3 bpm)

72. Behavioural Markers (TechRO): Data Summary
Processed Behavioural Markers (1/2)
● Sedentary duration
○ 801 ± 192 min (~13 h) / day
○ Mild disease > healthy (+42 min)
○ Hungary > Spain (+88 min)
○ Male > female (+242 min)
● Light intensity duration
○ 213 ± 57 min (~3.5 h) / day
○ Healthy > mild disease (+20 min)
○ Spain > Hungary (+30 min)
○ Female > male (+20 min)
● Fair intensity duration
○ 21 ± 13 min / day
○ All group means 16-22 min

73. Behavioural Markers (TechRO): Data Summary
Processed Behavioural Markers (2/2)
● Vigorous intensity duration
○ 26 ± 21 min / day
○ All group means 19-28 min
○ Male > female (+10-15 min)
● Total active duration
○ 280 ± 68 min (4 h 40 min)
○ Spain > Hungary (+37 min)
● Sleep duration
○ 7 ± 1.6 h / day
○ Median 7 h 30 min / day
○ Healthy > mild disease (+18 min)

74. Results: Physical Activity (IPAQ)

75. Physical Activity (IPAQ): Raw Data
Scores
● Numeric scores
○ Weekly effort points using METs
○ Overall, per domain
● Categorical score
○ Low, moderate, or high
Answers
● 27 answers
Distribution
● 14: low activity
● 1: moderate activity
● 12: high activity

76. Physical Activity (IPAQ): Data Summary
Score
● Overall numeric score
○ Mean 9535 ± 7106
Comparisons
● Hungary > Spain
○ +457 overall
numeric score
● Male > female
○ +1658 overall
numeric score

77. Physical Activity (IPAQ): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Domestic moderate (8)
○ Domestic+garden total (8)
○ Garden moderate (7)
○ Leisure moderate (7)
● Healthy participants
○ Domestic moderate (11)
○ Garden moderate (10)
● Participants with mild disease
○ Garden vigorous (12)
○ Leisure vigorous (12)
○ Work vigorous (11)
○ Work moderate (10)

78. Results: Social Support (MSPSS)

79. Social Support (MSPSS): Raw Data
Scores
● Numeric scores
○ Overall, significant other, family, friends
○ 1 (no social support) to 7 (high)
● Categorical score
○ Low, moderate, or high
Answers
● 55 answers
Distribution
● Over half: moderate
● Under half: high

80. Social Support (MSPSS): Data Summary
Score
● Overall numeric score
○ Mean 5.36 ± 0.92
Comparisons
● Mild disease > healthy
○ 5.5 vs 5.3 overall score
○ 5.75 vs 5.51 significant other score
○ 5.62 vs 5.46 family score
○ 5.62 vs 5.38 friends score
● Female > male
○ 5.53 vs 5.16 overall score
○ 5.63 vs 5.52 significant other score
○ 5.66 vs 5.2 friends score

81. Social Support (MSPSS): Co-Calibrations
Notable PROs (# correlations 0.5 with TechROs)
● All participants
○ Q8 family talks about problems (10)
○ Q11 family willing to help decide (10)
● Healthy participants
○ Q3 family tries to help (14)
○ Q6 friends try to help (14)
○ Q9 friends share (13)
○ Q10 significant other cares (12)
○ Q12 friends talk problems (13)
○ Friends score (12)

82. Results: Anxiety / Depression (GADS)

83. Anxiety / Depression (GADS): Raw Data
Scores
● Numeric score
○ 0 (no) to 90 (severe)
● Categorical score
○ No, possible, mild, moderate, severe
Answers
● 34 answers
Distribution
● 10: no
● 12: possible
● 6: mild
● 4: moderate
● 2: severe

84. Anxiety / Depression (GADS): Data Summary
Score
● Numeric score
○ 20.79 ± 18.1
Comparisons
● Mild disease > healthy
○ 31 vs 15 mean numeric score
● Female > male
○ 23.75 vs 13.7 mean numeric score

85. Anxiety / Depression (GADS): Co-Calibrations
Notable PROs (# correlations with TechROs)
● All participants
○ Q6D lost weight due to poor appetite (12)
○ Q8A worried own health (10)
○ Q1D lacking energy (10)
● Healthy participants
○ Q2D lost interest in things (12)
● Participants with mild disease
○ Q2A worrying a lot (11)

86. Results: Mediterranean Diet
(PREDIMED)

87. Mediterranean Diet (PREDIMED): Raw Data
Scores
● Numeric score
○ 0 (none) to 14 (full adherence)
● Categorical score
○ no, medium, high adherence
Answers
● 23 answers
Distribution
● One third: no adherence
● Two thirds: medium adherence
● None has high adherence

88. Mediterranean Diet (PREDIMED): Data Summary
Score
● Numeric score
○ 7.0 ± 2.44
Comparisons
● Spain > Hungary
○ 8.81 vs 5.33 mean numeric score
○ Country coincides to the score
■ All Spanish: 7 or above
■ All but one Hungarian: 7 or below
■ All without adherence: Hungary
● Male > female
○ 7.37 vs 6.8 numeric score

89. Mediterranean Diet (PREDIMED): Co-Calibrations
Notable PROs (# correlations with TechROs)
● All participants
○ Categorical score (10)
○ Numeric score (9)
○ Q12 nuts use (7)
○ Q14 sofrito use (7)
● Healthy participants
○ Q4 fruits use (7)
○ Categorical score (6)

90. Results: Nutrition (SelfMNA)

91. Nutrition (SelfMNA): Raw Data
Scores
● Numeric score
○ 0 (malnutrition) to 14 (normal)
● Categorical score
○ normal, risk, malnutrition
Answers
● 24 answers
Distribution
● One third: maximum score
● Two-thirds: enough nutrition
● Remaining: at risk of malnutrition
● None is malnourished

92. Nutrition (SelfMNA): Data Summary
Score
● Numeric score
○ 12.2 ± 1.7
Comparisons
● Only small differences

93. Nutrition (SelfMNA): Co-Calibrations
Notable PROs (# correlations with TechROs)
● All participants
○ Categorical score (6)
● Healthy participants
○ Categorical score (5)
● Participants with mild disease
○ Q2 weight lost (7)
○ Q1 food intake declined (6)

94. Results: Memory (MFE)

95. Memory (MFE): Raw Data
Scores
● Numeric score
○ 0 (none) to 56 (potential)
● Categorical score
○ no failures, potential failures
Answers
● 36 answers
Distribution
● Two thirds: no memory failures
● One third: potential memory failures
○ Predominantly females from Spain

96. Memory (MFE): Data Summary
Score
● Numeric score
○ 8.77 ± 4.74
Comparisons
● Mild disease > healthy
○ 9.41 vs 8.45
numeric score

97. Memory (MFE): Co-Calibrations
Notable PROs (# correlations with TechROs)
● All participants
○ Q12 having difficulty new skills (11)
○ Q14 forget to do planned things (10)
○ Q6 forgetting time of events (9)
● Healthy participants
○ Q6 forgetting time of events (14)
○ Q15 forget details of done things (13)
○ Q12 having difficulty new skills (12)
○ Q14 forget to do planned things (12)
● Participants with mild disease
○ Q13 word on tip of the tongue (13)
○ Q25 getting lost in often place (12)

98. Results: Sleep Quality (PSQI)

99. Sleep Quality (PSQI): Raw Data
Scores
● Numeric scores
○ Overall, sleep quality properties
○ Overall: 0 (no issues) to 21 (issues)
● Categoric score
○ good or poor
Answers
● 32 answers
Distribution
● One third: good quality
● Two thirds: poor quality

100. Score
● Overall numeric score
○ 6.31 ± 3.93
Comparisons
● Healthy > mild disease
○ 5.0 vs 8.0
● Spain > Hungary
○ 5.47 vs 7.53
Sleep Quality (PSQI): Data Summary

101. Sleep Quality (PSQI): Co-Calibrations
Notable PROs (# correlations with TechROs)
● All participants
○ Q7 trouble awake while ADL (14)
○ Q4 duration of actual sleep (11)
○ Daily dysfunction score (10)
● Healthy participants
○ Q4 duration of actual sleep (11)
○ Q5C trouble sleeping bathroom (10)
○ Q7 trouble awake while ADL (10)
○ Daily dysfunction score (9)
● Participants with mild disease
○ Daily dysfunction score (7)
○ Q6 duration of actual sleep (6)

102. Results: Quality of Life (EQ-5D-3L)

103. Quality of Life (EQ5D3L): Raw Data
Scores
● Domain scores
○ 1 (low) to 3 (high)
● Health state today score
○ 1 (low) - 100 (high)
Answers
● 30 answers
Distribution
● One sixth: health state 40-75 / 100
● One third: health state 80-85 / 100
● One third: health state 90-99 / 100
● One sixth: health state 100 / 100

104. Quality of Life (EQ5D3L): Data Summary
Scores
● Domain scores
○ 1.16 ± 0.37 mobility
○ 1.00 ± 0.00 self-care
○ 1.13 ± 0.33 usual activities
○ 1.46 ± 0.56 pain / discomfort
○ 1.23 ± 0.42 anxiety / depression
● Health state today score
○ 84.96 ± 13.8
Comparisons
● Mild disease > healthy
○ Pain / discomfort
○ Anxiety / depression

105. Quality of Life (EQ5D3L): Co-Calibrations
Notable PROs (# correlations with TechROs)
● All participants
○ Q6 health state today (8)
○ Q4 pain / discomfort (6)
● Healthy participants
○ Q4 pain / discomfort (7)
● Participants with mild disease
○ Q5 weight lost (5)