QUANTIFIED SELF

Nesta Hot Topic May 2012, Duncan Graham-Rowe Introduction

Businesses regularly use their turnover, profit and other indicators to try to improve their performance, and governments track hospital waiting times, inflation and school exam results to gauge whether or not policy is turning into progress. So then why not use similar metrics to keep track of and improve our health? Thats the thinking behind the Quantified Self, Nestas Hot Topic for May 2012. A grassroots movement made up of an eclectic mix of technology evangelists, fitness fanatics and hackers with a healthy curiosity about their lives, their aim is simple - to improve their quality of life. By measuring and keeping a log of their daily diet, mood, how much alcohol they consume, sleep cycles, exercise and pretty much any personal metric relating to their physical or mental health, they hope to find ways to improve their wellbeing. Just as its possible to piece together a picture of someone from their supermarket purchases, credit card behaviour or Internet traffic, so too can this kind of self-tracking, personal informatics or self-hacking as it is also known, reveal a lot about a person. By mining this data and finding correlations within our daily patterns, sufferers of depression, asthma, insomnia and many other complaints, as well as those curious enough to delve deep into their daily behaviour, have found ways to improve their lives.

Early days
Inspired by the dictum you cant improve something until you can measure it, the whole Quantified Self movement was founded in 2007 when Wired journalists Gary Wolf and Kevin Kelly started a blog of the same name, which looked at the notion of marrying technology with self-improvement. In many ways this is no different from the way sports coaches try to improve the performance of their athletes by monitoring every detail about their nutrition and training. With the Quantified Self, however, what was different was the emergence of new enabling technologies and the power of the crowd. Wolf and Kelly were intrigued by what could be achieved through the combination of cheap, portable sensors, powerful mobile computing, data visualisation tools and social networking, and quickly others followed. Soon regular meetings were held in cities across the US. Today with thousands of members and conferences now held on both sides of the Atlantic it has become a global phenomenon.

Hot Topics is a series of Nesta events driven by ideas and technologies. They aim to introduce the technological tools that will change how we do things in the coming years, and are designed to bring together the best of business, academia, start-ups and investors. Find out more at: http://www.nesta.org.uk/ events/hot_topics

Making sense
But while the early vanguard may have resorted to using homemade sensors and walking around with wires trailing off their bodies, today that is no longer necessary. For although the Quantified Self has empowered people with the ability to treat own their ailments by changing their lifestyles in some way, it has also created opportunities for entrepreneurs and inventors to develop a range of new gadgets aimed at recording just about every details of our daily lives. And indeed through this new companies and technologies have been spawned. FitBit, for example, is a small motion sensor that is designed to be worn on your belt, which records how many steps you take, much like an accelerometer, except that it also records how many stairs youve climbed and any movement during sleep. It then uploads this data to a website where it can be analysed, allowing users to compare it with others. San Francisco-based Jawbone also has a motion tracker in the form of a wristband called Up, which wirelessly uploads your data to an iPhone app, allowing activity patterns to be built up and shared with others. Similarly a headband made by Zeo is also designed to record sleep patterns. Formerly known as Axon Labs the company was founded by a bunch of students at Brown University, in Rhode Island, who were so sleep deprived they invented a solution. Their headband contains sensors, which record the wearers electroencephalogram (EEG) brain activity during sleep, transmitting it to a nearby device. This programmable monitor not only allows the user to study how their sleep cycle is affected by environmental factors, such as how much light there is or the weather, but it also serves as an alarm clock that will only wake the user during their optimal phase of sleep, to ensure they always feel refreshed when they rise. Another monitor poised to hit the market is made by Basis in San Francisco. This wristwatch comes packed with sensors to record your movement, temperature, galvanic skin response (which is used to measure ones level of arousal) and heart rate. Although this is not the first heart rate monitoring watch Basis prides itself on the fact that it can do this without the need and inconvenience of also having to wear a chest strap. And convenience is what its all about. None of this information is particularly difficult to collect but anything that can collect it passively with a minimal amount of input from the user is not only going to collect more data but its going to build up a more faithful and objective picture of that person. One example of this is the Body Blogger, an online log charting the continuous heart rate of researcher Kiel Gilleade at Liverpool John Moores University. Normally the only times our hearts are monitored is when something goes wrong with them. But by monitoring his heart 24/7 Gilleade is finding ways links between his behaviour and his physiology and use this to change his behaviour for the better. But beyond measuring physiology the Quantified Self can also involve monitoring other aspects of our daily lives. Greengoose, another San Francisco start-up, has created a wireless motion sensor that is small enough to be attached to just about anything. From a toothbrush to your dogs collar or toilet lid, the sensors automatically upload their data to a mobile phone app enabling you to record when and how often you brush your teeth, walk the dog, or go use the toilet.

Jon Cousins, Moodscope.com

Crowd Power
But its not just about collecting data, its what you do with it that counts. There are now plenty of examples of Quantified Self enthusiasts cross referencing their sleep patterns with other metrics such as alcohol consumption and nutritional intake or activity to improve their wellbeing. However not everyone may feel capable of crunching the numbers and doing this kind of analysis. Thats where patient driven social networking websites like CureTogether come in. They are helping to empower patients by providing tools to allow people to compare data on more than 500 different chronic health complaints. By taking this crowdsourcing approach, sharing quantitative

data on symptoms and treatments, aggregating and analysing it, it becomes possible to reveal broad new trends, such as the discovery that vertigo sufferers were four times more likely to experience painful side-effects when taking a particular migraine treatment. While these kinds of studies lack the scientific rigour of formal clinical trials they have the advantage of more accurately representing sufferers because, unlike trials, they dont exclude patients who are on other medications or have additional complaints. Whats more the sheer scale of the data that Quantified Self enthusiasts collect on themselves is in itself a huge draw. As more increasing numbers of people share their data it is fast becoming a valuable resource in an age where Big Data crunching is seen as the next wave of innovation and discovery. Neither drug companies nor clinicians would ever be able to accrue the same amounts of data on patients. Indeed in 2008 another social networking health site called PatientsLikeMe developed a tool to follow patients who had already begun taking lithium to see if it slowed the progress of amyotrophic lateral sclerosis, or Lou Gehrigs disease, following a promising, but small scale trial reported by Italian scientists. It turned out that it didnt and these negative results were further backed up by larger and more rigorous clinical trials. Some companies, like Asthmapolis, are using both data collection devices and aggregation to get results. With the help of the Spiroscout, a small device that attaches to asthma inhalers, the Madison, Wisconsin, company has found a way to gather real-time data on where patients use their inhalers and how often. Equipped with a GPS receiver, the Spiroscout sends this data to Asthmapolis servers. How often a person uses their inhaler is not only an indication of how well their condition is managed, but it also provides valuable clues about environmental exposures that cause attacks. This information can then be fed back to patients via mobile apps, helping them to avoid respiratory hotspots, and it can help clinicians and public health officials gain a better understanding of the disease and its environmental triggers. Of course an important part of making this tick over is anonymity. From the patients perspective it allows them to share their experiences with fellow sufferers and respect their privacy, but it provides a means for companies like PatientsLikeMe to fund itself, selling off the anonymised data to pharmaceutical firms and other companies.

Adriana Lukas, London Quantified Self Group

Mind Games
But another crucial aspect of the Quantified Self is its gamification. This is the idea that games can be used to improve uptake by making the kinds of everyday activities involved in monitoring and improving health more fun and engaging, such as by awarding points and rewards for reaching certain targets. Boozerlyzer, an Android app, is one example of this. Although still only available as an early stage alpha software release, it is designed to use games to help users track and measure their alcohol consumption and the effect of this consumption on co-ordination, reaction times, memory and emotional state. So rather than giving users disapproving and ultimately off-putting messages about their lifestyles and habits, apps like Boozerlyzer try to take more of an agnostic position, letting the data speak for itself and allowing the user to draw their own conclusions. But the Quantified Self also has another altogether different kind of mind game going on. Given its nature it is impossible to know whether or not the placebo effect is at play; that is, whether people are feeling better because they are focusing on the activity by measuring it, and so more aware of their actions. However for advocates, often people who have seen major improvements, that hardly matters. And the fact is with companies like Philips, Vodafone and Intel sponsoring Quantified Self conferences, the big guns are clearly taking it very seriously too. In many respects for clinicians, public health officials and the medical and drug industries it is a dream come true: a plentiful source of rich medical data that is

generated by the public, and at its own cost. And as smartphone and wireless sensors technology make it more mainstream, attracting increasing numbers of users from the ranks of the walking well, control data will also start to build up, it is likely to secure a permanent role in the future of healthcare and medicine.

Speakers
Jon Cousins Founder, Moodscope.com With a background in advertising Jon Cousins is a social entrepreneur, founder of Moodscope and a founding member of the London Quantified Self group. Diagnosed with suspected bipolar disorder, Cousins was asked by his psychiatrist to keep a record of his mood for three months to help confirm the diagnosis. But rather than subjectively evaluating it every day, Cousins wanted to find a way of rating his mood objectively and so designed the system that he called Moodscope. Purely by chance he discovered that sharing his daily scores with a friend seemed to, in and of itself, elevate his mood. Following this personal success Cousins turned the tracking project into an enterprise, Moodscope, which now has more than 30,000 users and a database of nearly a million scores. It is being independently evaluated by Londons Institute of Psychiatry. Moodscope was voted the No 1 app in a recent Department of Health poll, and Moodscopers have written to say they believe that tracking and sharing their mood scores has stopped them committing suicide. Moodscope is one of 25 winners of the Big Venture Challenge, a national competition to identify the UKs most ambitious Adriana Lukas Co-founder, London Quantified Self Group Adriana Lukas is a leading figure in the UKs self-hacking community and cofounder of the London Quantified Self Group and the Mine! Project, an opensource project for online data and relationships logistics. A prominent blogger, Lukas also founded the Big Blog Company. Starting out as a political blogger on Samizdata.net, Lukas went on to found the Big Blog Company in early 2003. Since then she has advised companies in Europe and the US on how to make sense of the web and social media hype and if, and how, to use blogs, feeds, wikis, tags and social networks in their communications and beyond. Lukas currently also works on the Project VRM (Vendor Relationship Management) headed by Doc Searls, a fellow of Berkman Center. She blogs about media and business on Media Influencer. Kiel Gilleade Research Assistant, Liverpool John Moores University Kiel Gilleade is a research assistant in the School of Psychology at Liverpool John Moores University and creator and subject of the Body Blogger. He is a computer scientist working in the field of Physiological Computing, systems which use brain and body signals as an input control. His research background is in affective interface adaptation in interactive entertainment; he currently works on a range of physiological computing applications including adaptive experiences, self-tracking and middleware. In this presentation Kiel will be talking about the benefits and issues involved in long-term physiological tracking and data sharing on the Internet using the Body Blogger as a real-world case study. The Body Blogger was a physiological tracking project which involved the speaker recording his physiological data for over a year and disseminating it over the Internet in real-time.

Kiel Gilleade, Liverpool John Moores University

Attendees
Busayo Abidakun Participle Andrea Acevedo Participle Peter Adediran Pail Solicitors Carl Allen Steve Anston Anston Enterprises Louise Armstrong Forum for the Future Oli Ashness DFJ Esprit Douglas Atkinson London College of Fashion Ulrich Atz Quadrangle Vivienne Avery Age Uk Peter Baeck Innovation Unit Gemma Ball Portland Lisa Bamforth Virgin Care Haidee Bell Nesta Iban Benzal Muoz Raona Catherine Bithell Deena Blumenkrantz Imperial College London Anne Boden Anne Boden Associates Irina Bolychevsky Open Knowledge Foundation David Bovill OPN Technologies LLP Alan Boyles Uscreates Scott Brenman MEC Michelle Brook The Physiological Society Emily Brown David Brown Cushman & Wakefield Laura Bunt Nesta Ross Cairns The Workers Cheryl Campsie Forster Andrea Casalotti Jo Casebourne Nesta Alex Chan NHS PC Chan Joanna Choukeir Uscreates Panikos Christodoulou Economic development Lysa Clavenna Samsung Toby Coffey National Theatre Andrew Collinge Greater London Authority Annick Collins CCW, University of the Arts London Jon Cousins Moodscope Leonie Cumiskey Brand Advocate Stuart Curran ThoughtWorks Francesco Dorazio Face Linda Damerell Tapestry Innovation Ltd Jessica Daniels Map of Medicine Yolanda de los Bueis spyoy Inga Deakin Imperial Innovations James Dobree LevelBusiness Graham Dove City University London Kirsten Downie The Young Foundation Ian Dowson William Garrity Associates Ltd Farzana Dudhwala University of Cambridge Richard Dunn IAC Jess Eagar Virgin Care Sumi Ejiri London Sustainability Exchange Christopher Exeter Faculty of Medicine, Imperial College London Nic Fleming New Scientist Michael Forrest Good To Hear Ltd Deborah Fox Nesta Joanna Foy Forster Adrian Fry KAE Pete Gale Blue Latitude Edward Gardiner Warwick Business School Sarah Gill Nesta Kiel Gilleade Liverpool John Moores University Jon Goodbun Rheomode Amanda Gore Design Council Laura Grace Mint Digital Andrew Grant Satalia Felix Greaves Imperial College Jimmy Greer Brazilintel Gedi Grudzinskas LCC Azfar Haider ENIKKA Peter Harrison BrainJuicer Chris Hatherill super/collider Richard Heap Kingston Smith LLP Bruce Hellman uMotif Iain Henderson The Customers Voice Stephen Hignell Nordicity Chris Howroyd Design Council Kay Hutchison Belle Media Ltd Mia Iwama Hastings BVCA Corinna Jaensch Albion London MK Jaffer Marie James Channel 4 Elaine Jewell Wycombe District Council Peter Jordan Government Digital Service Kleomenis Katevas Queen Mary, University of London John Kenny Delta Partners Endaf Kerfoot Games for Brands Miriam Kingsley Map of Medicine Elina Kivinen Brook Lyndhurst Carla Lally Tony Langford Kinetica Museum Ltd Tommaso Lanza The Workers Peter Law Mother London Wendy Lee BEANii CIC Nicole Lentz Forster Dan Lockton WMG, University of Warwick / Brunel University Adriana Lukas London Quantified Self Elizabeth Lynch Elizabeth Lynch Projects Sinead MacManus 8fold: digital wellbeing company Sarah Macdonald BrainJuicer George MacKerron UCL CASA & LSE Hugh MacNaught Success Equity Ltd. Thomas Man The Royal Academy of Engineering Nic Marks Nic Marks Design

Obie Campbell
Participle

Christa Masbruch Turn2us Joe Mason Delta Partners Benita Matofska People Who Share Keiichi Matsuda Kerry McCarthy kclarity Anne Marie McEwan The Smart Work Company Ltd Danielle McMahon Australian Customs and Border Protection Service Ran Merkazy Samsung Electronics Kiki Michaelidou Sam Michel Chinwag Nathan Miller Face Mf Moline Marketing Evan Morgan Queen Mary University Jo Morrison Central Saint Martins Julie Moule NHS Frederik Neill Face Vivien Niblett Shared Intelligence Simon Nicol BRE Gavin OCarroll Digital Health Service Ellen ODonoghue Forster Kate OHagan Design Council Cabe Charles OMalley AccountAbility Mac Oosthuizen Participle/AJOTO

Jay Owens FACE Soner Ozenc RazorLAB Pedram Parasmand The Skills Lab Janet Parkinson The Smart Work Company Ankoor Patel FoodCycle Sumedha Pathak Rob Peach Reach UK Candice Pires BBC Ian Powling PowlingConsulting Rosi Prescott Central YMCA Nick Price of things immaterial Sian Prime Goldsmiths Anjali Ramachandran PHD Bill Ray Rodsit Andy Roberts Andy Roberts Lucy Roberts Yvonne Roberts The Observer Christopher Robertson Community Network Roz Robinson Sustain Wales Simon Rowell Ceadant Partners LLP Maria Salichou In Situ Cosmetics Pedro Sampaio Big Issue Invest Fee Schmidt-Soltau Freelance Tom Scott Big Issue Invest

Ali Shaw BrainJuicer Tim Shorten Re-Action Anoop Singh Finerday Kavita Singh Cushman & wakefield Rachel Sinha ICAEW/ The Finnance Innovation Lab Aphra Sklair Institute for Philanthropy Elizabeth Slade Map of Medicine Nick Smith Emot.io Paul Smith Ctrl-Shift Carl Smith Learning Technology Research Institute Graham Smith MyBnk Steve Souza Datameer Gail Spencer Cult Film Network Naomi Spurr UnitedHealth UK Steve Spyrou Burberry James Steiner PDD Stuart Stoter CBI Chris Stutz UCL Business Sharmila Subramanian Face Katrina Swanston TBFL Alex Talbott NHS London Paul Tanner Virtual Technologies

Ilana Taub ICAEW Yogesh Taylor Sitar Teli Doughty Hanson Technology Ventures Nicole Thomson NHS Alison Thomson Queen Mary, University of London Daniel Townsend Nigel Townsend Y Touring/ One KX Graham Tunnadine 3D4D Andreea Vrabie Brainjuicer Sophie Walker GDR Creative Intelligence Polly Walker Quod Matt Watkins Mudlark Nick Weldin Rix Centre Zee West iDreamr Robert Whitfield Envirostrat Jennie Winhall Participle Gareth Wong CXO Europe/Asia, GamBond William Wong 3become1 Jeremy Worrell Fujitsu Britt Wray OCAD University Colin Wren St Georges Healthcare NHS trust Michell Zappa Envisioning Technology

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May 2012