=Paper=
{{Paper
|id=Vol-2747/paper4
|storemode=property
|title=BookSense an Application for Mental Disorders Diagnosis: A Case Study for User Evaluation and Redesign
|pdfUrl=https://ceur-ws.org/Vol-2747/paper4.pdf
|volume=Vol-2747
|authors=Carlos Humberto Espino Salinas,Huizilopoztli Luna García,Carlos Eric Galván Tejada,Hamurabi Gamboa Rosales,Pablo César Rodríguez Aguayo,Jorge Issac Galván Tejada,José María Celaya Padilla,José G. Arceo Olague
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==BookSense an Application for Mental Disorders Diagnosis: A Case Study for User Evaluation and Redesign==
https://ceur-ws.org/Vol-2747/paper4.pdf
BookSense an Application for Mental Disorders
Diagnosis: A Case Study for User Evaluation
and Redesign
Carlos H. Espino-Salinas1[0000−0001−8092−1333] , Huizilopoztli
Luna-Garcı́a1[0000−0001−5714−7482] , Carlos E.
Galván-Tejada1[0000−0002−7635−4687] , Hamurabi
Gamboa-Rosales1[0000−0002−9498−6602] , Pablo C.
Rodrı́guez-Aguayo1[0000−0003−4724−9332] , Jorge I.
Galván-Tejada1[0000−0002−7555−5655] , José M.
Celaya-Padilla1[0000−0001−6847−3777] , and José G.
Arceo-Olaguea1[0000−0002−7240−8158]
1
Unidad Académica de Ingenierı́a Eléctrica, Universidad Autónoma de Zacatecas,
Jardı́n Juárez 147, Centro, Zacatecas 98000, Zac, México dantecore2@gmail.com
http://uaz.edu.mx
Abstract. Booksense, a mobile application that allows to identify men-
tal disorders such as depression, work stress and postraumatism [1],
through a series of questions based on a mental health assessment that
allows you to find out if you have a mental illness, the app can detect
if the user shows signs of a mental disorder, being the most important
to detect the problem from its stages initials, plus it also has a database
of institutions in the country where you can receive care. The World
Health Organization (WHO) estimates that there are currently 300 mil-
lion people on the planet who suffer from depression. This is why it is
important to have assisted diagnostic tools that help prevent this type
of affectations in the population, as well as keep informed. the people
about help centers. All this would not be possible if you do not count an
application that has three important aspects that are: Efficiency, effec-
tiveness and satisfaction aspects that are not present in this diagnostic
tool is why the importance of the use of usability evaluations. This re-
search aims to generate a redesign of this application based on it and
the Nielsen heuristic’s that fill the gaps and usability problems, using a
user-centered design methodology and concluding that applying the pro-
posed methodology in a mobile context it was possible to increase the
levels of efficiency, effectiveness and satisfaction in a way considerable.
Keywords: Depression· Heuristic · Usability evaluation · User centered
design · Mobile apps.
1 Introduction
Booksense is a software for mobile devices with information on mental disorders
and tests capable of giving an approximate diagnosis about whether a person
Copyright c 2020 for this paper by its authors. Use permitted under Creative Commons
License Attribution 4.0 International (CC BY 4.0).
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2 Carlos H. Espino Salinas et al.
suffers from a mental disorder [1], because this is important to perform evalua-
tions that allow a greater experience of usability in the systems, specifically for
this type of mobile applications, which today prove to be a very useful tool for
the prevention of mental disorders such as depression and that due to the deli-
cacy with which these conditions are treated it is essential to know how to offer a
usability experience in mobile systems for patients with this type of conditions.
It is necessary to establish the end user as the center of the entire product de-
velopment process. Within this context, a close relationship is established with
common users in order to evaluate the usability of a proposed redesign based
on Nielsen’s heuristics of this mobile application that diagnoses and displays in-
formation about mental disorder problems. There are different research projects
that have the user as their main point since a new trend in software develop-
ment has emerged, moving from desktop applications to those of web and mobile
environment, getting people with different physical and cognitive conditions to
enter and access to them, therefore, the level of quality of these programs must
be excellent, since there is a varied number of users with complex needs, abilities
and skills [2]. Jacob Nielsen considered the father of web usability defines the
term in consideration of information on the Internet as ”the quality attribute
that measures the ease of web interfaces” with this means that design is not
important or how great it looks your website, if it is complicated to use [3].This
research paper mainly addresses the 10 Nielsen heuristics or collections of pat-
terns that contemplate similar characteristics in mobile devices [4] applied to
the redesign of the Booksense.
It is important to consider the following three aspects of usability for all
types of software: More efficient to use: takes less time to complete a particular
task, Easier to learn: operations can be learned by observing the object, More
user satisfaction: meets user expectations.
ISO 9241 defines usability as ”the extent to which a product can be used by
specified users to achieve specified goals with effectiveness, efficiency, and satis-
faction in a specified context of use”[5] Abran et al. [6] consolidate the ISO 9241
[5], IOS 9126 [7], ISO 13407 [8]. This model defines usability as a combination
of effectiveness, efficiency, satisfaction, learnability, and security, along with a
recommended set of related measures. Every usability evaluation method has its
advantages and disadvantages. Some are difficult to apply, and others are depen-
dent on the measure’s opinions or instruments. In addition to these challenges,
mobile devices and applications change very quickly, and updated methods of
usability evaluation and measurement are required on an ongoing basis [9].
For this, it is necessary apply a series of metrics that allow to redesign the
different elements within the application, in this case the 10 Usability Heuristics
for User Interface Design of Nielsen 1. Visibility of system status 2. Match be-
tween system and the real world 3. User control and freedom 4. Consistency and
standards 5. Error prevention 6. Recognition rather than recall, 7. Flexibility
and efficiency of use 8. Aesthetic and minimalist design 9. Help users recognize,
diagnose, and recover from errors 10. Help and documentation. For later make a
usability evaluations where the main objective is validating the prototype gen-
2
A Case Study for User Evaluation and Redesign 3
erated from of redefinition of the Nielsen heuristics in a mobile context where
each aspect was implemented of these metrics, in order to know level of usability
compared to the study application (Booksense) and to conclude that there is a
considerable or not improvement.
2 Theoretical Fundament
Many studies have been involved in the area of health, proposing new ways to
improve people’s quality of life or expedite repetitive processes by proposing au-
tomated systems such as Doctor’s innovative clinic: An application of Artificial
Intelligence and Physiological Sensors which allows measuring five main physio-
logical parameters when entering a medical clinic, these physiological parameters
are weight, height, body temperature, pressure and heart rate, this allowed med-
ical staff to create a rapid diagnostic report and automate the administrative
process of the clinics also offering the patient greater comfort as it is a very
little invasive system [10]. Within the biomedical area there is also research that
focuses on improving the quality of life of people with disabilities as shown in
the article A Novel EOG/EEG Hybrid Human-Machine Interface Adopting Eye
Movements and ERPs: Application to Robot Control which offers people with
disabilities to perform housework through a humanoid robot with the sole act
of performing some kind of gesture with their eyes [11].
Having a good design is important for the development of a computer or tech-
nological system as presented in the article Integration of User Centered Design
in The Development of Health Monitoring System for Elderly focuses on how to
develop a simple system to use for the elderly and can monitor their health, the
health monitoring system is designed on three levels: personal medical device
layer, mobile application layer and remote central service layer. An apparatus
based on a chair for the acquisition of physiological signals was built and a mobile
application for data delivery and health management was developed [12].
On the other hand, there are also systems that help keep track of a dis-
ease such as diabetes is the case of mHealth Diabetes Self-Management which
allows the most independent management of patient health care [13]. mHealth
is, according to the WHO definition, the practice of medicine and public health
supported by devices such as telephones, patient monitoring devices, digital as-
sistants and other wireless devices [14].
To measure usability in mobile applications and obtain real results, it is
necessary to consider the context as an integral part of the application for this
it was necessary to perform the evaluations in a real environment with common
users regardless of their experience with the use of mobile applications since it
also there is a heuristic evaluation that is a widely accepted method to diagnose
usability problems in the user interface [15]. It can be done with a small group
of evaluators (3 to 5) and allows judging the degree of compliance with specific
usability principles [16][17].
It is clear that there are many systems that are in charge of health care
and that in a way for its use there is always the predisposition of the user, but
3
4 Carlos H. Espino Salinas et al.
that is not the case for people with a mental health problem for this exist some
applications that monitor physical and emotional well-being such as: Moodpath,
Youper, Wysa, etc. but that the lack of user-centered designs poses a great
challenge for this area due to the complexity of treating people with a mental
disorder.
3 Materials and Methods
The Booksense mobile application shown in Fig. 1 is an application developed
by Mexican students of the Center for Technological Scientific Studies (CECyT)
of the National Polytechnic Institute with information on mental disorders and
tests capable of giving an approximate diagnosis to know if you suffer any mental
disorder[1].
Fig. 1. Screenshots of the Mobile BookSense application for the diagnosis of mental
disorders
This application to be redesigned is in beta, so the contributions of this re-
search could help improve this system through a focus on UCD (User Centered
Design) that is defined as the active involvement of users for a clear understand-
ing of user and task requirements, iterative design and evaluation, and a multi-
disciplinary approach Fig. 2 shows the diagram used to represent UCD processes
[18]. and tools such as heuristics, taking into account the following methodology:
1) Evaluate the application testing different components that make it up to fi-
nally answer a series of questions that allowed know about its usability 2) Create
4
A Case Study for User Evaluation and Redesign 5
a prototype based on the study application and the implementing Nielsen guide-
lines 3) Evaluate the proposed prototype 4) present the results obtained from
the two evaluations. The users performed a series of tasks within the application
and the proposed prototype and then answered a questionnaire that, based on
the results, allows the creation of a comparative and justify a redesign.
Fig. 2. Diagram representing each of the parts that make up the user-centered design
scheme
3.1 Participants
The population of interest for this study were students and full-time office work-
ers with different characteristics as shown in Table 1 that presented useful an-
swers for usability evaluate, which in addition to not being familiar with the
application carried out the tasks assigned and considered the questions easy to
answer.
Table 1. 10 participants with different occupations performed usability tests. Sex
categories: female (F) and male (M).
Participant Age Sex Occupation
1 20 F Student of biology
2 29 M Engineer
3 30 F Accountant
4 20 M Psychology student
5 21 M Psychology student
6 20 F Psychology student
7 21 F Psychology student
8 38 M Accountant
9 37 F Accountant
10 29 F Accountant
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6 Carlos H. Espino Salinas et al.
3.2 Procedure
The tasks established here are those performed by participants for this research
work and are shown in Fig. 3 and are explained below: 1) Enter to the different
sections of the ENCYCLOPEDIA 2) Enter to the TEST section 3) Perform a
test of each of the disorders The information presented in the application
4) Enter the instructions of each of the tests provided by the application 5) Enter
the test results 6) Obtain test results 7) Exit the application. A mobile device
was provided with the Booksense application installed to perform the established
tasks, subsequently the proposed prototype was presented to the user to perform
the same established tasks and answer the assigned questionnaire.
Fig. 3. Flujograma of the tasks to be performed for the evaluation.
To measure the usability of the application and the prototype, a research
paper called Measuring Usability was used through questionnaires (Measuring
Usability with the USE Questionnaire) where USE means Usefulness, Satisfac-
tion y Ease of use It states that usability seems to consist of utility and ease, and
utility and ease of use are correlated. Each factor in turn drives user satisfaction
and frequency of use [19].
A brief questionnaire allow for significant comparisons between two products
and perhaps under different circumstances such as this research. The Question-
naires were constructed as Likert rating scales that are a format in which the
answers are scored in a range of 5-point values that users were asked to, ranging
from completely disagree to totally agree, dividing the questions in sets that
allow to determine the dimension of three main usability factors to be measured
which are: utility, ease of use, ease of learning and satisfaction, as shown in Table
2.
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A Case Study for User Evaluation and Redesign 7
Table 2. Questionnaire submitted to the user for the evaluation of the application
and the proposed prototype on a Likert scale from 1 to 5.
Utility No. Type of Response
Save time when I use it 1 Likert (1 = Disagree; 5 = Agree)
Satisfy my needs 2 Likert (1 = Disagree; 5 = Agree)
He does everything he expects me to do 3 Likert (1 = Disagree; 5 = Agree)
Easy to use No. Type of Response
I found it easy to use 4 Likert (1 = Disagree; 5 = Agree)
It requires the least steps 5 Likert (1 = Disagree; 5 = Agree)
It can be used without written instructions 6 Likert (1 = Disagree; 5 = Agree)
Learning facility No. Type of Response
I learned to use them quickly 7 Likert (1 = Disagree; 5 = Agree)
I easily remember how to use it 8 Likert (1 = Disagree; 5 = Agree)
I can quickly become skilled at using it 9 Likert (1 = Disagree; 5 = Agree)
Satisfaction No. Type of Response
I’m satisfied with that 10 Likert (1 = Disagree; 5 = Agree)
I would recommend it to a friend 11 Likert (1 = Disagree; 5 = Agree)
It works like I want it to work 12 Likert (1 = Disagree; 5 = Agree)
4 Results and Discussion
The context for performing the usability tests of this research it is important
to clarify that the application does not require a connection width of band,
nor is it focused on professionals who treat mental disorders, the context is
simple, the person who performs the evaluations is a common user who can
be highly experienced in the use of mobile technologies or not, mobility is not
a factor that already influences that the application does not use the internet
to work and finally users do not have previously diagnosed psychological status.
Additionally, objective evaluation metrics are not taken, such as: time
required, number of errors, time needed to learn, number of errors,
etc. If not rather subjective metrics that help give a more subjective
assessment of the usability of the Booksense application.
The surveys carried out presented the results obtained in the evaluation of the
application and the proposed prototype based on the Nielsen applied heuristics.
Fig. 4 shows the comparative graph of the score obtained, as you can see the
degree of usability of the prototype has a high index compared to the Booksense
application.
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8 Carlos H. Espino Salinas et al.
Fig. 4. Graph of result comparison obtained in usability evaluations carried out by
common users.
It is evident that applying Nielsen’s heuristics it was possible to
make a prototype that was able to verify the need to apply a redesign
of this application since usability in this type of projects is very important so
that it has the impact that the creator expects to have your product and thus
benefit the end user.
To have a clearer picture of the prototype made based on Nielsen’s heuristics,
it is important to specify where they were applied and how they differ from the
original application as shown in the Fig. 5 First a loading symbol was added for
each of the sections that kept the user informed about what happened in the
application between the change from one section to another, the following is to
show understandable information avoiding medical language that can confuse
the user, another added as part of the applied heuristics was to allow a complete
navigation from any part of the system providing freedom to move from the
beginning of a mental disorder test to the encyclopedia, on the other hand the
standardization of elements such as the buttons with which it will count, in the
fifth place, the application has the option of preventing the user from finishing
a test in case of wrongly answering a question by displaying a message ensuring
that the action to be carried out is actually intended to be completed, another
important element that offers added value to the usability of the application was
the implementation of an instruction in each of the sections that allowed the user
to remember what had to be done and how, the flexibility and efficiency that
was proposed to apply was to offer the possibility of choosing a configuration for
different types of users for example people with some mental disorder, people
with acquaintances who have some mental disorder, etc. It is a fact that all
the aforementioned elements are presented in a simple way, the heuristic nine is
8
A Case Study for User Evaluation and Redesign 9
applied in the questions section which facilitates returning to the beginning, to a
previous question recovering from errors and finally the necessary documentation
to know the details with which the application has.
Fig. 5. Captures of the proposed prototype based on Nielsen’s heuristics and study
application.
5 Conclusions
Many of the existing applications lack a methodology to analyze usability and
are released to the market or distribution platforms for free, which implies that
end users are not satisfied with the result, thus having very low satisfaction,
which, even if it complies with other important aspects such as efficiency and
effectiveness will reach the point of not being considered by the user to cover
any need or activity required. For this reason, we can conclude that using a well-
organized methodology that has as its central theme the involvement of the user,
turns out to be very effective when creating more friendly interfaces, increasing
certain aspects of usability, not to mention that applying certain metrics such
as heuristics of Nielsen that although they are based on a web context, they can
be migrated to a mobile one, offering considerable improvements such as those
showed by the results presented.
We very clear that there are other types of evaluations that can identify other
types of usability deficiencies and that thanks to these you can create mobile
software products that meet certain standards.
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10 Carlos H. Espino Salinas et al.
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