SOMTimeS: Self Organizing Maps for Time Series Clustering and its Application to Serious Illness Conversations

There is an increasing demand for scalable algorithms capable of clustering and analyzing large time series datasets. The Kohonen self-organizing map (SOM) is a type of unsupervised artificial neural network for visualizing and clustering complex data, reducing the dimensionality of data, and selecting influential features. Like all clustering methods, the SOM requires a measure of similarity between input data (in this work time series). Dynamic time warping (DTW) is one such measure, and a top performer given that it accommodates the distortions when aligning time series. Despite its use in clustering, DTW is limited in practice because it is quadratic in runtime complexity with the length of the time series data. To address this, we present a new DTW-based clustering method, called SOMTimeS (a Self-Organizing Map for TIME Series), that scales better and runs faster than other DTW-based clustering algorithms, and has similar performance accuracy. The computational performance of SOMTimeS stems from its ability to prune unnecessary DTW computations during the SOM's training phase. We also implemented a similar pruning strategy for K-means for comparison with one of the top performing clustering algorithms. We evaluated the pruning effectiveness, accuracy, execution time and scalability on 112 benchmark time series datasets from the University of California, Riverside classification archive. We showed that for similar accuracy, the speed-up achieved for SOMTimeS and K-means was 1.8x on average; however, rates varied between 1x and 18x depending on the dataset. SOMTimeS and K-means pruned 43% and 50% of the total DTW computations, respectively. We applied SOMtimeS to natural language conversation data collected as part of a large healthcare cohort study of patient-clinician serious illness conversations to demonstrate the algorithm's utility with complex, temporally sequenced phenomena.

A General Model of Conversational Dynamics and an Example Application in Serious Illness Communication

Conversation has been a primary means for the exchange of information since ancient times. Understanding patterns of information flow in conversations is a critical step in assessing and improving communication quality. In this paper, we describe COnversational DYnamics Model (CODYM) analysis, a novel approach for studying patterns of information flow in conversations. CODYMs are Markov Models that capture sequential dependencies in the lengths of speaker turns. The proposed method is automated and scalable, and preserves the privacy of the conversational participants. The primary function of CODYM analysis is to quantify and visualize patterns of information flow, concisely summarized over sequential turns from one or more conversations. Our approach is general and complements existing methods, providing a new tool for use in the analysis of any type of conversation. As an important first application, we demonstrate the model on transcribed conversations between palliative care clinicians and seriously ill patients. These conversations are dynamic and complex, taking place amidst heavy emotions, and include difficult topics such as end-of-life preferences and patient values. We perform a versatile set of CODYM analyses that (a) establish the validity of the model by confirming known patterns of conversational turn-taking and word usage, (b) identify normative patterns of information flow in serious illness conversations, and (c) show how these patterns vary across narrative time and differ under expressions of anger, fear and sadness. Potential applications of CODYMs range from assessment and training of effective healthcare communication to comparing conversational dynamics across language and culture, with the prospect of identifying universal similarities and unique "fingerprints" of information flow.