Visual exploration and cohort identification of acute patient histories aggregated from heterogeneous sources

How can we use information visualization to support retrospective, exploratory analysis of collections of histories for patients admitted to acute care? This paper describes a novel design for visual cohort identification and exploration. We have developed a tool that integrates multiple, heterogeneous clinical data sources and allows alignment, querying and abstraction in a common workbench. This paper presents results from two projects and a review of related work in the field of information visualization including both presentation and interactive navigation of the information. We have developed an interactive prototype and present the visualization aspect of this prototype and a brief demonstration of its use in a research project with a large cohort of patients. The prototype represents and reasons with patient events in different OWL-formalizations according to the perspective and use: One for integration and alignment of patient records and observations; Another for visual presentation of individual or cohort trajectories. Health researchers have successfully analyzed large cohorts (over 100,000 individuals) using the tool. We have also used the tool to produce interactive personal health time-lines (for more than 10,000 individuals) on the web. Utility, usability and effect have been tested extensively and the results so far are promising. We envision that clinicians who want to learn more about groups of patients and their treatment processes will find the tool valuable. In addition, we believe that the visualization can be useful to researchers looking at data to be statistically evaluated, in order to discover new hypotheses or get ideas for the best analysis strategies. Our main conclusion is that the tool is usable, but it can be challenging to use for large data sets.

[1]  Michael D. Maltz,et al.  Visualizing Lives: New Pathways for Analyzing Life Course Trajectories , 2000 .

[2]  Ben Shneiderman,et al.  A Visual Interface for Multivariate Temporal Data: Finding Patterns of Events across Multiple Histories , 2006, 2006 IEEE Symposium On Visual Analytics Science And Technology.

[3]  Michael S. Ambinder,et al.  Change blindness , 1997, Trends in Cognitive Sciences.

[4]  Vivian West,et al.  Innovative information visualization of electronic health record data: a systematic review , 2014, J. Am. Medical Informatics Assoc..

[5]  Ann Blandford,et al.  Making sense of personal health information: Challenges for information visualization , 2013, Health Informatics J..

[6]  Ben Shneiderman,et al.  Interactive Information Visualization to Explore and Query Electronic Health Records , 2013, Found. Trends Hum. Comput. Interact..

[7]  Ben Shneiderman,et al.  The eyes have it: a task by data type taxonomy for information visualizations , 1996, Proceedings 1996 IEEE Symposium on Visual Languages.

[8]  Luca Chittaro,et al.  Representation of temporal intervals and relations: information visualization aspects and their evaluation , 2001, Proceedings Eighth International Symposium on Temporal Representation and Reasoning. TIME 2001.

[9]  Rema Padman,et al.  Paving the COWpath: Learning and visualizing clinical pathways from electronic health record data , 2015, J. Biomed. Informatics.

[10]  Sourav S. Bhowmick,et al.  Fuse: towards multi-level functional summarization of protein interaction networks , 2011, BCB '11.

[11]  Ben Shneiderman,et al.  Designing the User Interface: Strategies for Effective Human-Computer Interaction , 1998 .

[12]  John Karat,et al.  Visualizing medical records with LifeLines , 1998, CHI Conference Summary.

[13]  Ben Shneiderman,et al.  LifeLines: visualizing personal histories , 1996, CHI.

[14]  Sourav S. Bhowmick,et al.  GBLENDER: towards blending visual query formulation and query processing in graph databases , 2010, SIGMOD Conference.

[15]  Stuart K. Card,et al.  Information foraging in information access environments , 1995, CHI '95.

[16]  Colin Ware,et al.  Information Visualization: Perception for Design , 2000 .

[17]  Ben Shneiderman,et al.  LifeLines: using visualization to enhance navigation and analysis of patient records , 1998, AMIA.

[18]  K H Englmeier,et al.  Visualization of Medical Data Based on EHR Standards , 2012, Methods of Information in Medicine.

[19]  Daniel T. Larose,et al.  Discovering Knowledge in Data: An Introduction to Data Mining , 2005 .

[20]  Håkon Dale Wågbø The Patient Perspective: Utilizing Information Visualization to Present Health Records to Patients , 2014 .

[21]  Ben Shneiderman,et al.  Towards event sequence representation, reasoning and visualization for EHR data , 2012, IHI '12.

[22]  Victoria Interrante,et al.  Fundamental issues of visual perception for effective image generation , 1999, SIGGRAPH 1999.