Data visualization in cancer control

Data Visualization in Cancer Control

Bradford W. Hesse, PhDChief, Health Communication & Informatics ResearchNational Cancer Institute

In 2005, 61.6% (+/- 1.6) of Americans thought of cancer as a death sentence.

Is it?

In 2015, news outlets reported that cancer is “just bad luck.”

Is that right?

What do the Data Say? What researchers found:

Correlation between • Type of cell (frequent / infrequent

division) &• Life time risk (not luck vs. cause)

“It’s like ... traffic patterns. There is a tight correlation between the number

of cars on the roads and the number of accidents, but that doesn’t mean that it’s

pure bad luck if you have an accident.

Bad luck is not scientific: Many cases can be prevented”

Age-Adjusted Mortality: Trend

Unpacking Trend: Males

public health control of h-pylori

public health control of tobacco

early detection, better treatment

Unpacking Trend: Females

public health control of h-pylori

public health control of tobacco

early detection, better treatment

224,210

preventable,

371,040

detectable, treatable

604,040


836,710


Just a 1% reduction would save $400 billion

Confusion Can Cost LivesPhilip Morris CEO, 1971

Confusion Can Cost Lives

“Selling Scientific Doubt”

Tobacco Lobby Document found through Discovery


Do vaccines cause autism?



“One in four people in the United States—nearly 80 million—are infected with at least one type of

human papillomavirus (HPV)”


Decision Paralysis

Anxiety

Confusion

Impulsivity

Frustration, Anger


Poorly DesignedData Displays

Making Data Talk

Inform Support Decisions

Educate Persuade

Nelson, Hesse, Croyle, 2009

Knowledge in the Head*

Knowledge in The World*

Task Relevant Schemata

General model

Chapter 4: Visual Displays

SOURCE: http://alleydog.com/topics/sensation_and_perception.php

Perceptual Basics

http://alleydog.com/topics/sensation_and_perception.php

source: Carpenter PA, Shah P. A model of the perceptual and conceptual processes in graph comprehension. J Educ Psychol. 1999, 91(4): 690-702.

• Constructive process

• Gaze goes to center for pattern

• Contiguous labels for meaning

• Left to right tendency in western culture

• Perceptual rules guide meaning

Cognitive / Perceptual Research

source: Carpenter PA, Shah P. A model of the perceptual and conceptual processes in graph comprehension. J Educ Psychol. 1999, 91(4): 690-702.






Visualizing Long Term Change






Hans Rosling, BBC

Visualizing Change Dynamically

Monitoring for Change in EHR Systems

Aging In Place, IntelRule of Thumb* for “Big Data” Systems

• Overview

• Zoom / filter

• Details on demand

*Ben Shneiderman

Overcome “small numbers” bias

Exceptional Case

Fallacy of small numbers;Tversky & Kahneman, 1971

Illnesses322,000,000

Hospitalizations21,000,000

Prevented

Deaths732,000

See: Fagerlin, A., Ubel, P. A., Smith, D. M., & Zikmund-Fisher, B. J. (2007). Making numbers matter: present and future research in risk communication. Am J Health Behav, 31 Suppl 1, S47-56.

Icon arrays designed to convey natural frequencies

Portraying trends to policy makersChoropleth Maps: CDC Obesity Trends, BRFSS 1985

Nonsegmented geographic data

Isopleth “Weather Maps,” HINTS

Juxtaposing geographic distributionsFor Example: Knowledge Maps (HINTS): Does Smoking Cause Cancer?

Juxtaposing geographic distributions

Mortality Maps (SEER): Lung Cancer Mortality

For Example: Knowledge Maps (HINTS): Does Smoking Cause Cancer?

Added User Controls 14 datasets spanning 6 years

NSF, NIH Collaboration

Disolving Barriers Between Clinical and Community Health

source: Hesse, Bradford W. (2007). Public Health Informatics. In M. C. Gibbons (Ed.), eHealth Solutions for Healthcare Disparities (pp. 109-129). New York, NY: Springer.

Why is this Important?

National Committee on Vital and Health Statistics, 2001

The Case of Hugo Campos*

* see: http://tedxtalks.ted.com/video/TEDxCambridge-Hugo-Campos-fight

http://tedxtalks.ted.com/video/TEDxCambridge-Hugo-Campos-fight







Self-DeterminationAutonomyMasteryConnectedness

source: Hesse, B. W. (2008). Enhancing Consumer Involvement in Health Care. Health Communication in the New Media Landscape. J. C. Parker and E. Thornson. New York, NY, Springer Publishing Company: 119-149.

AutonomyMasteryConnectedness

Self-Determination


AutonomyMasteryConnectedness

Self-Determination


Connecting Home and Office

Jim Cleary, David GustafsonU of Wisconsin

Coordinating Multiple Input Streams

Hospital Based EHR Data

Hospital Based EHR Data

Health Information Exchange

MedicalTeam

Patient &

FamilyHospital System

DecisionSupportNeeds

Subjective• Chief complaint• Patient Reported Outcomes

• Risk modeling• Diagnostic support • Treatment selection • Guideline adherence• Error detection/correction

Medical Researcher

• Situational awareness• Population health• Continuity of care• Identify side effects• Inform discovery

Objective• Clinical measures• Laboratory findings • Sensor data

Assessment• Diagnosis• Categorical reporting• Prognosis

Plan• Treatment planning• Self-care planning• Post treatment• Surveillance

source: Hesse, B. W. (2015). Decisional Architectures. Handbook of Health Decision Science. M. A. Dieffenbach, S. M. Miller and D. Bowen. New York, NY, Springer Verlag.

Ubiquitous Access to Patient Data

Exploring Data Over Timeand Over Patients

UMD Lifelines

• Manage populations, not just individuals

• Consider upstream causes, prevention

• Form interdisciplinary teams

Where are we going?

Na#onal Cancer Ins#tute

Precision Medicine Initiative

Big Data

Big DataKnowledge

Big Data &Action

Knowledge

“We are only going to succeed

if we work closely together -‐-‐

between those with biological

sophis9ca9on and those with

computa9onal sophis9ca9on”

Dr. Francis S. CollinsDirector, Na9onal Ins9tutes of HealthOct. 23, 2011

American Medical Informa9cs Associa9on, Keynote Address 2011

http://en.wikipedia.org/wiki/File:Francis_Collins_official_portrait.jpg

Data & Analytics

Data visualization in cancer control