Presentation on theme: "AnamneVis: A Framework for the Visualization of Patient History and Medical Diagnostics Chains 1 Department of Computer Science 2 Department of Emergeny."— Presentation transcript:
AnamneVis: A Framework for the Visualization of Patient History and Medical Diagnostics Chains 1 Department of Computer Science 2 Department of Emergeny Medicine Zhiyuan Zhang 1, Faisal Ahmed 1, Arunesh Mittal 1, IV Ramakrishnan 1, Rong Zhao 1, Asa Viccellio 2, Klaus Mueller 1
Medical History - Anamnesis Includes patient demographics, problems, symptoms, diagnoses, progress notes, treatments, medication, vital signs, past medical history, immunizations, laboratory data, radiology reports, and many others. Should: accurately reflect the diseases/problems indicate the probable cause of disease
Electronic Medical Record (EMR) Full of documentation + tables Non-intuitive interfaces Fragmented display of patient information
Problems of Current EMR Acceptance of the EMR in clinical practice lags far behind its expectation and potential. Related information and overviews are difficult to obtain Severely impedes a physician’s diagnostic reasoning. Possible reason: Inefficient, fragmented display of patient information
Objectives Simple Interfaces to make data and information exploration easier Comprehensibly organizing the patient medical history from different sources Support and enhance the clinical decision-making Visualization and interaction are the key Provide a suitable visual mapping for each visual information. Ease of data and information access is the key AnamneVis – Visualization of Anamnesis
The 5-W Scheme Use a strongly structured paradigm, the 5-W WHO and WHAT : the patient and the history, in terms of symptoms, tests and results, diagnosis, treatments and medications, etc. ICD, ICD-procedure. WHERE : locations (when appropriate) of the WHAT on the human body WHEN, WHY and HOW : show a case under (doctor) collaborative diagnosis/treatment, or an entire life span. It demonstrates for each node what, when, why, and how that node appears.
Identify the Five W’s : Information Extraction Input: Medical reports Doctor-patient dialogs and other interactive inputs Results from triage, and data acquired from the patient, such as radiological images, lab analyses... NLP (Natural Language Processing) engine (cTake) + online medical ontology server(SNOMED) Extract structured information and relationships. Formats the extraction results into the Five W model Passes it on to the visualization engine.
Visual Encoding of 5-W’s Two cooperating displays: A hierarchical radial (patient overview) display with an integrated body outline primarily for the who and where. A sequential (diagnostic reasoning) display primarily for the when, why, and how.
Visual Encoding of 5-W’s Two cooperating displays: A hierarchical radial (patient overview) display with an integrated body outline primarily for the who and where. A sequential (diagnostic reasoning) display primarily for the when, why, and how. The what is part of both displays In form of the various nodes Context-sensitive. The two interfaces are linked operations on either view will be reflected in the other.
Hierarchical Radial Display – Data Model Data Model: Tree data structure to store the code hierarchy information. Insert each incident into the tree Node structure:
Hierarchical Radial Display – Visual Design Tree Visualization. Node+Edge Hard to show additional info. for each node and integrate body map
Hierarchical Radial Display – Visual Design Tree Visualization. Space filling: Circle Pack: Size grows very fast. Icicle: Not fully utilize space; Difficult to integrate body map
Hierarchical Radial Display – Visual Design We use the sunburst visualization paradigm. Space-filling diagram. Fully utilize the space. Easy to integrate with a body map.
Hierarchical Display Examples Hierarchy-centric Node is sized by how many sub-categories it has Focus more on the hierarchical information of the medical codes Serve as an illustration of the complexity of a sub-system and its composition
Hierarchical Display Examples Patient-centric More radial space is dedicated for diagnoses/procedures the patient had activities in. Other nodes will be collapsed to save space for others
Hierarchical Display Examples Three predefined code hierarchies to support multi-scale visualization. Level 1: the highest code hierarchy level. Level 2: more detailed categories. Level 3: incident nodes (symptoms/procedures/diagnosis that the patient has activities in. ) Help users quickly explore these three levels. Users can expand and collapse the nodes interactively by their expertise.
Typical Diagnostic Information Flow Patient visits physician Obtain patient’s information Physical examination Order laboratory data Request and obtain consultation Make diagnosis Give treatments A sequential display can show these reasoning chains very well.
Sequential (Causal) Display Demonstrate the what, when, why and how information. The medical records are organized by an underlying graph data structure. Each node corresponds to one incident (medical primitive), which could be a doctor visit, symptom, test/data, diagnosis or treatment. Edges represent relationships.
Visual Design A node is displayed as one elongated box Better utilizes the rectangular screen Better fits the text Better scalability Edges represent relationships. Edge bundling is used to reduce cluttering. Back edges May be due to treatments causing new symptoms, or treatments constituting doctor referrals. Shown in different color (red) to make them easy to see. Diagnosis
Conclusions Implemented a preliminary framework for clinical visual analytics For clinical scenarios Patient-focused Unifies all EMR information fragments into a single interactive visual framework
Current/Future Work Improvements, fine-tuning, and additional features Include more formal user and affordance studies Potentially used by coding personnel who work in the hospital billing office to translate medical records to ICD code. -Better recognize relationships in medical services. -Perform more accurate billing statements. Treatment Outcome Google body browser Integrate with current EMR system.