Title
Visual analogies, not graphs, increase patients' comprehension of changes in their health status.
Abstract
Objectives: Patients increasingly use patient-reported outcomes (PROs) to self-monitor their health status. Visualizing PROs longitudinally (over time) could help patients interpret and contextualize their PROs. The study sought to assess hospitalized patients' objective comprehension (primary outcome) of text-only, non-graph, and graph visualizations that display longitudinal PROs. Materials and Methods: We conducted a clinical research study in 40 hospitalized patients comparing 4 visualization conditions: (1) text-only, (2) text plus visual analogy, (3) text plus number line, and (4) text plus line graph. Each participant viewed every condition, and we used counterbalancing (systematic randomization) to control for potential order effects. We assessed objective comprehension using the International Organization for Standardization protocol. Secondary outcomes included response times, preferences, risk perceptions, and behavioral intentions. Results: Overall, 63% correctly comprehended the text-only condition and 60% comprehended the line graph condition, compared with 83% for the visual analogy and 70% for the number line (P=.05) conditions. Participants comprehended the visual analogy significantly better than the text-only (P=.02) and line graph (P=.02) conditions. Of participants who comprehended at least 1 condition, 14% preferred a condition that they did not comprehend. Low comprehension was associated with worse cognition (P<.001), lower education level (P=.02), and fewer financial resources (P=.03). Conclusions: The results support using visual analogies rather than text to display longitudinal PROs but caution against relying on graphs, which is consistent with the known high prevalence of inadequate graph literacy. The discrepancies between comprehension and preferences suggest factors other than comprehension influence preferences, and that future researchers should assess comprehension rather than preferences to guide presentation decisions.
Year
DOI
Venue
2020
10.1093/jamia/ocz217
JOURNAL OF THE AMERICAN MEDICAL INFORMATICS ASSOCIATION
Keywords
DocType
Volume
data visualization,consumer health informatics,human-computer interaction,patient-reported outcome measures,health communication
Journal
27
Issue
ISSN
Citations 
5
1067-5027
1
PageRank 
References 
Authors
0.37
0
6