Blood transfusion is a frequently performed medical procedure in surgical and nonsurgical contexts. Although it is often necessary or even life-saving, it has been identified as one of the most overused procedures in hospitals. Unnecessary transfusions not only waste resources but can also be detrimental to patient outcomes. Patient blood management (PBM) is the clinical practice of optimizing transfusions and associated outcomes. In this paper, we introduce Sanguine, a visual analysis tool for transfusion data and related patient medical records. Sanguine was designed with two user groups in mind: PBM experts who oversee blood management practices across an institution and clinicians performing transfusions. PBM experts use Sanguine to explore and analyze transfusion practices and their associated medical outcomes. They can compare individual surgeons, or compare outcomes or time periods, such as before and after an intervention regarding transfusion practices. PBM experts then curate and annotate views for communication with clinicians, with the goal of improving their transfusion practices. We validate the utility and effectiveness of Sanguine through case studies.

Background: Neuromodulation therapies, such as deep brain stimulation (DBS), spinal cord stimulation (SCS), responsive neurostimulation (RNS), transcranial magnetic stimulation (TMS), transcranial direct stimulation (tDCS), and vagus nerve stimulation (VNS) are used to treat neurological and psychiatric conditions for patients who have failed to benefit from other treatment approaches. Although generally effective, seemingly similar cases often have very different levels of effectiveness. While there is ongoing interest in developing predictors, it can be difficult to aggregate the necessary data from limited cohorts of patients at individual treatment centers. Objective: In order to increase the predictive power in neuromodulation studies, we created an informatics platform called the International Neuromodulation Registry (INR). The INR platform has a data flow process that will allow researchers to pool data across multiple centers to enable population health research. Methods: This custom informatics platform has a Neo4j graph database and includes a harmonization process that allows data from different studies to be aggregated and compared. Users of the INR can download deidentified patient imaging, patient demographic data, device settings, and medical rating scales. The INR supports complex network analysis and patient timeline visualization. Results: The INR currently houses and allows visualization of deidentified imaging and clinical data from hundreds of patients with a wide range of diagnoses and neuromodulation therapies. Conclusion: Ultimately, we believe that widespread adoption of the INR platform will improve population health research in neuromodulation therapy.

Figure 1: The remains of maintenance art. Material scraps of the term chartjunk, all destined for the trash.