Influence of data display formats on physician investigators' decisions to stop clinical trials: prospective trial with repeated measures

Abstract

Objective To examine the effect of the method of data display on physician investigators' decisions to stop hypothetical clinical trials for an unplanned statistical analysis. Design Prospective, mixed model design with variables between subjects and within subjects (repeated measures). Setting Comprehensive cancer centre. Participants 34 physicians, stratified by academic rank, who were conducting clinical trials. Interventions Participants were shown tables, pie charts, bar graphs, and icon displays containing hypothetical data from a clinical trial and were asked to decide whether to continue the trial or stop for an unplanned statistical analysis. Main outcome measure Percentage of accurate decisions with each type of display. Results Accuracy of decisions was affected by the type of data display and positive or negative framing of the data. More correct decisions were made with icon displays than with tables, pie charts, and bar graphs (82% v 68%, 56%, and 43%, respectively; P = 0.03) and when data were negatively framed rather than positively framed in tables (93% v 47%; P = 0.004). Conclusions Clinical investigators' decisions can be affected by factors unrelated to the actual data. In the design of clinical trials information systems, careful consideration should be given to the method by which data are framed and displayed in order to reduce the impact of these extraneous factors.

Dashboards for improving patient care: Review of the literature

“…The way in which information is presented to individuals may also affect the decisions they make [23,24]. Nine of the eleven studies in this review presented information to clinicians using color coding based on a 'traffic light' alerting system, where red indicates a measure that requires action and green indicates that at present the indicator is 'normal' or that no action needs to be taken.…”

“…has been shown to impact on the accuracy of decisions taken by clinicians [24] . At a time when health care organizations are being encouraged to introduce dashboards in order to improve quality of care and patient safety, it is important to review the effect of quality and clinical dashboards on care processes and patient outcomes and to understand how variations in the design of dashboards impact their effectiveness.…”

Influencing visual judgment through affective priming

“…For example, a study by Elting et al [14] compared visualization formats for communicating clinical trial risk. In clinical trials, a significant difference in error can often mean a number of lives lost (or saved).…”

“…Specifically, we follow Cleveland and McGill's experiments which compare user accuracy with various position-length chart types (see Figure 1). We also extend their work by building on both recent crowdsourced graphical perception studies [16,20] and affective priming studies [14,27] to examine how emotion influences visual judgment [23].…”

Implied dynamics in information visualization

“…This can lead to odd descriptions of the data, such as, "The more male a person is, the taller he/she is." More seriously, Elting et al [5] found significant differences in the number of errors produced by physicians viewing the same clinical study data in several charts of different types and presentation styles. The design of data presentation in this case affects not only users' immediate perceptions, but also the decisions they make.…”