Work

Evaluation and redesign of longitudinal patient-reported outcome score visualizations for improved trend interpretability: A randomized experimental study

Year: 2026

Type: article

Abstract: Objectives Design and test an alternative visualization of Patient-Reported Outcomes Measurement Information System (PROMIS) scores to improve visualization efficacy by addressing common confusion surrounding the direction of improvement when reading line charts of PROMIS symptom scores over time. Materials and Methods We designed a "smiley"-timeline visualization that encodes scores via color and pictographs instead of y-axis direction. We compared trend interpretation when using smiley-timelines vs. line charts via a preregistered, online, randomized, between-subjects experiment with pair-wise comparisons of charts. Participants were recruited via Prolific.com, fluent in English, over age 45, and able to interpret stimuli correctly without initial instruction, allowing for analysis of differences in response times without explicit instruction or learning time confounding results. Results We analyzed 383 participant responses. Color-encoded line charts in which "up" indicated improvement in symptoms and function resulted in the quickest response times. Smiley-timeline response times were second-fastest and not significantly slower. Color-encoded line charts resulted in faster response times than their grayscale counterparts. Smiley-timelines ranked significantly higher than line charts in ease of use, intuitiveness, perceived speed to use, and likelihood of being recommended. Conclusion Color encoding and pictographic timelines may address confusion stemming from longitudinal symptom score line charts. We provide evidence that smiley-timelines are more intuitive than line charts and may be a viable depiction of PROMIS scores. Additional user testing is necessary to determine performance when increasing the number of scores per chart and the number of charts shown. Impact Statement Our research advances the viability of PRO score use by addressing a pervasive problem with interpretability of PRO symptom scores by assessing the comparative effectiveness of an alternate visualization method, a new color-encoded smiley-timeline. The results inform concrete design decisions that can make PROMIS information, and potentially other PRO scores, easier for clinicians and patients to understand and use.

Source: Advances in Patient-Reported Outcomes

DOI: 10.1016/j.apro.2026.100333

Authors: Racquel Fygenson, Enrico Bertini, Heather T. Gold

Institutions: Northeastern University, New York University

Language: English

Topic: Data Visualization and Analytics

Subfield: Computer Vision and Pattern Recognition

Field: Computer Science

Domain: Physical Sciences

SDG: Good health and well-being

Open Access status: hybrid

Estimated APC paid: $2,400