A Picture is Worth a Thousand Tables

pp 391-413


Using Exploratory Visualization in the Analysis of Medical Product Safety in Observational Healthcare Data

  • Patrick RyanAffiliated withEpidemiology Analytics, Janssen Research and Development Email author 

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Increasing the knowledge about the safety of medical products remains a top priority throughout the pharmaceutical development life cycle and particularly after regulatory approval when the products are used in real-world populations. The increasing availability and use of observational healthcare data, such as administrative claims and electronic health records, provides opportunity for generating ­better information to support therapeutic decision-making. Analysis of observational databases is quite different from randomized clinical trials, and offers unique opportunities for exploratory visualization to complement traditional epidemiologic investigations. The Observational Medical Outcomes Partnership was established to conduct methodological research on the appropriate use of observational data to identify and evaluate the effects of medical products in the real world. Several visualization tools were developed throughout the process, which demonstrate the value in combining standardized analytics with interactive graphics. These tools include a patient profile to study longitudinal patterns within clinical observations for a given person; a cohort profile to evaluate collections of patients; a treemap to assess ­disease prevalence across a database; a trellis scatterplot to investigate subgroup differences in drug utilization; a heatmap to support evaluation of high-dimensional confounding adjustment; and a multi-method forest plot to enable sensitivity analyses of estimated effects of drug and outcomes. This chapter illustrates these visualizations through a case study exploring the relationship between ACE inhibitor exposure and the subsequent health event angioedema.