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The value of visual aids in clinical assessments is underscored by a recent study conducted at the University of Missouri, which investigates how different graph formats can influence doctors’ evaluations of patients’ blood pressure.
Blood pressure can vary significantly in short periods and from one day to the next, complicating doctors’ ability to ascertain whether it falls within a healthy range. The phenomenon known as white coat hypertension, in which patients exhibit elevated blood pressure readings in a clinical setting but have normal levels at home, raises further challenges. According to Victoria Shaffer, a psychology professor and the study’s lead author, it is estimated that between 10% and 20% of high blood pressure diagnoses may actually be cases of white coat hypertension.
In this study, Shaffer and her colleagues presented 57 physicians with hypothetical blood pressure data using two distinct graph types. One graph displayed the raw data, revealing fluctuations, while the other featured a newly designed smoothed graph that averaged those variations.
Notably, when patients maintained controlled blood pressure despite significant fluctuations, doctors were able to make more accurate health assessments with the smoothed graph compared to the traditional raw data visualization. Shaffer noted, “Raw data can be visually noisy and difficult to interpret, making it easy to focus on extremes rather than the overall picture. Patients and their doctors primarily want confirmation that blood pressure is under control, and the smoothed graph serves as a helpful tool to expedite that determination.”
This study serves as a precursor to ongoing research that Shaffer is conducting with Richelle Koopman from the School of Medicine. Their collaboration, which also includes partnerships with Vanderbilt University and Oregon Health & Science University, aims to investigate the potential for these smoothed graphs to be utilized by patients monitoring their blood pressure at home. The research team is focused on integrating this technology with HIPAA-compliant electronic health records accessible to both patients and their healthcare providers.
Such advancements could reduce the burden on the healthcare system by minimizing unnecessary in-person visits for patients whose blood pressure is stable, while also decreasing the likelihood of false positives that could result in over-treatment.
Shaffer pointed out that some patients may be subjected to excessive blood pressure medication, which can cause adverse effects such as dizziness and a lower heart rate, particularly affecting older adults who are more susceptible to falls. She emphasized, “This initiative could help discern those patients who are being over-treated.”
For Shaffer, the findings align with well-established psychological principles. “Our inherent biases shape our judgments and decisions,” she explained. “As humans, we are naturally inclined to focus on extreme examples, perceiving them as threats—a tendency that affects both patients and healthcare providers alike.”
With the rising trend of health informatics and smart wearable devices that monitor vital signs, the application of smoothed graphing techniques could extend to various other health metrics in the future.
As Shaffer articulated, “We now possess unprecedented access to health data, yet the challenge lies in utilizing this information constructively without overwhelming individuals. Enhanced visualization tools can provide essential context regarding health information and empower people to take necessary action.”
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