Vision for a systems architecture to integrate and transform population health

Digital dashboards visualizing public health data: a systematic review

Introduction

Public health is not only threatened by diseases, pandemics, or epidemics. It is also challenged by deficits in the communication of health information. The current COVID-19 pandemic demonstrates that impressively. One way to deliver scientific data such as epidemiological findings and forecasts on disease spread are dashboards. Considering the current relevance of dashboards for public risk and crisis communication, this systematic review examines the state of research on dashboards in the context of public health risks and diseases.

Method

Nine electronic databases where searched for peer-reviewed journal articles and conference proceedings. Included articles (n = 65) were screened and assessed by three independent reviewers. Through a methodological informed differentiation between descriptive studies and user studies, the review also assessed the quality of included user studies (n = 18) by use of the Mixed Methods Appraisal Tool (MMAT).

Results

65 articles were assessed in regards to the public health issues addressed by the respective dashboards, as well as the data sources, functions and information visualizations employed by the different dashboards. Furthermore, the literature review sheds light on public health challenges and objectives and analyzes the extent to which user needs play a role in the development and evaluation of a dashboard. Overall, the literature review shows that studies that do not only describe the construction of a specific dashboard, but also evaluate its content in terms of different risk communication models or constructs (e.g., risk perception or health literacy) are comparatively rare. Furthermore, while some of the studies evaluate usability and corresponding metrics from the perspective of potential users, many of the studies are limited to a purely functionalistic evaluation of the dashboard by the respective development teams.

Conclusion

The results suggest that applied research on public health intervention tools like dashboards would gain in complexity through a theory-based integration of user-specific risk information needs.

Systematic review registration

https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=200178, identifier: CRD42020200178.

Cancer Informatics for Cancer Centers (CI4CC): Building a Community Focused on Sharing Ideas and Best Practices to Improve Cancer Care and Patient Outcomes

Cancer Informatics for Cancer Centers (CI4CC) is a grassroots, nonprofit 501c3 organization intended to provide a focused national forum for engagement of senior cancer informatics leaders, primarily aimed at academic cancer centers anywhere in the world but with a special emphasis on the 70 National Cancer Institute-funded cancer centers. Although each of the participating cancer centers is structured differently, and leaders' titles vary, we know firsthand there are similarities in both the issues we face and the solutions we achieve. As a consortium, we have initiated a dedicated listserv, an open-initiatives program, and targeted biannual face-to-face meetings. These meetings are a place to review our priorities and initiatives, providing a forum for discussion of the strategic and pragmatic issues we, as informatics leaders, individually face at our respective institutions and cancer centers. Here we provide a brief history of the CI4CC organization and meeting highlights from the latest CI4CC meeting that took place in Napa, California from October 14-16, 2019. The focus of this meeting was "intersections between informatics, data science, and population science." We conclude with a discussion on "hot topics" on the horizon for cancer informatics.

Valuing Health: Evolution, Revolution, Resistance, and Reform

A number of methods have sought to determine the value of interventions and services that promote health, even when no agreement exists on the proper way to determine and define "value." Previous valuation efforts began simply by counting deaths or measuring life expectancy, slowly evolving to the widespread use of cost-effectiveness analysis (CEA) as the de facto normative standard for medical interventions. Users of CEA recognize that the method is incomplete. Further, no meaningful agreement exists on how best to apply CEA in decision settings because of either inadequacies in the CEA framework or lack of consensus on how to use it in a setting with budget constraints. Yet efforts to value health still predominantly use (and continue to recommend) this limited framework. Is this owing to a lack of new ideas and motivation, resistance to change, or an aversion to embrace more comprehensive systems approaches? We argue that tools of systems engineering can advance our capabilities, but they have had only limited use in health policy. We identify some reasons and specifically highlight the promise of systems-analytic platforms-such as multicriteria decision support systems-and the need to make them more accessible for different uses in real situations with real consequences. We also explore the need for comparative testing of different multicriteria approaches (including direct comparisons with CEA) to learn when and by how much the recommendations differ and what the consequences might be.