Visualizing the Timeline of Care: Development of a Graphical Approach to Better Understanding Complex,Longitudinal Surgical Care of Cleft Lip/Palate

Abstract

Objective

Develop and apply novel data visualization techniques to analyze longitudinal cleft surgical care and to identify patterns in treatment timing and procedural burden across 2 cleft teams.

Design

Retrospective cohort study of operative data using novel data visualization methods.

Setting

Two cleft teams in the United States.

Patients and Participants

Patients with cleft lip and/or palate with operative clinical encounters between 2018 and 2023. Team A had 228 patients and team B had 355.

Interventions

Visualization of primary cleft-related surgical procedures which were cleft lip and palate repair, fistula repair, alveolar bone grafting, correction of velopharyngeal insufficiency, orthognathic surgery, and rhinoplasty.

Main Outcome Measure(s)

Visual interpretation of surgical timing, frequency, volume, and distribution using novel timelines, stacked-bar charts, and ridgeplots.

Results

Timeline visualizations clarified procedural sequencing and highlighted variation in treatment timing by team and phenotype but were too dense for interpretation for a large volume of patients. Stacked-bar charts illustrated procedural volume but lacked temporal insight. Ridgeplots demonstrated both timing of procedures and aggregate team volume.

Conclusions

Individual patient timelines can effectively depict deviation from “ideal” care protocols, but aggregate data may be best depicted by a ridgeplot. These tools may support quality improvement initiatives by transforming raw data into actionable insights and enhancing multidisciplinary team reflection.