Show-Me State Times

A recent study from the University of Missouri has explored how different visual presentations of blood pressure data can influence clinical decision-making. The study emphasizes the challenges doctors face in accurately assessing blood pressure due to its fluctuating nature.

The research, led by Victoria Shaffer, a psychology professor at the university's College of Arts and Science, sheds light on "white coat hypertension"—a condition where a patient's blood pressure appears elevated in a clinical setting but remains normal at home. Shaffer stated, "Sometimes a patient’s blood pressure is high at the doctor’s office but normal at home... it’s just white coat hypertension."

In the study, 57 doctors were asked to evaluate a hypothetical patient’s blood pressure using two types of graphs. One was a traditional raw data graph displaying peaks and valleys, and the other was a newly developed smoothed graph that averages fluctuations. The findings suggested that when blood pressure was monitored with significant variability, doctors made more accurate health assessments using the smoothed graph.

Shaffer explained, "Raw data can be visually noisy and hard to interpret because it is easy to get distracted by outliers in the data." She added that the smoothed graph serves as an "additional tool" to help doctors quickly and accurately assess if blood pressure is under control.

The study serves as a foundation for further research with Richelle Koopman from the School of Medicine and collaborations with Vanderbilt University and Oregon Health & Science University. The research team aims to integrate the smoothed graph technology with HIPAA-compliant electronic health records accessible to patients and medical professionals. This development could reduce unnecessary in-person visits and minimize over-treatment risks, as Shaffer noted, "There are some people who are being over-treated with unnecessary blood pressure medication."

While the research findings were not unexpected for Shaffer, the growing use of health informatics and wearable devices makes the study's implications for future use significant. As stated by Shaffer, "We have access to all this data now like never before, but how do we make use of it in a meaningful way?"

The study titled "The impact of an enhanced data visualization tool for hypertension in the electronic health record on physician judgments about hypertension control" appears in the Journal of General Internal Medicine.