V-Model: a new perspective for EHR-based phenotyping (BMC Medical Informatics and Decision Making)

Background: Narrative resources in electronic health records make clinical phenotyping study difficult to achieve. If a narrative patient history can be represented in a timeline, this would greatly enhance the efficiency of information-based studies. However, current timeline representations have limitations in visualizing narrative events. In this paper, we propose a temporal model named the `V-Model` which visualizes clinical narratives into a timeline. Methods: We developed the V-Model which models temporal clinical events in v-like graphical structure. It visualizes patient history on a timeline in an intuitive way. For the design, the representation, reasoning, and visualization (readability) aspects were considered. Furthermore, the unique graphical notation helps to find hidden patterns of a specific patient group. For evaluation, we verified our distinctive solutions, and surveyed usability. The experiments were carried out between the V-Model and a conventional timeline model group. Eighty medical students and physicians participated in this evaluation. . Results: The V-Model was proven to be superior in representing narrative medical events, provide sufficient information for temporal reasoning, and outperform in readability compared to a conventional timeline model. The usability of the V-Model was assessed as positive. Conclusions: The V-Model successfully resolves visualization issues of clinical documents, and provides better usability compared to a conventional timeline model.