%PDF-1.3
%
1 0 obj
<<
/Creator(Arbortext Advanced Print Publisher 9.1.440/W Unicode)
/Producer(PDFsharp 1.50.5147 \(www.pdfsharp.com\) \(Original: Acrobat Distiller 10.0.0 \(Windows\); modified using iText 5.3.5 2000-2012 1T3XT BVBA \(SPRINGER SBM; licensed version\)\))
/Title(Exploring the usefulness of Lexis diagrams for quality improvement)
/Keywords(Feedback, Lexis diagram, Survival data, Timeliness, Quality improvement, Complexity, )
/ModDate(D:20240329144543+00'00')
/Subject(Background: Visualization is important to aid practitioners in understanding local care processes and drive quality improvement \(QI\). Important aspects include timely feedback and ability to plot data over time. Moreover, the complexity of care also needs to be understood, as it affects the variation of care processes. However, there is a lack of QI methods visualizing multiple, related factors such as diagnosis date, death date, and cause of death to unravel their complexity, which is necessary to understand processes related to survival data. Lexis diagrams visualize individual patient processes as lines and mark additional factors such as key events. This study explores the potential of Lexis diagrams to support QI through survival data analysis, focusing on feedback, timeliness, and complexity, in a gynecological cancer setting in Sweden. Methods: Lexis diagrams were produced based on data from a gynecological cancer quality registry \(4481 patients\). The usefulness of Lexis diagrams was explored through iterative data identification and analysis through semi-structured dialogues between the researcher and domain experts \(clinically active care process owners\) during five meetings. Visualizations were produced and adapted by the researcher between meetings, based on the dialogues, to ensure clinical relevance, resulting in three relevant types of visualizations. Results: Domain experts identified different uses depending on diagnosis group and data visualization. Key results include timely feedback through close-to-real-time visualizations, supporting discussion and understanding of trends and hypothesis-building. Visualization of care process complexity facilitated evaluation of given care. Combined visualization of individual and population levels increased patient focus and may possibly also function to motivate practitioners and management. Conclusion: Lexis diagrams can aid understanding of survival data, triggering important dialogues between care givers and supporting care quality improvement and new perspectives, and can therefore complement survival curves in quality improvement.)
/Author(Dahlin, S.)
/CreationDate(D:20200226103549+08'00')
>>
endobj
2 0 obj
<<
/Type/Metadata
/Subtype/XML
/Length 23497
>>
stream
Quality improvement,Survival data,Feedback,Timeliness,Complexity,Lexis diagram
Acrobat Distiller 10.0.0 (Windows); modified using iText® 5.3.5 ©2000-2012 1T3XT BVBA (SPRINGER SBM; licensed version)
application/pdf
10.1186/s12911-019-1017-3
BMC Medical Informatics and Decision Making
BMC Medical Informatics and Decision Making, 2020, doi:10.1186/s12911-019-1017-3
Quality improvement
Survival data
Feedback
Timeliness
Complexity
Lexis diagram
Exploring the usefulness of Lexis diagrams for quality improvement
Sara Dahlin
2020-02-27T10:21:52+01:00
2020-02-27T10:21:52+01:00
2020-02-26T10:35:49+08:00
Arbortext Advanced Print Publisher 9.1.440/W Unicode
uuid:6c71aa62-efb9-4fb8-aa0d-0e8f05a446ff
uuid:9658b8d6-f76e-4b96-8ad4-ef8bf157438b
default
1
converted
uuid:6c71aa62-efb9-4fb8-aa0d-0e8f05a446ff
converted to PDF/A-2b
pdfToolbox
2020-02-26T19:04:43+08:00
2
B
Sara Dahlin
http://orcid.org/0000-0002-2813-3548
Springer Nature ORCID Schema
http://springernature.com/ns/xmpExtensions/2.0/
sn
authorInfo
Bag AuthorInformation
external
Author information: contains the name of each author and his/her ORCID (ORCiD: Open Researcher and Contributor ID). An ORCID is a persistent identifier (a non-proprietary alphanumeric code) to uniquely identify scientific and other academic authors.
editorInfo
Bag EditorInformation
external
Editor information: contains the name of each editor and his/her ORCID identifier.
seriesEditorInfo
Bag SeriesEditorInformation
external
Series editor information: contains the name of each series editor and his/her ORCID identifier.
AuthorInformation
http://springernature.com/ns/xmpExtensions/2.0/authorInfo/
author
Specifies the types of author information: name and ORCID of an author.
name
Text
Gives the name of an author.
orcid
URI
Gives the ORCID of an author.
EditorInformation
http://springernature.com/ns/xmpExtensions/2.0/editorInfo/
editor
Specifies the types of editor information: name and ORCID of an editor.
name
Text
Gives the name of an editor.
orcid
URI
Gives the ORCID of an editor.
SeriesEditorInformation
http://springernature.com/ns/xmpExtensions/2.0/seriesEditorInfo/
seriesEditor
Specifies the types of series editor information: name and ORCID of a series editor.
name
Text
Gives the name of a series editor.
orcid
URI
Gives the ORCID of a series editor.
http://ns.adobe.com/pdf/1.3/
pdf
Adobe PDF Schema
internal
A name object indicating whether the document has been modified to include trapping information
Trapped
Text
http://ns.adobe.com/xap/1.0/mm/
xmpMM
XMP Media Management Schema
internal
UUID based identifier for specific incarnation of a document
InstanceID
URI
internal
The common identifier for all versions and renditions of a document.
OriginalDocumentID
URI
internal
A reference to the original document from which this one is derived. It is a minimal reference; missing components can be assumed to be unchanged. For example, a new version might only need to specify the instance ID and version number of the previous version, or a rendition might only need to specify the instance ID and rendition class of the original.
DerivedFrom
ResourceRef
Identifies a portion of a document. This can be a position at which the document has been changed since the most recent event history (stEvt:changed). For a resource within an xmpMM:Ingredients list, the ResourceRef uses this type to identify both the portion of the containing document that refers to the resource, and the portion of the referenced resource that is referenced.
http://ns.adobe.com/xap/1.0/sType/Part#
stPart
Part
http://ns.adobe.com/xap/1.0/t/pg/
xmpTPg
XMP Paged-Text
internal
A structure containing the characteristics of a font used in a document
Fonts
Bag Font
internal
XMP08 Spec: An ordered array of plate names that are needed to print the document (including any in contained documents).
PlateNames
Seq Text
A structure containing the characteristics of a font used in a document.
http://ns.adobe.com/xap/1.0/sType/Font#
stFnt
Font
http://ns.adobe.com/pdfx/1.3/
pdfx
PDF/X ID Schema
internal
ID of PDF/X standard
GTS_PDFXVersion
Text
internal
Conformance level of PDF/X standard
GTS_PDFXConformance
Text
internal
Company creating the PDF
Company
Text
internal
Date when document was last modified
SourceModified
Text
http://www.aiim.org/pdfa/ns/id/
pdfaid
PDF/A ID Schema
internal
Part of PDF/A standard
part
Integer
internal
Amendment of PDF/A standard
amd
Text
internal
Conformance level of PDF/A standard
conformance
Text
endstream
endobj
3 0 obj
<<
/LastChar 246
/BaseFont/PHBKPF+XqkwywAdvTTb5929f4c
/Type/Font
/Subtype/Type1
/Encoding/WinAnsiEncoding
/Widths[0 0 0 0 0 0 0 0 260 260 0 0 166 291 166 343 479 479 479 479 479 479 479 479 479 479 166 166 0 593 0 375 708 583 500 562 645 458 458 614 625 208 343 489 447 770 635 666 500 666 500 458 458 625 500 812 541 500 531 260 0 260 0 0 0 447 541 437 541 479 260 541 531 208 208 416 208 812 531 531 541 541 291 364 302 520 447 718 427 437 395 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 666 0 0 0 291 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 447 0 0 447 0 750 0 0 479 0 0 0 208 0 0 0 531 0 0 0 0 531]
/FontDescriptor 4 0 R
/FirstChar 32
>>
endobj
4 0 obj
<<
/FontBBox[-41 -250 812 864]
/CapHeight 674
/Type/FontDescriptor
/FontFile3 170 0 R
/StemV 0
/Descent -209
/XHeight 480
/Flags 32
/FontName/PHBKPF+XqkwywAdvTTb5929f4c
/Ascent 711
/ItalicAngle 0
>>
endobj
5 0 obj
<<
/D[6 0 R/FitR 0 791 596 0]
>>
endobj
6 0 obj
<<
/CropBox[0 0 595.276 790.866]
/Parent 182 0 R
/Type/Page
/Contents 248 0 R
/Resources
<<
/ExtGState
<<
/GS2 14 0 R
>>
/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]
/ColorSpace
<<
/Cs6 11 0 R
>>
/Font
<<
/F1 18 0 R
/F2 19 0 R
/F3 3 0 R
/F10 20 0 R
/F14 249 0 R
/F9 24 0 R
/F15 250 0 R
/F7 25 0 R
>>
>>
/Thumb 251 0 R
/MediaBox[0 0 595.276 790.866]
/B[252 0 R 253 0 R]
/Annots[254 0 R 255 0 R 256 0 R 257 0 R 258 0 R]
/Rotate 0
/Group
<<
/CS/DeviceRGB
/S/Transparency
>>
>>
endobj
7 0 obj
<<
/D[8 0 R/FitR 0 300 596 300]
>>
endobj
8 0 obj
<<
/CropBox[0 0 595.276 790.866]
/Parent 182 0 R
/Type/Page
/Contents 54 0 R
/Resources
<<
/ExtGState
<<
/GS2 14 0 R
>>
/ProcSet[/PDF/Text/ImageB/ImageC/ImageI]
/ColorSpace
<<
/Cs6 11 0 R
>>
/Font
<<
/F1 20 0 R
/F2 19 0 R
/F10 55 0 R
/F4 21 0 R
/F5 22 0 R
/F6 23 0 R
/F7 25 0 R
>>
>>
/Thumb 56 0 R
/MediaBox[0 0 595.276 790.866]
/B[57 0 R 58 0 R 59 0 R 60 0 R]
/Annots[61 0 R 62 0 R 63 0 R 64 0 R 65 0 R 66 0 R 67 0 R 68 0 R 69 0 R 70 0 R 71 0 R 72 0 R 73 0 R 74 0 R 75 0 R 76 0 R 77 0 R 78 0 R 79 0 R 80 0 R]
/Rotate 0
/Group
<<
/CS/DeviceRGB
/S/Transparency
>>
>>
endobj
9 0 obj
<<
/Subtype/Type1C
/Length 630
/Filter/FlateDecode
>>
stream
Hbd`af`ddTpqv*LJKpL) 03L2H62 !CI-??dx~ΓayUAy3#cxfs~AeQfzFJ#ǔTbϼĒ=ǜ bԢ2` P.D%XO 5/%3/]i\:ii*82:8#+cZ> |?|+RPP[[W)W;v
Nn1wB `8Az&JtwN'Bag9bh#::PNgh'Nl}#Ltܵ\bڞ:vN1nB{{_{og/GwlgƢI n*n**,+, ф\ڬTƾfަV l1̮KY~SY 7{KgqY,P 3)IS&-e5qԔ9Sn
ҕ@/nX6i\m oyvm,dmmmyL@` 8ДHM)ˏ?V|}O5[U(+?d
,` y
endstream
endobj
10 0 obj
<<
/Intent/Perceptual
/Type/XObject
/ColorSpace 11 0 R
/Subtype/Image
/BitsPerComponent 8
/Width 1387
/Length 591416
/Height 1279
/Filter/FlateDecode
>>
stream
h[IlY-EEETu( j.h ę J!BibeFk}dd}7]FDv[ F䍸be}k{= ꫯB <|cW/}\=__{|
.g?ԧ|_$W>ϑ+GTO~
/|RonW_}+I>Wr?)
'>tDtQ|m;`;|ӟkF^mZ|(}CGmx{|xw-w]ᘣo_o~hs"cW^yG?Fx