Lasagna plots to visualize results in surgical studies

Area of Science:

• Medical Visualization
• Surgical Research Methodology
• Data Analysis in Clinical Trials

Background:

• Lasagna plots are graphical tools for displaying multiple longitudinal outcomes.
• Their application in surgical study publications is novel.
• This study aimed to assess their utility in surgical randomized controlled trials (RCTs).

Purpose of the Study:

• To demonstrate the application of lasagna plots in surgical RCTs.
• To evaluate if lasagna plots reveal new observations from existing surgical trial data.
• To assess the potential of lasagna plots to improve data interpretation.

Main Methods:

• Lasagna plots were generated using R software.
• Applied to three surgical RCTs: AJAX (abdominal aortic aneurysm repair), LAFA (colon cancer surgery), and DROP (pancreatic cancer surgery).
• Compared findings from lasagna plots with original study publications.

Main Results:

• Lasagna plots revealed the timing of outcome occurrences, increases, and decreases (e.g., renal replacement therapy, death) in the AJAX trial, which were not in the original report.
• Similar novel observations on multiple longitudinal outcomes were identified in the LAFA and DROP trials.
• The graphical representation provided insights beyond the original study's tables.

Conclusions:

• Lasagna plots can uncover new observations from previously published data.
• These new insights can generate novel hypotheses and theories regarding patient outcomes.
• Lasagna plots may enhance the interpretation of surgical trial results when used alongside traditional methods.