Page 20 - Recommendations-for-biostatisticians-in-managing-and-conducting-medical-research-consultations

4.1 Time and event visualization

Any data collection activity, particularly for a research purpose, will always revolve
around a story regarding what, where, when, who and how the data are collected.
This story will describe the nature of data collection and the subsequent flow of data
which can all be summarized by using a simple illustration. This e-book/book will
specifically name this illustration as a “Time and Event Visualization” or TEV in
short. TEV is a plot that summarizes the flow of data collection and its specific research
purpose. It can also be considered as an alternative for a flow chart, but the emphasis of
TEV is to illustrate the relationship between time and specific details of the event
occurring. TEV is rarely mentioned in the literature for describing a ‘flow chart’ or a ‘figure’
in the published research articles, which is in sharp contrast to a flow chart which has
commonly been reported in many published research articles.

However, this e-book/book now attempts to strongly recommend a biostatistician to
learn how to scratch the TEV on a piece of paper as and when the relevant input is
provided by a research client during the consultation session, in order to record both the
nature and flow of data collection. By doing so, it will also help to facilitate a biostatistician
to acquire a better level of understanding of the subject matter during the consultation
session. An example of a TEV is shown in Figure 1, which is an illustration of the temporal
relationship between the important processes or events that have occurred for patients
with type 2 diabetes mellitus (T2DM).

Let’s say the aim of a study has been designed to determine the risk factors for poor
glucose control among patients with T2DM. Then the TEV is a useful technique can be
applied by anyone who does not have a medical background to understand the occurrence
of the process or/and event of the disease in relation to time. Referring to Figure 1 as a
starting point, different patients will be characterized by various specific and known
demographic profiles such as gender, ethnicity, etc. As time goes by, each of these T2DM
patients will gradually exhibit many lifestyle choices such as dietary habits and level of
daily activities that can become a risk factor contributing to poor glucose control. These
happen during the early stages of a typical T2DM patient’s lifespan. Sooner or later, the
disease will either manifest itself which results in the patient being awareness of his/her
disease, or when this disease has been detected during a routine check-up or after the
patient has developed some signs and symptoms of diabetes (that are subsequently
confirmed by a proper clinical diagnosis).

Once diagnosed with T2DM, the necessary medical treatment will be rendered to
patients to control their glucose level to prevent them from developing diabetic
complications. Some of the major processes and events occurring in patients with T2DM
have a temporal relationship with the disease. Hence, by having a proper understanding of
disease progression, a researcher will automatically realize that diabetic complications are
not the risk factors for poor glucose control since diabetic complications do not contribute