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In various fields, including medicine, age distributions are crucial. Despite widespread media coverage of health topics, there remains a need to enhance health communication. Narrative medical visualization is promising for improving information comprehension and retention. This study explores the most effective ways to present age distributions of diseases through narrative visualizations. We conducted a thorough analysis of existing visualizations, held workshops with a broad audience, and reviewed relevant literature. From this, we identified design choices focusing on comprehension, aesthetics, engagement, and memorability. We specifically tested three pictogram variants: pictograms as bars, stacked pictograms, and annotations. After evaluating 18 visualizations with 72 participants and three expert reviews, we determined that annotations were most effective for comprehension and aesthetics. However, traditional bar charts were preferred for engagement, and other variants were more memorable. The study provides a set of design recommendations based on these insights., Comment: 11 pages, 7 figures

As the world increasingly relies on mathematical models for forecasts in different areas, effective communication of uncertainty in time series predictions is important for informed decision making. This study explores how users estimate probabilistic uncertainty in time series predictions under different variants of line charts depicting uncertainty. It examines the role of individual characteristics and the influence of user-reported metrics on uncertainty estimations. By addressing these aspects, this paper aims to enhance the understanding of uncertainty visualization and for improving communication in time series forecast visualizations and the design of prediction data dashboards.As the world increasingly relies on mathematical models for forecasts in different areas, effective communication of uncertainty in time series predictions is important for informed decision making. This study explores how users estimate probabilistic uncertainty in time series predictions under different variants of line charts depicting uncertainty. It examines the role of individual characteristics and the influence of user-reported metrics on uncertainty estimations. By addressing these aspects, this paper aims to enhance the understanding of uncertainty visualization and for improving communication in time series forecast visualizations and the design of prediction data dashboards.

Science communication aims at making key research insights accessible to the broad public. If explanatory and exploratory visualization techniques are combined to do so, the approach is also referred to as exploranation. In this context, the audience is usually not required to have domain expertise. However, we show that exploranation can not only support the communication between researchers and a broad audience, but also between researchers directly. With the goal of communicating an existing method for conducting causal inference on spatio-temporal conflict event data, we investigated how to perform exploranation for experts, i.e., expert exploranation. Based on application scenarios of the inference method, we developed three versions of an interactive visual story to explain the method to conflict researchers. We abstracted the corresponding design process and evaluated the stories both with experts who were unfamiliar with the explained method and experts who were already familiar with it. The positive and extensive feedback from the evaluation shows that expert exploranation is a promising direction for visual storytelling, as it can help to improve scientific outreach, methodological understanding, and accessibility for researchers new to a field., Comment: 40 pages, 4 figures, 2 tables

Purpose: Machine learning models can only be reliably evaluated if training, validation, and test data splits are representative and not affected by the absence of classes of interest. Surgical workflow and instrument recognition tasks are complicated in this manner, because of heavy data imbalances resulting from different lengths of phases and their erratic occurrences. Furthermore, the issue becomes difficult as sub-properties that help define phases, like instrument (co-)occurrence, are usually not considered when defining the split. We argue that such sub-properties must be equally considered. Methods: This work presents a publicly available data visualization tool that enables interactive exploration of dataset splits for surgical phase and instrument recognition. It focuses on the visualization of the occurrence of phases, phase transitions, instruments, and instrument combinations across sets. Particularly, it facilitates the assessment and identification of sub-optimal dataset splits. Results: We performed an analysis of common Cholec80 dataset splits using the proposed application and were able to uncover phase transitions and combinations of instruments that were not represented in one of the sets. Additionally, we outlined possible improvements to the splits. A user study with ten participants demonstrated the ability of participants to solve a selection of data exploration tasks using the proposed application. Conclusion: In highly unbalanced class distributions, special care should be taken with respect to the selection of an appropriate dataset split. Our interactive data visualization tool presents a promising approach for the assessment of dataset splits for surgical phase and instrument recognition. Evaluation results show that it can enhance the development of machine learning models. The application is available at https://cardio-ai.github.io/endovis-ml/ ., Comment: Accepted at IPCAI 2023 as long abstract; Submitted to IJCARS as original article; 21 pages, 10 figures, 3 tables

In recent years, the use of expressive surface visualizations in the representation of vascular structures has gained significant attention. These visualizations provide a comprehensive understanding of complex anatomical structures and are crucial for treatment planning and medical education. However, to aid decision-making, physicians require visualizations that accurately depict anatomical structures and their spatial relationships in a clear and well-perceivable manner. This work extends a previous paper and presents a thorough examination of common techniques for encoding distance information of 3D vessel surfaces and provides an implementation of these visualizations. A Unity environment and detailed implementation instructions for sixteen different visualizations are provided. These visualizations can be classified into four categories: fundamental, surface-based, auxiliary, and illustrative. Furthermore, this extension includes tools to generate endpoint locations for vascular models. Overall this framework serves as a valuable resource for researchers in the field of vascular surface visualization by reducing the barrier to entry and promoting further research in this area. By providing an implementation of various visualizations, this paper aims to aid in the development of accurate and effective visual representations of vascular structures to assist in treatment planning and medical education.

While narrative visualization has been used successfully in various applications to communicate scientific data in the format of a story to a general audience, the same has not been true for medical data. There are only a few exceptions that present tabular medical data to non-experts. However, a key component of medical visualization is the interactive analysis of 3D data, such as 3D models of anatomical structures, which were rarely included in narrative visualizations so far. In this design study, we investigate how neurological disease data can be communicated through narrative visualization techniques to a general audience in an understandable way. We designed a narrative visualization explaining cerebral small vessel disease. Learning about its avoidable risk factors serves to motivate the audience watching the resulting visual data story. Using this example, we discuss the adaption of basic narrative components. This includes the conflict and characters of a story, as well as the story's structure and content to address and communicate specific characteristics of medical data. Furthermore, we explore the extent to which complex medical relationships need to be simplified to be understandable to a general audience without distorting the underlying data and evidence. In particular, the data needs to be preprocessed for non-experts and appropriate forms of interaction must be found. We explore approaches to make the data more personally relatable, such as including a fictional patient. We evaluated our approach in a user study with 40 participants in a web-based implementation of the designed story. We found that the combination of a carefully thought-out storyline with a clear key message, appealing visualizations combined with easy-to-use interactions, and credible references are crucial for creating a narrative visualization about a neurological disease that engages an audience., Comment: 11 pages, 9 figures

Narrative visualization aims to communicate scientific results to a general audience and garners significant attention in various applications. Merging exploratory and explanatory visualization could effectively support a non-expert understanding of scientific processes. Medical research results, e.g., mechanisms of the healthy human body, explanations of pathological processes, or avoidable risk factors for diseases, are also interesting to a general audience that includes patients and their relatives. This paper discusses how narrative techniques can be applied to medical visualization to tell data-driven stories about diseases. We address the general public comprising people interested in medicine without specific medical background knowledge. We derived a general template for the narrative medical visualization of diseases. Applying this template to three diseases selected to span bone, vascular, and organ systems, we discuss how narrative techniques can support visual communication and facilitate understanding of medical data. Other scientists can adapt our proposed template to inform an audience on other diseases. With our work, we show the potential of narrative medical visualization and conclude with a comprehensive research agenda.

We introduce a Virtual Reality (VR) one-on-one tutoring system to support anatomy education. A student uses a fully immersive VR headset to explore the anatomy of the base of the human skull. A teacher guides the student by using the semi-immersive zSpace. Both systems are connected via network and each action is synchronized between both systems. The teacher is provided with various features to direct the student through the immersive learning experience. She can influence the student's navigation or provide annotations on the fly and, hereby, improve the students learning experience. The system is implemented using the \textit{Unity} game engine. A qualitative user study demonstrates that the one-on-one tutoring approach is feasible and sets a solid base for future research in the area of shared virtual environments for anatomy education., Comment: 18 pages, 10 figures

An accurate assessment of the cardiovascular system and prediction of cardiovascular diseases (CVDs) are crucial. Measured cardiac blood flow data provide insights about patient-specific hemodynamics, where many specialized techniques have been developed for the visual exploration of such data sets to better understand the influence of morphological and hemodynamic conditions on CVDs. However, there is a lack of machine learning approaches techniques that allow a feature-based classification of heart-healthy people and patients with CVDs. In this work, we investigate the potential of morphological and hemodynamic characteristics, extracted from measured blood flow data in the aorta, for the classification of heart-healthy volunteers and patients with bicuspid aortic valve (BAV). Furthermore, we research if there are characteristic features to classify male and female as well as older heart-healthy volunteers and BAV patients. We propose a data analysis pipeline for the classification of the cardiac status, encompassing feature selection, model training and hyperparameter tuning. In our experiments, we use several feature selection methods and classification algorithms to train separate models for the healthy subgroups and BAV patients. We report on classification performance and investigate the predictive power of morphological and hemodynamic features with regard to the classification of the defined groups. Finally, we identify the key features for the best models., Comment: 29 pages, 7 figures

Background and objective: MeshCNN is a recently proposed Deep Learning framework that drew attention due to its direct operation on irregular, non-uniform 3D meshes. On selected benchmarking datasets, it outperformed state-of-the-art methods within classification and segmentation tasks. Especially, the medical domain provides a large amount of complex 3D surface models that may benefit from processing with MeshCNN. However, several limitations prevent outstanding performances of MeshCNN on highly diverse medical surface models. Within this work, we propose MedMeshCNN as an expansion for complex, diverse, and fine-grained medical data. Methods: MedMeshCNN follows the functionality of MeshCNN with a significantly increased memory efficiency that allows retaining patient-specific properties during the segmentation process. Furthermore, it enables the segmentation of pathological structures that often come with highly imbalanced class distributions. Results: We tested the performance of MedMeshCNN on a complex part segmentation task of intracranial aneurysms and their surrounding vessel structures and reached a mean Intersection over Union of 63.24\%. The pathological aneurysm is segmented with an Intersection over Union of 71.4\%. Conclusions: These results demonstrate that MedMeshCNN enables the application of MeshCNN on complex, fine-grained medical surface meshes. The imbalanced class distribution deriving from the pathological finding is considered by MedMeshCNN and patient-specific properties are mostly retained during the segmentation process., Comment: 7 pages, 7 figures, 1 table, Submitted to Computer Methods and Programs in Biomedicine

Given the multitude of challenges surgeons face during mitral valve repair surgery, they should have a high confidence in handling of instruments and in the application of surgical techniques before they enter the operating room. Unfortunately, opportunities for surgical training of minimally-invasive repair are very limited, leading to a situation where most surgeons undergo a steep learning curve while operating the first patients. In order to provide a realistic tool for surgical training, a commercial simulator was augmented by flexible patient-specific mitral valve replica. In an elaborated production pipeline, finalized after many optimization cycles, models were segmented from 3D ultrasound and then 3D-printable molds were computed automatically and printed in rigid material, the lower part being water-soluble. After silicone injection, the silicone model was dissolved from the mold and anchored in the simulator. To our knowledge, our models are the first to comprise the full mitral valve apparatus, i.e. the annulus, leaflets, chordae tendineae and papillary muscles. Nine different valve molds were automatically created according to the proposed workflow (seven prolapsed valves and two valves with functional mitral insufficiency). From these mold geometries, 16 replica were manufactured. A material test revealed that Ecoflex\textsuperscript{TM} 00-30 is the most suitable material for leaflet-mimicking tissue out of seven mixtures. Production time was around 36h per valve. Twelve surgeons performed various surgical techniques, e.g. annuloplasty, neo-chordae implantation, triangular leaflet resection and assessed the realism of the valves very positively. The standardized production process guarantees a high anatomical recapitulation of the silicone valves to the segmented models and the ultrasound data..., Comment: Accepted for IJCARS Special Issue IPCAI 2019 (Information Processing in Computer-Assisted Interventions)