All these charts lament the high prices charged by U.S. hospitals

A former student asked me about this chart from the New York Times that highlights much higher prices of hospital procedures in the U.S. relative to a comparison group of seven countries.

The dot plot is clearly thought through. It is not a default chart that pops out of software.

Based on its design, we surmise that the designer has the following intentions:

1. The names of the medical procedures are printed to be read, thus the long text is placed horizontally.
   
   
2. The actual price is not as important as the relative price, expressed as an index with the U.S. price at 100%. These reference values are printed in glaring red, unignorable.
   
   
3. Notwithstanding the above point, the actual price is still of secondary importance, and the values are provided as a supplement to the row labels. Getting to the actual prices in the comparison countries requires further effort, and a calculator.
   
   
4. The primary comparison is between the U.S. and the rest of the world (or the group of seven countries included). It is less important to distinguish specific countries in the comparison group, and thus the non-U.S. dots are given pastels that take some effort to differentiate.
   
   
5. Probably due to reader feedback, the font size is subject to a minimum so that some labels are split into two lines to prevent the text from dominating the plotting region.

***

In the Trifecta Checkup view of the world, there is no single best design. The best design depends on the intended message and what’s in the available data.

To illustate this, I will present a few variants of the above design, and discuss how these alternative designs reflect the designer's intentions.

Note that in all my charts, I expressed the relative price in terms of discounts, which is the mirror image of premiums. Instead of saying Country A's price is 80% of the U.S. price, I prefer to say Country A's price is a 20% saving (or discount) off the U.S. price.

First up is the following chart that emphasizes countries instead of hospital procedures:

This chart encourages readers to draw conclusions such as "Hospital prices are 60-80 percent cheaper in Holland relative to the U.S." But it is more taxing to compare the cost of a specific procedure across countries.

The indexing strategy already creates a barrier to understanding relative costs of a specific procedure. For example, the value for angioplasty in Australia is about 55% and in Switzerland, about 75%. The difference 75%-55% is meaningless because both numbers are relative savings from the U.S. baseline. Comparing Australia and Switzerland requires a ratio (0.75/0.55 = 1.36): Australia's prices are 36% above Swiss prices, or alternatively, Swiss prices are a 64% 26% discount off Australia's prices.

The following design takes it even further, excluding details of individual procedures:

For some readers, less is more. It’s even easier to get a rough estimate of how much cheaper prices are in the comparison countries, for now, except for two “outliers”, the chart does not display individual values.

The widths of these bars reveal that in some countries, the amount of savings depends on the specific procedures.

The bar design releases the designer from a horizontal orientation. The country labels are shorter and can be placed at the bottom in a vertical design:

It's not that one design is obviously superior to the others. Each version does some things better. A good designer recognizes the strengths and weaknesses of each design, and selects one to fulfil his/her intentions.

 

P.S. [1/3/20] Corrected a computation, explained in Ken's comment.

Revisiting global car sales

We looked at the following chart in the previous blog. The data concern the growth rates of car sales in different regions of the world over time.

Here is a different visualization of the same data.

Well, it's not quite the same data. I divided the global average growth rate by four to yield an approximation of the true global average. (The reason for this is explained in the other day's post.)

The chart emphasizes how each region was helping or hurting the global growth. It also features the trend in growth within each region.

 

How to read this cost-benefit chart, and why it is so confusing

Long-time reader Antonio R. found today's chart hard to follow, and he isn't alone. It took two of us multiple emails and some Web searching before we think we "got it".

 

Antonio first encountered the chart in a book review (link) of Hal Harvey et. al, Designing Climate Solutions. It addresses the general topic of costs and benefits of various programs to abate CO2 emissions. The reviewer praised the "wealth of graphics [in the book] which present complex information in visually effective formats." He presented the above chart as evidence, and described its function as:

policy-makers can focus on the areas which make the most difference in emissions, while also being mindful of the cost issues that can be so important in getting political buy-in.

(This description is much more informative than the original chart title, which states "The policy cost curve shows the cost-effectiveness and emission reduction potential of different policies.")

Spend a little time with the chart now before you read the discussion below.

Warning: this is a long read but well worth it.

 

***

 

If your experience is anything like ours, scraps of information flew at you from different parts of the chart, and you had a hard time piecing together a story.

What are the reasons why this data graphic is so confusing?

Everyone recognizes that this is a column chart. For a column chart, we interpret the heights of the columns so we look first at the vertical axis. The axis title informs us that the height represents "cost effectiveness" measured in dollars per million metric tons of CO2. In a cost-benefit sense, that appears to mean the cost to society of obtaining the benefit of reducing CO2 by a given amount.

That's how far I went before hitting the first roadblock.

For environmental policies, opponents frequently object to the high price of implementation. For example, we can't have higher fuel efficiency in cars because it would raise the price of gasoline too much. Asking about cost-effectiveness makes sense: a cost-benefit trade-off analysis encapsulates the something-for-something principle. What doesn't follow is that the vertical scale sinks far into the negative. The chart depicts the majority of the emissions abatement programs as having negative cost effectiveness.

What does it mean to be negatively cost-effective? Does it mean society saves money (makes a profit) while also reducing CO2 emissions? Wouldn't those policies - more than half of the programs shown - be slam dunks? Who can object to programs that improve the environment at no cost?

I tabled that thought, and proceeded to the horizontal axis.

I noticed that this isn't a standard column chart, in which the width of the columns is fixed and uneventful. Here, the widths of the columns are varying.

***

In the meantime, my eyes are distracted by the constellation of text labels. The viewing area of this column chart is occupied - at least 50% - by text. These labels tell me that each column represents a program to reduce CO2 emissions.

The dominance of text labels is a feature of this design. For a conventional column chart, the labels are situated below each column. Since the width does not usually carry any data, we tend to keep the columns narrow - Tufte, ever the minimalist, has even advocated reducing columns to vertical lines. That leaves insufficient room for long labels. Have you noticed that government programs hold long titles? It's tough to capture even the outline of a program with fewer than three big words, e.g. "Renewable Portfolio Standard" (what?).

The design solution here is to let the column labels run horizontally. So the graphical element for each program is a vertical column coupled with a horizontal label that invades the territories of the next few programs. Like this:

The horror of this design constraint is fully realized in the following chart, a similar design produced for the state of Oregon (lifted from the Plan Washington webpage listed as a resource below):

In a re-design, horizontal labeling should be a priority.

 

***

Realizing that I've been distracted by the text labels, back to the horizontal axis I went.

This is where I encountered the next roadblock.

The axis title says "Average Annual Emissions Abatement" measured in millions metric tons. The unit matches the second part of the vertical scale, which is comforting. But how does one reconcile the widths of columns with a continuous scale? I was expecting each program to have a projected annual abatement benefit, and those would fall as dots on a line, like this:

Instead, we have line segments sitting on a line, like this:

Think of these bars as the bottom edges of the columns. These line segments can be better compared to each other if structured as a bar chart:

Instead, the design arranges these lines end-to-end.

To unravel this mystery, we go back to the objective of the chart, as announced by the book reviewer. Here it is again:

policy-makers can focus on the areas which make the most difference in emissions, while also being mindful of the cost issues that can be so important in getting political buy-in.

The primary goal of the chart is a decision-making tool for policy-makers who are evaluating programs. Each program has a cost and also a benefit. The cost is shown on the vertical axis and the benefit is shown on the horizontal. The decision-maker will select some subset of these programs based on the cost-benefit analysis. That subset of programs will have a projected total expected benefit (CO2 abatement) and a projected total cost.

By stacking the line segments end to end on top of the horizontal axis, the chart designer elevates the task of computing the total benefits of a subset of programs, relative to the task of learning the benefits of any individual program. Thus, the horizontal axis is better labeled "Cumulative annual emissions abatement".

 

Look at that axis again. Imagine you are required to learn the specific benefit of program titled "Fuel Economy Standards: Cars & SUVs".  

This is impossible to do without pulling out a ruler and a calculator. What the axis labels do tell us is that if all the programs to the left of Fuel Economy Standards: Cars & SUVs were adopted, the cumulative benefits would be 285 million metric tons of CO2 per year. And if Fuel Economy Standards: Cars & SUVs were also implemented, the cumulative benefits would rise to 375 million metric tons.

***

At long last, we have arrived at a reasonable interpretation of the cost-benefit chart.

Policy-makers are considering throwing their support behind specific programs aimed at abating CO2 emissions. Different organizations have come up with different ways to achieve this goal. This goal may even have specific benchmarks; the government may have committed to an international agreement, for example, to reduce emissions by some set amount by 2030. Each candidate abatement program is evaluated on both cost and benefit dimensions. Benefit is given by the amount of CO2 abated. Cost is measured as a "marginal cost," the amount of dollars required to achieve each million metric ton of abatement.

This "marginal abatement cost curve" aids the decision-making. It lines up the programs from the most cost-effective to the least cost-effective. The decision-maker is presumed to prefer a more cost-effective program than a less cost-effective program. The chart answers the following question: for any given subset of programs (so long as we select them left to right contiguously), we can read off the cumulative amount of CO2 abated.

***

There are still more limitations of the chart design.

• We can't directly read off the cumulative cost of the selected subset of programs because the vertical axis is not cumulative. The cumulative cost turns out to be the total area of all the columns that correspond to the selected programs. (Area is height x width, which is cost per benefit multiplied by benefit, which leaves us with the cost.) Unfortunately, it takes rulers and calculators to compute this total area.
  
  
• We have presumed that policy-makers will make the Go-No-go decision based on cost effectiveness alone. This point of view has already been contradicted. Remember the mystery around negatively cost-effective programs - their existence shows that some programs are stalled even when they reduce emissions in addition to making money!
  
  
• Since many, if not most, programs have negative cost-effectiveness (by the way they measured it), I'd flip the metric over and call it profitability (or return on investment). Doing so removes another barrier to our understanding. With the current cost-effectiveness metric, policy-makers are selecting the "negative" programs before the "positive" programs. It makes more sense to select the "positive" programs before the "negative" ones!

***

In a Trifecta Checkup (guide), I rate this chart Type V. The chart has a great purpose, and the design reveals a keen sense of the decision-making process. It's not a data dump for sure. In addition, an impressive amount of data gathering and analysis - and synthesis - went into preparing the two data series required to construct the chart. (Sure, for something so subjective and speculative, the analysis methodology will inevitably be challenged by wonks.) Those two data series are reasonable measures for the stated purpose of the chart.

The chart form, though, has various shortcomings, as shown here.  

***

In our email exchange, Antonio and I found the Plan Washington website useful. This is where we learned that this chart is called the marginal abatement cost curve.

Also, the consulting firm McKinsey is responsible for popularizing this chart form. They have published this long report that explains even more of the analysis behind constructing this chart, for those who want further details.

Pulling the multi-national story out, step by step

Reader Aleksander B. found this Economist chart difficult to understand.

Given the chart title, the reader is looking for a story about multinationals producing lower return on equity than local firms. The first item displayed indicates that multinationals out-performed local firms in the technology sector.

The pie charts on the right column provide additional information about the share of each sector by the type of firms. Is there a correlation between the share of multinationals, and their performance differential relative to local firms?

***

We can clean up the presentation. The first changes include using dots in place of pipes, removing the vertical gridlines, and pushing the zero line to the background:

The horizontal gridlines attached to the zero line can also be removed:

Now, we re-order the rows. Start with the aggregate "All sectors". Then, order sectors from the largest under-performance by multinationals to the smallest.

The pie charts focus only on the share of multinationals. Taking away the remainders speeds up our perception:

Help the reader understand the data by dividing the sectors into groups, organized by the performance differential:

For what it's worth, re-sort the sectors from largest to smallest share of multinationals:

Having created groups of sectors by share of multinationals, I simplify further by showing the average pie chart within each group:

***

To recap all the edits, here is an animated gif: (if it doesn't play automatically, click on it)

***

Judging from the last graphic, I am not sure there is much correlation between share of multinationals and the performance differentials. It's interesting that in aggregate, local firms and multinationals performed the same. The average hides the variability by sector: in some sectors, local firms out-performed multinationals, as the original chart title asserted.

This Wimbledon beauty will be ageless

This Financial Times chart paints the picture of the emerging trend in Wimbledon men’s tennis: the average age of players has been rising, and hits 30 years old for the first time ever in 2019.

The chart works brilliantly. Let's look at the design decisions that contributed to its success.

The chart contains a good amount of data and the presentation is carefully layered, with the layers nicely tied to some visual cues.

Readers are drawn immediately to the average line, which conveys the key statistical finding. The blue dot  reinforces the key message, aided by the dotted line drawn at 30 years old. The single data label that shows a number also highlights the message.

Next, readers may notice the large font that is applied to selected players. This device draws attention to the human stories behind the dry data. Knowledgable fans may recall fondly when Borg, Becker and Chang burst onto the scene as teenagers.

 

Then, readers may pick up on the ticker-tape data that display the spread of ages of Wimbledon players in any given year. There is some shading involved, not clearly explained, but we surmise that it illustrates the range of ages of most of the contestants. In a sense, the range of probable ages and the average age tell the same story. The current trend of rising ages began around 2005.

 

Finally, a key data processing decision is disclosed in chart header and sub-header. The chart only plots the players who reached the fourth round (16). Like most decisions involved in data analysis, this choice has both desirable and undesirable effects. I like it because it thins out the data. The chart would have appeared more cluttered otherwise, in a negative way.

The removal of players eliminated in the early rounds limits the conclusion that one can draw from the chart. We are tempted to generalize the finding, saying that the average men’s player has increased in age – that was what I said in the first paragraph. Thinking about that for a second, I am not so sure the general statement is valid.

The overall field might have gone younger or not grown older, even as the older players assert their presence in the tournament. (This article provides side evidence that the conjecture might be true: the author looked at the average age of players in the top 100 ATP ranking versus top 1000, and learned that the average age of the top 1000 has barely shifted while the top 100 players have definitely grown older.)

So kudos to these reporters for writing a careful headline that stays true to the analysis.

I also found this video at FT that discussed the chart.

***

This chart about Wimbledon players hits the Trifecta. It has an interesting – to some, surprising – message (Q). It demonstrates thoughtful processing and analysis of the data (D). And the visual design fits well with its intended message (V). (For a comprehensive guide to the Trifecta Checkup, see here.)

Too much of a good thing

Several of us discussed this data visualization over twitter last week. The dataviz by Aero Data Lab is called “A Bird’s Eye View of Pharmaceutical Research and Development”. There is a separate discussion on STAT News.

Here is the top section of the chart:

We faced a number of hurdles in understanding this chart as there is so much going on. The size of the shapes is perhaps the first thing readers notice, followed by where the shapes are located along the horizontal (time) axis. After that, readers may see the color of the shapes, and finally, the different shapes (circles, triangles,...).

It would help to have a legend explaining the sizes, shapes and colors. These were explained within the text. The size encodes the number of test subjects in the clinical trials. The color encodes pharmaceutical companies, of which the graphic focuses on 10 major ones. Circles represent completed trials, crosses inside circles represent terminated trials, triangles represent trials that are still active and recruiting, and squares for other statuses.

The vertical axis presents another challenge. It shows the disease conditions being investigated. As a lay-person, I cannot comprehend the logic of the order. With over 800 conditions, it became impossible to find a particular condition. The search function on my browser skipped over the entire graphic. I believe the order is based on some established taxonomy.

***

In creating the alternative shown below, I stayed close to the original intent of the dataviz, retaining all the dimensions of the dataset. Instead of the fancy dot plot, I used an enhanced data table. The encoding methods reflect what I’d like my readers to notice first. The color shading reflects the size of each clinical trial. The pharmaceutical companies are represented by their first initials. The status of the trial is shown by a dot, a cross or a square.

Here is a sketch of this concept showing just the top 10 rows.

Certain conditions attracted much more investment. Certain pharmas are placing bets on cures for certain conditions. For example, Novartis is heavily into research on Meningnitis, meningococcal while GSK has spent quite a bit on researching "bacterial infections."

It's hot even in Alaska

A twitter user pointed to the following chart, which shows that Alaska has experienced extreme heat this summer, with the July statewide average temperature shattering the previous record;

This column chart is clear in its primary message: the red column shows that the average temperature this year is quite a bit higher than the next highest temperature, recorded in July 2004. The error bar is useful for statistically-literate people - the uncertainty is (presumably) due to measurement errors. (If a similar error bar is drawn for the July 2004 column, these bars probably overlap a bit.)

The chart violates one of the rules of making column charts - the vertical axis is truncated at 53F, thus the heights or areas of the columns shouldn't be compared. This violation was recently nominated by two dataviz bloggers when asked about "bad charts" (see here).

Now look at the horizontal axis. These are the years of the top 20 temperature records, ordered from highest to lowest. The months are almost always July except for the year 2004 when all three summer months entered the top 20. I find it hard to make sense of these dates when they are jumping around.

In the following version, I plotted the 20 temperatures on a chronological axis. Color is used to divide the 20 data points into four groups. The chart is meant to be read top to bottom. 

 

Three estimates, two differences trip up an otherwise good design

Reader Fernando P. was baffled by this chart from the Perception Gap report by More in Common. (link to report)

Overall, this chart is quite good. Its flaws are subtle. There is so much going on, perhaps even the designer found it hard to keep level.

The title is "Democrat's Perception Gap" which actually means the gap between Democrats' perception of Republicans and Republican's self-reported views. We are talking about two estimates of Republican views. Conversely, in Figure 2 (not shown), the "Republican's Perception Gap" describes two estimates of Democrat views.

The gap is visually shown as the gray bar between the red dot and the blue dot. This is labeled perception gap, and its values are printed on the right column, also labeled perception gap.

Perhaps as an after-thought, the designer added the yellow stripes, which is a third estimate of Republican views, this time by Independents. This little addition wreaks havoc. There are now three estimates - and two gaps. There is a new gap, between Independents' perception of Republican views, and Republican's self-reported views. This I-gap is hidden in plain sight. The words "perception gap" obstinately sticks to the D-gap.

***

Here is a slightly modified version of the same chart.

 

The design focuses attention on the two gaps (bars). It also identifies the Republican self-perception as the anchor point from which the gaps are computed.

I have chosen to describe the Republican dot as "self-perception" rather than "actual view," which connotes a form of "truth." Rather than considering the gap as an error of estimation, I like to think of the gap as the difference between two groups of people asked to estimate a common quantity.

Also, one should note that on the last two issues, there is virtual agreement.

***

Aside from the visual, I have doubts about the value of such a study. Only the most divisive issues are being addressed here. Adding a few bipartisan issues would provide controls that can be useful to tease out what is the baseline perception gap.

I wonder whether there is a self-selection in survey response, such that people with extreme views (from each party) will be under-represented. Further, do we believe that all survey respondents will provide truthful answers to sensitive questions that deal with racism, sexism, etc.? For example, if I am a moderate holding racist views, would I really admit to racism in a survey?

 

 

Putting the house in order, two Brexit polls

Reader Steve M. noticed an oversight in the Guardian in the following bar chart (link):

The reporter was discussing an important story that speaks to the need for careful polling design. He was comparing two polls, one by Ipsos Mori, and one by YouGov, that estimates the vote support for each party in the future U.K. general election. The bottom line is that the YouGov poll predicts about double the support for the Brexit Party than the Ipsos-Mori poll.

The stacked bar chart should only be used for data that can be added up. Here, we should be comparing the numbers side by side:

I've always found this standard display inadequate. The story here is the gap in the two bar lengths for the Brexit Party. A secondary story is that the support for the Brexit Party might come from voters breaking from Labour. In other words, we really want the reader to see:

Switching to a dot plot helps bring attention to the gaps:

Now, putting the house in order:

Why do these two polls show such different results? As the reporter explained, the answer is in how the question was asked. The Ipsos-Mori is unprompted, meaning the Brexit Party was not announced to the respondent as one of the choices while the YouGov is prompted.

This last version imposes a direction on the gaps to bring out the secondary message - that the support for Brexit might be coming from voters breaking from Labour.

 

 

Wayward legend takes sides in a chart of two sides, plus data woes

Reader Chris P. submitted the following graph, found on Axios:

From a Trifecta Checkup perspective, the chart has a clear question: are consumers getting what they wanted to read in the news they are reading?

Nevertheless, the chart is a visual mess, and the underlying data analytics fail to convince. So, it’s a Type DV chart. (See this overview of the Trifecta Checkup for the taxonomy.)

***

The designer did something tricky with the axis but the trick went off the rails. The underlying data consist of two set of ranks, one for news people consumed and the other for news people wanted covered. With 14 topics included in the study, the two data series contain the same values, 1 to 14. The trick is to collapse both axes onto one. The trouble is that the same value occurs twice, and the reader must differentiate the plot symbols (triangle or circle) to figure out which is which.

It does not help that the lines look like arrows suggesting movement. Without first reading the text, readers may assume that topics change in rank between two periods of time. Some topics moved right, increasing in importance while others shifted left.

The design wisely separated the 14 topics into three logical groups. The blue group comprises news topics for which “want covered” ranking exceeds the “read” ranking. The orange group has the opposite disposition such that the data for “read” sit to the right side of the data for “want covered”. Unfortunately, the legend up top does more harm than good: it literally takes sides!

**

Here, I've put the data onto a scatter plot:

The two sets of ranks are basically uncorrelated, as the regression line is almost flat, with “R-squared” of 0.02.

The analyst tried to "rescue" the data in the following way. Draw the 45-degree line, and color the points above the diagonal blue, and those below the diagonal orange. Color the points on the line gray. Then, write stories about those three subgroups.

Further, the ranking of what was read came from Parse.ly, which appears to be surveillance data (“traffic analytics”) while the ranking of what people want covered came from an Axios/SurveyMonkey poll. As for as I could tell, there was no attempt to establish that the two populations are compatible and comparable.