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Visualizing Multimorbidity in Chronically Ill Populations Using UpSet Plots

      We read with great interest the recent article in this journal by Dreisbach et al. in which they analyzed and clustered unrelieved symptoms in patients with one or more chronic conditions.
      • Dreisbach C
      • Grayson S
      • Leggio K
      • Conway A
      • Koleck T.
      Predictors of unrelieved symptoms in all of US research program participants with chronic conditions.
      In particular, Fig. 1, Panel A, which illustrates the overlap of chronic conditions, caught our eye. We would like to use this as an opportunity to point out a novel and innovative approach to visualize intersecting sets which we find particularly useful for illustrating multimorbidity in chronically ill populations.
      Fig 1
      Fig. 1Recreation of a Venn Diagram as UpSet Plot. Panel A: Figure “Chronic condition diagnoses in study participant cohort (N=14,127)” reproduced from the Dreisbach et al. Journal of Pain and Symptom Management, Volume 64, Issue 6, P555-566 (permission pending). Panel B: Recreation of the Venn diagram from Dreisbach et al. in the form of an UpSet plot. Abbreviations: COPD = Chronic obstructive pulmonary disease. For interpretation of the references to color in this figure legend, the reader is referred to the web version of this article.
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      References

        • Dreisbach C
        • Grayson S
        • Leggio K
        • Conway A
        • Koleck T.
        Predictors of unrelieved symptoms in all of US research program participants with chronic conditions.
        J Pain Symptom Manage. 2022; (S0885-3924(22)00872-7) (Published online)
        • Venn J.I.
        On the diagrammatic and mechanical representation of propositions and reasonings.
        Lond Edinb Dublin Philos Mag J Sci. 1880; 10: 1-18https://doi.org/10.1080/14786448008626877
        • Lex A
        • Gehlenborg N
        • Strobelt H
        • Vuillemot R
        • Pfister H.
        UpSet: visualization of intersecting sets.
        IEEE Trans Vis Comput Graph. 2014; 20: 1983-1992https://doi.org/10.1109/TVCG.2014.2346248
      1. Nils Gehlenborg. UpSetR: a more scalable alternative to venn and euler diagrams for visualizing intersecting sets. R package version 1.4.0. Published online 2019. Available at: https://CRAN.R-project.org/package=UpSetR. Accessed November 22, 2022.

      2. Alexander Lex. UpSet. Published online, 2021. Available at: https://upset.app/. Accessed November 22, 2022.