Impact of the Edmonton Labeled Visual Information System on physician recall of metastatic cancer patient histories: A randomized controlled trial

The Edmonton Labeled Visual Information System (ELVIS) is a novel method of documenting clinical information because it is a pictorial method of representing cancer burden and treatment. This randomized, crossover, multiperiod trial involved 16 physicians who each reviewed two ELVIS and two control (text) cancer patient cases (total 32 ELVIS and 32 text cases). Short-answer questionnaires were administered immediately and 18-24 hours following. Mean (± SD) recall of basic disease and treatment information was superior immediately following the ELVIS cases (83% ± 14%) versus text cases (60% ± 14%, P < 0.0001) and 18-24 hours later (ELVIS cases 65% ± 21% versus text cases 43% ± 21%, P < 0.0001). Mean (± SD) time required to memorize information was reduced in the ELVIS cases (4 ± 2 min) versus text cases (13 ± 6 min, P < 0.0001). Ratings of overall physician preference strongly favored the ELVIS over text. The data indicate that ELVIS aids the process of learning complex cancer patient histories.