Tag Archives: epidemiology

van der Beugel, Jacob. The Pathways of Patients

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Steven Oliver – January 2017….

In 2015 I was approached by Jacob van der Beugel in my role as a member of the University of York Epidemiology and Cancer Statistics Group (ECSG) research group. He was interested in an artists in residence scheme being supported by the University and in developing an art work that related to the work.  We focus our research predominantly on ‘Blood Cancers’ a complex mixture of different malignancies including leukaemias, lymphomas, myeloma.
Jacob came to visit our research group on 3-4 occasions across the year and met with researchers, laboratory staff, clinicians and patients.
He had come with an initial metaphor ‘concrete cancer’ which describes the situation where the integrity of concrete chemically deteriorates, potentially exposing structural metal reinforcement and leading to the failure of structures.
The work of the ECSG is broad in scope and we talked about many aspects of this – but the element that caught his imagination was the work we had done on the social patterning of survival for patients with blood cancers. Essentially, the fact that patients from poorer backgrounds have shorter survival – not unusual, but normally made more complex by the fact that poorer people are more likely to develop cancer, which isn’t the case for blood cancers.
We talked a lot about the processes and methods of observational epidemiology in which we seek to accurately represent patterns and distributions of disease in populations and some of the challenges that this poses.

An example of the way we’d normally present such patterns – survival curves for patients with Chronic Myeloid Leukaemia by the Index of Multiple Deprivation (IMD) for the area they live at diagnosis (1-3 more affluent, 4-5 less affluent)

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In the end Jacob represented both these ideas and the methods of epidemiology in a ‘diptych’ of two panels – one representing the ‘world as it is’ and one representing the way in which epidemiologists model observed data. He used concrete as an example of a medium that was associated both with high prestige constructions (when polished) and in cheap functional structures where the finish might be rough. He used rust to represent blood trails – and in a way we often use in teaching – showed the length of life by the length of the path.

In ‘Pathways of Patients II’ the shorter, ‘rougher’ experience of patients from less advantaged areas in our regional population is clearly contrasted with the longer, smoother, tracks of those from less deprived areas. The same pattern is present in ‘Pathways of Patients I’, but (as in a real population) the mixture of exposures initially obscures this. The ‘science’ of epidemiology is in part that restructuring of data to reveal the patterns within it.

You can see more of Jacob’s work at his website – this link will take you to more pictures of the pieces, and also some of the artist’s thoughts about it.

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