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The ggswim package eases the development of swimmer plots in R through extension of ggplot2. In this vignette, we’ll walk through how users can create visually striking swimmer plots.

ggswim offers several layering functions that mimic other “geom” functions from ggplot2:

The former, an extension of geom_segment(), allows users to construct the horizontal bars, what we’ll sometimes refer to as “lanes.” Meanwhile, geom_swim_marker() wraps geom_text() to effortlessly embed key events of interest, or “markers,” onto the lanes. These can take the form of shapes, symbols, or even emojis.

Drawing from the well-established principles of ggplot2, ggswim allows users to apply familiar layer-building techniques, including the application of styles and themes. You’ll also see that common behaviors are still accessible with ggswim such as auto-completing aes() parameters with piping.

Adding a Lane Layer

Let’s get started building our swimmer plot! As with the README, we will be using ggswim’s internal datasets: patient_data, infusion_events, and end_study_events.

Let’s start with observing patient_data’s structure:

#> # A tibble: 75 × 4
#>    pt_id disease_assessment       start_time end_time
#>    <chr> <chr>                         <dbl>    <dbl>
#>  1 01    CR/CRi + B Cell Recovery       -2.8      0  
#>  2 01    RD                              0        0.9
#>  3 01    CR/CRi + B Cell Aplasia         0.9      0  
#>  4 01    CR/CRi + B Cell Aplasia         0        1.8
#>  5 01    CR/CRi + B Cell Recovery        1.8      2  
#>  6 02    RD                             -2.8      0  
#>  7 02    CRi                             0        0.2
#>  8 03    CR/CRi + B Cell Recovery       -2.4      0  
#>  9 03    CR/CRi + B Cell Recovery        0        0.9
#> 10 03    CR/CRi + B Cell Aplasia         0.9      2.8
#> # ℹ 65 more rows

patient_data contains a long dataset where patient ID’s (pt_id) can be repeated. These rows are differentiated by disease_assessmentss combined with corresponding start and end times, representing months. Together, these rows detail clinical trial timelines for a given patient.

  • disease_assessment is broken down into a few categories where:
    • CR = “Complete Response”
    • CRi = “Complete Response with Incomplete Blood Count Recovery”
    • RD = “Relapsed Disease”

Now, let’s make the plot using ggplot() and our first layer with geom_swim_lane():

library(ggplot2)

p <- ggplot() +
  geom_swim_lane(
    data = patient_data,
    mapping = aes(
      x = start_time,
      xend = end_time,
      y = pt_id,
      color = disease_assessment
    ),
    linewidth = 3
  )

p

Here we have a simple bar graph showing infusions grouped by patients with a given disease assessment status. geom_swim_lane() does the work of setting up geom_segment() and readying our plot layers for additional ggswim-specific features such as the “markers” mentioned earlier. It’s worth noting that geom_swim_lane() is a very thin wrapper around geom_segment() and supports the same functionality apart from a yend since swimmer plots tend to be horizontal.

Adding a Marker Layer: Points

Now, let’s add a marker layer by first inspecting the infusion_events and end_study_events datasets:

infusion_events
#> # A tibble: 18 × 5
#>    pt_id time_from_initial_infusion label             glyph colour 
#>    <chr>                      <dbl> <chr>             <chr> <chr>  
#>  1 01                           1   First Reinfusion  ⬤     #999999
#>  2 02                           0   First Reinfusion  ⬤     #999999
#>  3 03                           2   First Reinfusion  ⬤     #999999
#>  4 03                           3   Second Reinfusion ⬤     #f57dc1
#>  5 04                           5   First Reinfusion  ⬤     #999999
#>  6 05                           2   First Reinfusion  ⬤     #999999
#>  7 05                           4.3 Second Reinfusion ⬤     #f57dc1
#>  8 06                           2   First Reinfusion  ⬤     #999999
#>  9 08                           1   First Reinfusion  ⬤     #999999
#> 10 08                           2.5 Second Reinfusion ⬤     #f57dc1
#> 11 09                           7   First Reinfusion  ⬤     #999999
#> 12 12                           6   First Reinfusion  ⬤     #999999
#> 13 13                           1   First Reinfusion  ⬤     #999999
#> 14 14                           0   First Reinfusion  ⬤     #999999
#> 15 15                           0   First Reinfusion  ⬤     #999999
#> 16 17                           1   First Reinfusion  ⬤     #999999
#> 17 18                           3   First Reinfusion  ⬤     #999999
#> 18 19                           4   First Reinfusion  ⬤     #999999

This dataset is much simpler, indicating the time from the initial infusion (0), and reinfusions at some point beyond 0 (if a patient had any). These are also categorized under label. glyph and colour will serve as helpful specifiers when we add our markers onto our swimmer plot. Initial infusions aren’t a part of this dataset since the plot itself is centered around them, and having markers for all segments at month 0 would be relatively meaningless.

Next, let’s look at our end of study events, i.e. events that indicate a patient has left the study for various reasons.

end_study_events
#> # A tibble: 7 × 4
#>   pt_id time_from_initial_infusion label                     glyph
#>   <chr>                      <dbl> <chr>                     <chr>
#> 1 01                           2   Other End Study Reason    ⚠️    
#> 2 02                           0.2 Deceased                  ❌   
#> 3 03                          11.9 Completed Study Follow-Up ✅   
#> 4 05                          14.1 Completed Study Follow-Up ✅   
#> 5 06                           4.8 Other End Study Reason    ⚠️    
#> 6 08                          11.7 Other End Study Reason    ⚠️    
#> 7 12                           9.7 Other End Study Reason    ⚠️

You’ll notice that this dataset includes use of emojis under glyph. In addition to shapes and symbols, ggswim supports the use of emojis when rendering swimmer plots. If issues arise in rendering, you may need to check your options settings and ensure a proper graphics device like “AGG”.

While it’s common to encounter these as separate datasets in the wild, it will make our lives much easier to combine end_study_events and infusion_events together since they share roughly the same data structure and the markers exist on the same timeline.

all_events <- dplyr::bind_rows(
  infusion_events,
  end_study_events
)

all_events
#> # A tibble: 25 × 5
#>    pt_id time_from_initial_infusion label             glyph colour 
#>    <chr>                      <dbl> <chr>             <chr> <chr>  
#>  1 01                           1   First Reinfusion  ⬤     #999999
#>  2 02                           0   First Reinfusion  ⬤     #999999
#>  3 03                           2   First Reinfusion  ⬤     #999999
#>  4 03                           3   Second Reinfusion ⬤     #f57dc1
#>  5 04                           5   First Reinfusion  ⬤     #999999
#>  6 05                           2   First Reinfusion  ⬤     #999999
#>  7 05                           4.3 Second Reinfusion ⬤     #f57dc1
#>  8 06                           2   First Reinfusion  ⬤     #999999
#>  9 08                           1   First Reinfusion  ⬤     #999999
#> 10 08                           2.5 Second Reinfusion ⬤     #f57dc1
#> # ℹ 15 more rows

Let’s now call geom_swim_marker() and add the events onto our plot. To do this, we will use geom_swim_marker()’s custom marker aes() parameter:

p <- p +
  geom_swim_marker(
    data = all_events,
    aes(
      x = time_from_initial_infusion,
      y = pt_id,
      marker = label
    ),
    size = 4
  )

p

We’ve successfully made a swimmer plot with lanes and two different kinds of marker layers! Notice how even though both the lanes and markers use the color scale, they are separated in the legend output. Let’s take it one step further and make use of the glyph and colour columns we specified.

A Sense of Scale

Scales are a unique component of the ggplot2 framework. For more information on them and understanding how they work, you are encouraged to read the “Scales” chapter from ggplot2: Elegant Graphics for Data Analysis. In short, scales are responsible for connecting data with aesthetics and communicating those connections through elements like the plot legend.

scale_marker_discrete() makes it easy to specify and take finer control over your markers and their appearance in the legend. Typically, it can be difficult to have emojis and labels appear in the place of legend glyphs. Let’s take a look at a typical output using base ggplot2 with geom_text():

ggplot() +
  geom_text(
    data = all_events,
    aes(x = time_from_initial_infusion, y = pt_id, label = label, colour = glyph),
    size = 4
  )

geom_text() does a decent job, and is actually what geom_swim_marker() wraps. However, at it’s base level it doesn’t quite set up the use of glyphs the way we would like to see them in the legend display. Additionally, those glyphs don’t appear in the plot. You could try to rework this with geom_point() or geom_label(), but would still run into issues with scale assignment. This pain point is one of the foundational reasons we made ggswim in the first place!

Thanks to ggswim we can specify what belongs in the glyph versus text elements of our legend. Additionally, we are able to use the “colour” scales under the marker definition so ggswim can use the same colour scale under the hood, but keep the identity of “markers” and “lanes” separate in the output:

p <- p +
  scale_marker_discrete(
    name = "Study Events",
    glyphs = all_events$glyph,
    colours = all_events$colour,
    limits = all_events$label
  )

p

A Full Swimmer Plot

As mentioned in the README, all of the same ggplot2 techniques you would apply to your usual plots apply here. Below, we update the lanes to match a nicer palette with a new name and add on some plot labels:

library(ggplot2)

p <- p +
  theme_minimal() +
  scale_color_brewer(
    name = "Disease Assessments",
    palette = "Set1"
  ) +
  labs(title = "My Swimmer Plot") +
  xlab("Time (Months)") + ylab("Patient ID")

p

We can also apply the theme_ggswim() function to give it some additional beautification:

Additional notes

Some additional considerations to keep in mind when working with ggswim:

  • Rendering Emojis and Custom Shapes: To ensure emojis and other custom shapes display correctly, users may need to switch their graphics rendering device to AGG.
  • ggswim supports use of FontAwesome and Bootstrap icons for glyph definition in addition to shapes and emojis. Check out the Gallery for examples on how to add them to your plots!