Debate: what is the best method to monitor surgical performance?

dc.contributor.authorSteiner, Stefan H.en
dc.contributor.authorWoodall, William H.en
dc.date.accessioned2016-10-25T13:24:39Zen
dc.date.available2016-10-25T13:24:39Zen
dc.date.issued2016-04-05en
dc.description.abstractBackground There is considerable recent interest in the monitoring of individual surgeon or hospital surgical outcomes. If one aggregates data over time and assesses performance with a funnel plot, then the detection of any process deterioration or improvement could be delayed. The variable life adjusted display (VLAD) is widely used for monitoring on a case-by-case basis, but we show that use of the risk-adjusted Bernoulli cumulative sum (RA-CUSUM) chart leads to much better performance. Discussion We use simulation to illustrate that the RA-CUSUM chart has better performance than the VLAD in detecting changes in the rates of adverse events. Summary We recommend the RA-CUSUM approach over the VLAD approach for monitoring surgical performance. If the VLAD is used, we recommend running the RA-CUSUM chart in the background to generate signals that the process performance has changed.en
dc.description.versionPublished versionen
dc.format.extent4 pagesen
dc.format.mimetypeapplication/pdfen
dc.identifier.citationBMC Surgery. 2016 Apr 05;16(1):15en
dc.identifier.doihttps://doi.org/10.1186/s12893-016-0131-8en
dc.identifier.issn1471-2482en
dc.identifier.urihttp://hdl.handle.net/10919/73325en
dc.identifier.volume16en
dc.language.isoenen
dc.publisherBiomed Centralen
dc.relation.urihttp://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcApp=PARTNER_APP&SrcAuth=LinksAMR&KeyUT=WOS:000373322100001&DestLinkType=FullRecord&DestApp=ALL_WOS&UsrCustomerID=930d57c9ac61a043676db62af60056c1en
dc.rightsCreative Commons Attribution 4.0 Internationalen
dc.rights.holderSteiner and Woodall.en
dc.rights.urihttp://creativecommons.org/licenses/by/4.0/en
dc.subjectSurgeryen
dc.subjectDETECTING CHANGESen
dc.titleDebate: what is the best method to monitor surgical performance?en
dc.title.serialBMC Surgeryen
dc.typeArticle - Refereeden
dc.type.dcmitypeTexten
pubs.organisational-group/Virginia Techen
pubs.organisational-group/Virginia Tech/All T&R Facultyen
pubs.organisational-group/Virginia Tech/Scienceen
pubs.organisational-group/Virginia Tech/Science/COS T&R Facultyen
pubs.organisational-group/Virginia Tech/Science/Statisticsen

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