Title |
Debate: what is the best method to monitor surgical performance?
|
---|---|
Published in |
BMC Surgery, April 2016
|
DOI | 10.1186/s12893-016-0131-8 |
Pubmed ID | |
Authors |
Stefan H. Steiner, William H. Woodall |
Abstract |
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. 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. 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. |
X Demographics
Geographical breakdown
Country | Count | As % |
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Spain | 3 | 33% |
United Kingdom | 3 | 33% |
Unknown | 3 | 33% |
Demographic breakdown
Type | Count | As % |
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Members of the public | 5 | 56% |
Practitioners (doctors, other healthcare professionals) | 3 | 33% |
Science communicators (journalists, bloggers, editors) | 1 | 11% |
Mendeley readers
Geographical breakdown
Country | Count | As % |
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Unknown | 22 | 100% |
Demographic breakdown
Readers by professional status | Count | As % |
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Student > Postgraduate | 4 | 18% |
Student > Ph. D. Student | 3 | 14% |
Professor | 2 | 9% |
Student > Doctoral Student | 1 | 5% |
Lecturer | 1 | 5% |
Other | 3 | 14% |
Unknown | 8 | 36% |
Readers by discipline | Count | As % |
---|---|---|
Medicine and Dentistry | 10 | 45% |
Engineering | 2 | 9% |
Unknown | 10 | 45% |