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Parsonnet, D. Dean, Bernstein Ad (1989)
A method of uniform stratification of risk for evaluating the results of surgery in acquired adult heart disease.Circulation, 79 6 Pt 2
S. Nashef, F. Roques, P. Michel, E. Gauducheau, S. Lemeshow, R. Salamon (1999)
European system for cardiac operative risk evaluation (EuroSCORE).European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery, 16 1
G. Grunkemeier, Yingxing Wu, A. Furnary (2003)
Cumulative sum techniques for assessing surgical results.The Annals of thoracic surgery, 76 3
D. Montgomery (1985)
Introduction to Statistical Quality Control
Samuel Brown, J. Benneyan, Daniel Theobald, K. Sands, Matthew Hahn, G. Potter-Bynoe, J. Stelling, T. O'Brien, D. Goldmann (2002)
Use of Binary Cumulative Sums and Moving Averages in Nosocomial Infection Cluster DetectionEmerging Infectious Diseases, 8
G. Teasdale (2002)
Learning from Bristol: report of the public inquiry into children's heart surgery at Bristol Royal Infirmary 1984-1995British Journal of Neurosurgery, 16
M. Leval, K. François, C. Bull, W. Brawn, D. Spiegelhalter (1994)
Analysis of a cluster of surgical failures. Application to a series of neonatal arterial switch operations.The Journal of thoracic and cardiovascular surgery, 107 3
J. Green, N. Wintfeld (1995)
Report cards on cardiac surgeons. Assessing New York State's approach.The New England journal of medicine, 332 18
R. Sauter (1992)
Introduction to Statistical Quality Control (2nd ed.)Technometrics, 34
K. McPherson (1974)
Statistics: the problem of examining accumulating data more than once.The New England journal of medicine, 290 9
D. Altman, J. Royston (1988)
The hidden effect of time.Statistics in medicine, 7 6
G. Scally, L. Donaldson (1998)
Clinical governance and the drive for quality improvement in the new NHS in EnglandBMJ, 317
Chris Rogers, Chris Rogers, B. Reeves, M. Caputo, J. Ganesh, R. Bonser, G. Angelini (2004)
Control chart methods for monitoring cardiac surgical performance and their interpretation.The Journal of thoracic and cardiovascular surgery, 128 6
A. Crathorne, W. Shewhart (1933)
Economic Control of Quality of Manufactured Product.American Mathematical Monthly, 40
J. Lovegrove, O. Valencia, T. Treasure, C. Sherlaw-Johnson, S. Gallivan (1997)
Monitoring the results of cardiac surgery by variable life-adjusted displayThe Lancet, 350
D. Spiegelhalter, O. Grigg, R. Kinsman, T. Treasure (2003)
Risk-adjusted sequential probability ratio tests: applications to Bristol, Shipman and adult cardiac surgery.International journal for quality in health care : journal of the International Society for Quality in Health Care, 15 1
R. Novick, L. Stitt (1999)
The Learning Curve of an Academic Cardiac Surgeon: Use of the CUSUM MethodJournal of Cardiac Surgery, 14
P. Tekkis, P. Mcculloch, A. Steger, I. Benjamin, J. Poloniecki (2003)
Jan using hospital mortality data performance of surgical units : validation study Mortality control charts for comparing
M. Caputo, M. Chamberlain, F. Ozalp, M. Underwood, F. Ciulli, G. Angelini (2001)
Off-pump coronary operations can be safely taught to cardiothoracic trainees.The Annals of thoracic surgery, 71 4
J. Riddick, N. Giddings (1971)
Computerized preparation of average CUSUM charts for clinical chemistry.Clinical biochemistry, 4 3
Dominique Boulmier, Marc Bedossa, C. Almange, H. Breton (2002)
Intrathoracic organ transplantation in the United Kingdom 1995–99: results from the UK cardiothoracic transplant auditHeart, 87
E. Page (1954)
CONTINUOUS INSPECTION SCHEMESBiometrika, 41
J. Poloniecki, C. Sismanidis, M. Bland, Paul Jones (2004)
Retrospective cohort study of false alarm rates associated with a series of heart operations: the case for hospital mortality monitoring groupsBMJ : British Medical Journal, 328
Objective: Guidelines are needed for real-time quality monitoring in heart and lung transplantation. The cumulative sum (CUSUM) methodology with boundary limits derived from the sequential probability ratio test (SPRT) provide a means of monitoring performance without the need for repeated statistical testing. The variable life adjusted display (VLAD) complements the SPRT chart and provides a directly interpretable assessment of performance. We present our experience with these charts in monitoring cardiothoracic transplant outcomes in the UK. Methods: Thirty-day-post-transplantation mortality after isolated first time transplantation of the heart (n=1634) or lung (n=1162) in adults, between July 1995 and March 2004 in eight centres were monitored. CUSUM charts, with and without risk-adjustment and risk-adjusted VLAD plots were constructed. Thirty-day mortality rates for the UK as a whole were taken as the reference values for the unadjusted charts and a 50% increase in risk provided the basis for construction of boundary lines for the SPRT. Risk-adjustment was based on multivariate models previously developed from the national database. Results: For heart transplantation without risk-adjustment, four centres crossed the lower boundary, indicating 30-day mortality was in-line with or better than seen nationally. Two centres were close to signalling an alert, warning of a rise in mortality rate, but neither chart signalled an alarm. After risk-adjustment one centre's graph moved towards the centre of the chart, indicating monitoring should continue and the other signalled an alarm. For lung transplantation the unadjusted mortality rate at one centre was confirmed acceptable and the results remained inconclusive for five. At the other centre, following an alert to a possible increase in mortality half-way through the sequence, results improved. Case-mix adjustment served to pull the charts away from the upper boundary lines; no chart suggested any cause for concern. For most centres the VLAD charts oscillated around the horizontal axis. Conclusions: CUSUM charts are useful tools for monitoring performance, and provide a basis for visually comparing results between centres and identifying periods of ‘bad runs’. Risk-adjustment, which down-weights higher risk activity, avoids inappropriate reaction to unadjusted breaches of alert and alarm lines.
European Journal of Cardio-Thoracic Surgery – Oxford University Press
Published: Jun 1, 2005
Keywords: CUSUM VLAD SPRT Case-mix Risk adjustment Monitoring
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