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dc.contributor.authorWoodall, William
dc.contributor.authorSteiner, Stefan H. 15:04:31 (GMT) 15:04:31 (GMT)
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.sponsorshipThe work of W. H. Woodall was partially supported by National Science Foundation grant CMMI-1436365. The work of S.H. Steiner was partially supported by the Natural Science and Engineering Research Council of Canada grant 105240.en
dc.publisherBioMed Centralen
dc.rightsAttribution 4.0 International*
dc.subjectSurgical outcomesen
dc.subjectVariable life adjusted display (VLAD)en
dc.subjectRisk-adjusted Bernoulli cumulative sum (RA-CUSUM)en
dc.titleDebate: what is the best method to monitor surgical performance?en
dcterms.bibliographicCitationSteiner, S. H., & Woodall, W. H. (2016). Debate: what is the best method to monitor surgical performance? BMC Surgery, 16(1).
uws.contributor.affiliation1Faculty of Mathematicsen
uws.contributor.affiliation2Statistics and Actuarial Scienceen

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