Debate: should we use variable adjusted life displays (VLAD) to identify variations in performance in general surgery?
| Autor: | Stephen J. Wigmore, Stephen O´Neill, Ewen M Harrison |
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| Jazyk: | angličtina |
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OUTCOMES
medicine.medical_specialty Quality Assurance Health Care Debate business.industry MORTALITY MEDLINE Better than Expected General Medicine Outcome assessment TIME Surgery Public interest Survival Rate Variable (computer science) General Surgery SAFER Outcome Assessment Health Care medicine Humans Clinical Competence Clinical competence business CARDIAC-SURGERY |
| Zdroj: | O'Neill, S, Wigmore, S J & Harrison, E M 2015, ' Debate : should we use variable adjusted life displays (VLAD) to identify variations in performance in general surgery? ', Bmc surgery, vol. 15, 102 . https://doi.org/10.1186/s12893-015-0087-0 BMC Surgery |
| ISSN: | 1471-2482 |
| DOI: | 10.1186/s12893-015-0087-0 |
| Popis: | Background 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. |
| Databáze: | OpenAIRE |
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