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Local and marginal control charts applied to methicillin resistant Staphylococcus aureus bacteraemia reports in UK acute National Health Service trusts

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  • O. A. Grigg
  • D. J. Spiegelhalter
  • H. E. Jones

Abstract

Summary. We consider the general problem of simultaneously monitoring multiple series of counts, applied in this case to methicillin resistant Staphylococcus aureus (MRSA) reports in 173 UK National Health Service acute trusts. Both within‐trust changes from baseline (‘local monitors’) and overall divergence from the bulk of trusts (‘relative monitors’) are considered. After standardizing for type of trust and overall trend, a transformation to approximate normality is adopted and empirical Bayes shrinkage methods are used for estimating an appropriate baseline for each trust. Shewhart, exponentially weighted moving average and cumulative sum charts are then set up for both local and relative monitors: the current state of each is summarized by a p‐value, which is processed by a signalling procedure that controls the false discovery rate. The performance of these methods is illustrated by using 4.5 years of MRSA data, and the appropriate use of such methods in practice is discussed.

Suggested Citation

  • O. A. Grigg & D. J. Spiegelhalter & H. E. Jones, 2009. "Local and marginal control charts applied to methicillin resistant Staphylococcus aureus bacteraemia reports in UK acute National Health Service trusts," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 172(1), pages 49-66, January.
    • Handle: RePEc:bla:jorssa:v:172:y:2009:i:1:p:49-66
    DOI: 10.1111/j.1467-985X.2008.00553.x
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    References listed on IDEAS

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    1. Grigg, Olivia & Spiegelhalter, David, 2007. "A Simple Risk-Adjusted Exponentially Weighted Moving Average," Journal of the American Statistical Association, American Statistical Association, vol. 102, pages 140-152, March.
    2. Clare Marshall & Nicky Best & Alex Bottle & Paul Aylin, 2004. "Statistical issues in the prospective monitoring of health outcomes across multiple units," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 167(3), pages 541-559, August.
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    Cited by:

    1. Du, Lilun & Wen, Mengtao, 2023. "False discovery rate approach to dynamic change detection," Journal of Multivariate Analysis, Elsevier, vol. 198(C).
    2. Willem Albers, 2011. "Control charts for health care monitoring under overdispersion," Metrika: International Journal for Theoretical and Applied Statistics, Springer, vol. 74(1), pages 67-83, July.

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