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Risk-Adjusted Cumulative Sum Charting Procedure Based on Multiresponses

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  • Xu Tang
  • Fah F. Gan
  • Lingyun Zhang

Abstract

The cumulative sum charting procedure is traditionally used in the manufacturing industry for monitoring the quality of products. Recently, it has been extended to monitoring surgical outcomes. Unlike a manufacturing process where the raw material is usually reasonably homogeneous, patients' risks of surgical failure are usually different. It has been proposed in the literature that the binary outcomes from a surgical procedure be adjusted using the preoperative risk based on a likelihood-ratio scoring method. Such a crude classification of surgical outcome is naive. It is unreasonable to regard a patient who has a full recovery, the same quality outcome as another patient who survived but remained bed-ridden for life. For a patient who survives an operation, there can be many different grades of recovery. Thus, it makes sense to consider a risk-adjusted cumulative sum charting procedure based on more than two outcomes to better monitor surgical performance. In this article, we develop such a chart and study its performance.

Suggested Citation

  • Xu Tang & Fah F. Gan & Lingyun Zhang, 2015. "Risk-Adjusted Cumulative Sum Charting Procedure Based on Multiresponses," Journal of the American Statistical Association, Taylor & Francis Journals, vol. 110(509), pages 16-26, March.
    • Handle: RePEc:taf:jnlasa:v:110:y:2015:i:509:p:16-26
    DOI: 10.1080/01621459.2014.960965
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    References listed on IDEAS

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    1. J Lovegrove & C Sherlaw-Johnson & O Valencia & T Treasure & S Gallivan, 1999. "Monitoring the performance of cardiac surgeons," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 50(7), pages 684-689, July.
    2. Bercedis Peterson & Frank E. Harrell, 1990. "Partial Proportional Odds Models for Ordinal Response Variables," Journal of the Royal Statistical Society Series C, Royal Statistical Society, vol. 39(2), pages 205-217, June.
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    1. Athanasios Sachlas & Sotirios Bersimis & Stelios Psarakis, 2019. "Risk-Adjusted Control Charts: Theory, Methods, and Applications in Health," Statistics in Biosciences, Springer;International Chinese Statistical Association, vol. 11(3), pages 630-658, December.

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