A new VLAD-based control chart for detecting surgical outcomes

Stat Med. 2017 Dec 10;36(28):4540-4547. doi: 10.1002/sim.7362. Epub 2017 Jun 7.

Abstract

The timely detection of surgical quality changes is becoming increasingly important. Variable life-adjusted display (VLAD) has a wide range of applications in the medical field. However, the control limits of VLAD are not defined; thus, the charts alone cannot reveal whether surgical quality underwent a significant change. This paper proposes a new risk-adjusted exponentially weighted moving average VLAD (RAEV) chart and provides a control limit that can be used with the VLAD. The RAEV chart is designed to detect shifts in the odds ratios of patients' surgical risk. Simulation is used to demonstrate that the proposed RAEV chart efficiently detects shifts of various magnitudes, and an example is provided to illustrate the implementation of the RAEV control limits in a VLAD chart. Copyright © 2017 John Wiley & Sons, Ltd.

Keywords: VLAD; exponentially weighted moving average; risk-adjusted; surgical outcomes.

MeSH terms

  • Computer Simulation
  • Hong Kong / epidemiology
  • Hospital Mortality
  • Hospitals
  • Humans
  • Postoperative Complications / epidemiology*
  • Risk Adjustment / methods*
  • Risk Assessment
  • Treatment Outcome