Direct comparison of risk-adjusted and non–risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes Richard J. Novick, MD, Stephanie A.

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Presentation transcript:

Direct comparison of risk-adjusted and non–risk-adjusted CUSUM analyses of coronary artery bypass surgery outcomes Richard J. Novick, MD, Stephanie A. Fox, BSc, RRCP, Larry W. Stitt, MSc, Thomas L. Forbes, MD, Stefan Steiner, PhD The Journal of Thoracic and Cardiovascular Surgery Volume 132, Issue 2, Pages 386-391 (August 2006) DOI: 10.1016/j.jtcvs.2006.02.053 Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Non–risk-adjusted CUSUM analysis of the surgeon’s adverse outcome rate. The curve designed to identify a decrement in surgical performance is placed above that designed to identify improvement in performance with a decreased complication rate. Pre-set control limits (dashed horizontal lines). The Journal of Thoracic and Cardiovascular Surgery 2006 132, 386-391DOI: (10.1016/j.jtcvs.2006.02.053) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Risk-adjusted CUSUM analysis of the surgeon’s adverse outcome rate. The curve designed to identify a decrement in surgical performance is placed above that designed to identify improvement in performance with a decreased complication rate. Pre-set control limits (dashed horizontal lines). The Journal of Thoracic and Cardiovascular Surgery 2006 132, 386-391DOI: (10.1016/j.jtcvs.2006.02.053) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Risk-adjusted CUSUM analysis of the surgeon’s adverse outcome rate, with resetting of the CUSUM curve to zero whenever a pre-set control limit was reached. The curve designed to identify a decrement in surgical performance is placed above that designed to identify improvement in performance with a decreased complication rate. Pre-set control limits (dashed horizontal lines). The Journal of Thoracic and Cardiovascular Surgery 2006 132, 386-391DOI: (10.1016/j.jtcvs.2006.02.053) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions

Figure 4 VLAD analysis of the surgeon’s cumulative expected minus actual adverse outcome rate. The 95% pointwise 2-sided prediction limits are plotted as aids in interpretation.14 The Journal of Thoracic and Cardiovascular Surgery 2006 132, 386-391DOI: (10.1016/j.jtcvs.2006.02.053) Copyright © 2006 The American Association for Thoracic Surgery Terms and Conditions