ArticleBMC surgery2016
Debate: what is the best method to monitor surgical performance?
Article in BMC surgery, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
6 citing papers in PubMed.
- Long-Term Skills Retention Following a Randomized Prospective Trial on Adaptive Procedural Training.Journal of surgical education · 2018Trial
- Risk-adjusted observed minus expected cumulative sum (RA O-E CUSUM) chart for visualisation and monitoring of surgical outcomes.BMJ quality & safety · 2025Article
- Anastomotic time was associated with postoperative complications: a cumulative sum analysis of thoracoscopic repair of tracheoesophageal fistula in a single surgeon's experience.Surgery today · 2023Article
- The influence of learning curve of robot-assisted laparoscopy on oncological outcomes in early-stage cervical cancer: an observational cohort study.BJOG : an international journal of obstetrics and gynaecology · 2021Observational
- Statistical process monitoring to improve quality assurance of inpatient care.BMC health services research · 2020Article
- Use of cumulative summation (CUSUM) as a tool for early feedback and monitoring in robot-assisted radical prostatectomy outcomes and performance.Canadian Urological Association journal = Journal de l'Association des urologues du Canada · 2019Article
Corrections and comments
- Comment on
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThere 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. 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.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.