Evidence map›Paper›PMID 36123624›Full record

ArticleBMC anesthesiology2022

The problem with dichotomizing quality improvement measures.

James Harvey Jones, Neal Fleming

Abstract read
In one paragraph

Article in BMC anesthesiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors.

James Harvey JonesDepartment of Anesthesiology, University of North Carolina at Chapel Hill, N2198 UNC Hospitals, CB #7010, Chapel Hill, NC, 27599-7010, USA. jamesjns137@gmail.com.
Neal FlemingDepartment of Anesthesiology and Pain Medicine, University of California Davis Medical Center, 4150 V Street, PSSB Suite 1200, Sacramento, CA, 95817, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

The Anesthesia Quality Institute (AQI) promotes improvements in clinical care outcomes by managing data entered in the National Anesthesia Clinical Outcomes Registry (NACOR). Each case included in NACOR is classified as "performance met" or "performance not met" and expressed as a percentage for a length of time. The clarity associated with this binary classification is associated with limitations on data analysis and presentations that may not be optimal guides to evaluate the quality of care. High compliance benchmarks present another obstacle for evaluating quality. Traditional approaches for interpreting statistical process control (SPC) charts depend on data points above and below a center line, which may not provide adequate characterizations of a QI process with a low failure rate, or few possible data points below the center line. This article demonstrates the limitations associated with the use of binary datasets to evaluate the quality of care at an individual organization with QI measures, describes a method for characterizing binary data with continuous variables and presents a solution to analyze rare QI events using g charts.

Indexed as

AnesthesiaAnesthesiologyQuality ImprovementG chartP chartQuality improvementStatistical process control

Identifiers

PMID36123624
PMCPMC9484068

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.