Yap Cheng-Hon, Colson Mark E, Watters David A
Cardiothoracic Care Centre, St Vincent's Hospital, Melbourne, Victoria, Australia.
ANZ J Surg. 2007 Jul;77(7):583-6. doi: 10.1111/j.1445-2197.2007.04155.x.
There has been increasing awareness of the need for monitoring the quality of health care, particularly in the area of surgery. The Cumulative Summation (Cusum) techniques have emerged as a popular tool for performance monitoring in surgery. They allow one to judge whether a given variation in performance is probably due to chance or greater than could be expected from random variation and thus a cause for concern. The Cusum techniques are simple to carry out and can be applied to any surgical process with a binary outcome. Four parameters need to be set in advance: acceptable outcome rate, unacceptable outcome rate, Type I and Type II error rates. In this article, we review the history, statistical methods and potential applications for the Cusum techniques in the field of surgery and illustrate the two common forms of charting (cumulative failure and Cusum charting) by using unadjusted outcome data from the Geelong Hospital and St Vincent's Hospital cardiac surgery databases.
人们越来越意识到监测医疗质量的必要性，尤其是在外科手术领域。累积求和（Cusum）技术已成为外科手术中绩效监测的常用工具。它们使人们能够判断给定的绩效变化是可能由于偶然因素还是大于随机变化所预期的，因此值得关注。Cusum技术实施起来很简单，可应用于任何具有二元结果的外科手术过程。需要预先设定四个参数：可接受结果率、不可接受结果率、I型和II型错误率。在本文中，我们回顾了Cusum技术在外科领域的历史、统计方法和潜在应用，并通过使用来自吉朗医院和圣文森特医院心脏手术数据库的未经调整的结果数据来说明两种常见的图表形式（累积失败和Cusum图表）。
