Department of Statistics and Actuarial Sciences, University of Waterloo, Waterloo, Ontario, Canada.
Stat Med. 2010 Feb 20;29(4):444-54. doi: 10.1002/sim.3788.
Monitoring medical outcomes is desirable to help quickly detect performance changes. Previous applications have focused mostly on binary outcomes, such as 30-day mortality after surgery. However, in many applications the survival time data are routinely collected. In this paper, we propose an updating exponentially weighted moving average (EWMA) control chart to monitor risk-adjusted survival times. The updating EWMA (uEWMA) operates in a continuous time; hence, the scores for each patient always reflect the most up-to-date information. The uEWMA can be implemented based on a variety of survival-time models and can be set up to provide an ongoing estimate of a clinically interpretable average patient score. The efficiency of the uEWMA is shown to compare favorably with the competing methods.
监测医疗结果是可取的，以帮助快速检测性能变化。以前的应用主要集中在二进制结果上，例如手术后 30 天的死亡率。然而，在许多应用中，生存时间数据通常是收集的。在本文中，我们提出了一种更新指数加权移动平均（EWMA）控制图来监测风险调整后的生存时间。更新的 EWMA（uEWMA）在连续时间中运行；因此，每个患者的得分始终反映最新的信息。uEWMA 可以基于各种生存时间模型来实现，并可以设置为提供临床可解释的平均患者得分的持续估计。uEWMA 的效率被证明优于竞争方法。
