Comparison of risk-adjusted cumulative quality control charts compared with standardized mortality ratios in critical care
Authors' conclusion
P-charts created with risk-adjusted mortality at monthly intervals are potentially useful tools for monitoring ICU performance.
Study context
- Population
- Patients in 17 medical-surgical Intensive Care Unit (ICUs) in Ontario, Canada
- Participants
- 29,592 patients · 17 ICUs
- Exposure
- P-chart vs cumulative sum (CUSUM) vs standardized mortality ratio (SMR)
- Outcome
- Sensitivity for detecting simulated increases in ICU mortality (positive signals / number of ICUs)
Methodological detailssimulation, multicentre
- Simulation
- Multicentre
Main finding
As reported in the abstract
Sensitivity for a 50% simulated increase in ICU mortality
Observational data: associations, not effects.
Further findings
| Outcome | P-chart | CUSUM | SMR |
|---|---|---|---|
| Signals generated in observed data | |||
| ICUs | 14 | 12 | 8 |
Signals generated in observed data
- Of CUSUM signals, p-charts agreed in 10 and SMR in 6
- Of p-chart signals, CUSUM and SMR each agreed in 10
- Of SMR signals, p-charts agreed in 10 and CUSUM in 6
Original publication
Comparison of risk-adjusted cumulative quality control charts compared with standardized mortality ratios in critical care. Can J Anaesth. Published 7 November 2024. doi:10.
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