The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures

Introduction: Quality of care and learning effect surveillance are two mandatory responsibilities within a changing therapeutical paradigm. We aimed to evaluate the feasibility and value of CUSUM chart method in assessing performance in consecutive endovascular procedures done by vascular surgeons o...

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Autores: Calsina Juscafresa, Laura, Clará Velasco, Alberto, Vidal-Barraquer, Francesc
Tipo de recurso: artículo
Estado:Versión aceptada para publicación
Fecha de publicación:2011
País:España
Institución:Universitat Pompeu Fabra
Repositorio:Repositorio Digital de la UPF
OAI Identifier:oai:repositori.upf.edu:10230/72123
Acceso en línea:http://hdl.handle.net/10230/72123
http://dx.doi.org/10.1016/j.ejvs.2011.01.003
Access Level:acceso abierto
Palabra clave:Endovascular procedures
CUSUM
Learning curve
Quality of care
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spelling The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular proceduresCalsina Juscafresa, LauraClará Velasco, AlbertoVidal-Barraquer, FrancescEndovascular proceduresCUSUMLearning curveQuality of careIntroduction: Quality of care and learning effect surveillance are two mandatory responsibilities within a changing therapeutical paradigm. We aimed to evaluate the feasibility and value of CUSUM chart method in assessing performance in consecutive endovascular procedures done by vascular surgeons of a single department on aorto-iliac, femoropopliteal and renal artery occlusive disease. Material and method: Data were collected in 405 consecutive patients, scheduled for endovascular intervention of aorto-iliac (n = 131, 32.3%), femoropopliteal (n = 142, 35%) and renal artery (n = 132, 32.7%) occlusive disease during a 6-year period. Quality indicators included inability to cross the lesion, peri- and post-procedural complications and significant residual stenosis or occlusion at 1 month. CUSUM curves were generated for each territory globally and according to each quality indicator. The relevance of curve upward inflections was evaluated with Fisher's Exact Test. Results: Failure to cross the lesion occurred in 6.9% (aorto-iliac), 10.6% (femoropopliteal) and 2.3% (renal) of patients. One-hundredth twenty aorto-iliac, 127 femoropopliteal and 132 renal angioplasties were finally performed. Peri- and post-procedural complications appeared in 14.5% (aorto-iliac), 9.2% (femoropopliteal) and 2.3% (renal), while significant residual stenosis or occlusion was seen in 0.8%, 4.9% and 2.3% of patients, respectively. Aorto-iliac CUSUM curve showed two upward inflections at the beginning and the end of the period, both associated with peri- and post-procedural complications (p = 0.002 and p = 0.0013) and the latter also with failure to cross the lesion (p = 0.009). Femoro-popliteal CUSUM curve moved progressively upward during all the period, initially related to peri- and post-procedural complications (p = 0.038) and later to failure to cross the lesion (p = 0.004). Renal CUSUM curve didn't show any upward inflection during the analysed period. Conclusion: CUSUM curves are an excellent tool for measuring learning effect and quality of care within a changing paradigm, such it is the case of endovascular interventions. Curve upward inflections can be further interpreted according to the type of "failure" thus helping to evaluate their underlying causes.Elsevier2025202520112025info:eu-repo/semantics/articleinfo:eu-repo/semantics/acceptedVersionapplication/pdfapplication/pdfhttp://hdl.handle.net/10230/72123http://dx.doi.org/10.1016/j.ejvs.2011.01.003reponame:Repositorio Digital de la UPFinstname:Universitat Pompeu FabraInglésEuropean journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery. 2011;41(5):21333562© Elsevier http://dx.doi.org/10.1016/j.ejvs.2011.01.003info:eu-repo/semantics/openAccessoai:repositori.upf.edu:10230/721232026-06-12T07:21:37Z
dc.title.none.fl_str_mv The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
title The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
spellingShingle The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
Calsina Juscafresa, Laura
Endovascular procedures
CUSUM
Learning curve
Quality of care
title_short The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
title_full The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
title_fullStr The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
title_full_unstemmed The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
title_sort The use of CUSUM chart method for surveillance of learning effects and quality of care in endovascular procedures
dc.creator.none.fl_str_mv Calsina Juscafresa, Laura
Clará Velasco, Alberto
Vidal-Barraquer, Francesc
author Calsina Juscafresa, Laura
author_facet Calsina Juscafresa, Laura
Clará Velasco, Alberto
Vidal-Barraquer, Francesc
author_role author
author2 Clará Velasco, Alberto
Vidal-Barraquer, Francesc
author2_role author
author
dc.subject.none.fl_str_mv Endovascular procedures
CUSUM
Learning curve
Quality of care
topic Endovascular procedures
CUSUM
Learning curve
Quality of care
description Introduction: Quality of care and learning effect surveillance are two mandatory responsibilities within a changing therapeutical paradigm. We aimed to evaluate the feasibility and value of CUSUM chart method in assessing performance in consecutive endovascular procedures done by vascular surgeons of a single department on aorto-iliac, femoropopliteal and renal artery occlusive disease. Material and method: Data were collected in 405 consecutive patients, scheduled for endovascular intervention of aorto-iliac (n = 131, 32.3%), femoropopliteal (n = 142, 35%) and renal artery (n = 132, 32.7%) occlusive disease during a 6-year period. Quality indicators included inability to cross the lesion, peri- and post-procedural complications and significant residual stenosis or occlusion at 1 month. CUSUM curves were generated for each territory globally and according to each quality indicator. The relevance of curve upward inflections was evaluated with Fisher's Exact Test. Results: Failure to cross the lesion occurred in 6.9% (aorto-iliac), 10.6% (femoropopliteal) and 2.3% (renal) of patients. One-hundredth twenty aorto-iliac, 127 femoropopliteal and 132 renal angioplasties were finally performed. Peri- and post-procedural complications appeared in 14.5% (aorto-iliac), 9.2% (femoropopliteal) and 2.3% (renal), while significant residual stenosis or occlusion was seen in 0.8%, 4.9% and 2.3% of patients, respectively. Aorto-iliac CUSUM curve showed two upward inflections at the beginning and the end of the period, both associated with peri- and post-procedural complications (p = 0.002 and p = 0.0013) and the latter also with failure to cross the lesion (p = 0.009). Femoro-popliteal CUSUM curve moved progressively upward during all the period, initially related to peri- and post-procedural complications (p = 0.038) and later to failure to cross the lesion (p = 0.004). Renal CUSUM curve didn't show any upward inflection during the analysed period. Conclusion: CUSUM curves are an excellent tool for measuring learning effect and quality of care within a changing paradigm, such it is the case of endovascular interventions. Curve upward inflections can be further interpreted according to the type of "failure" thus helping to evaluate their underlying causes.
publishDate 2011
dc.date.none.fl_str_mv 2011
2025
2025
2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/acceptedVersion
format article
status_str acceptedVersion
dc.identifier.none.fl_str_mv http://hdl.handle.net/10230/72123
http://dx.doi.org/10.1016/j.ejvs.2011.01.003
url http://hdl.handle.net/10230/72123
http://dx.doi.org/10.1016/j.ejvs.2011.01.003
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.relation.none.fl_str_mv European journal of vascular and endovascular surgery: the official journal of the European Society for Vascular Surgery. 2011;41(5):21333562
dc.rights.none.fl_str_mv © Elsevier http://dx.doi.org/10.1016/j.ejvs.2011.01.003
info:eu-repo/semantics/openAccess
rights_invalid_str_mv © Elsevier http://dx.doi.org/10.1016/j.ejvs.2011.01.003
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
application/pdf
dc.publisher.none.fl_str_mv Elsevier
publisher.none.fl_str_mv Elsevier
dc.source.none.fl_str_mv reponame:Repositorio Digital de la UPF
instname:Universitat Pompeu Fabra
instname_str Universitat Pompeu Fabra
reponame_str Repositorio Digital de la UPF
collection Repositorio Digital de la UPF
repository.name.fl_str_mv
repository.mail.fl_str_mv
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