Continuous Monitoring of Risk-Adjusted Outcomes: Excess Deaths vs. Lives Saved.

Publication Title

The Annals of thoracic surgery

Authors

Ruyun Jin, Center for Cardiovascular Analytics, Research, and Data Science; Providence St Joseph Heart Institute, Portland, ORFollow
Gary L Grunkemeier, Center for Cardiovascular Analytics, Research and Data Science (CARDS), Providence Heart Institute, Providence St. Joseph Health, Portland, OregonFollow
Anthony P Furnary, Starr-Wood Cardiothoracic Group, NorthStarr Cardiothoracic Surgery, Providence Alaska Medical Center, Anchorage, AlaskaFollow

Document Type

Article

Publication Date

4-24-2021

Keywords

oregon; portland; cards; cards publication

Abstract

Reporting of risk-adjusted surgical outcomes is commonly used to compare providers and track changes over time. Preferred graphical methods use the relationship of the observed to the expected values of outcome events, including their ratio (O/E), cumulative sum (CUSUM) of their differences over time, called Risk-Adjusted CUSUM (RA-CUSUM) or Variable Life Adjusted Display (VLAD). We demonstrate these methods using operative mortality data for 7,255 isolated coronary artery bypass graft patients from January 2014 to June 2017. RA-CUSUM and VLAD are excellent techniques to display risk-adjusted outcomes and, unlike O/E, can provide continuous monitoring as performance varies over time.

Specialty/Research Institute

Surgery