Journal article
Transplant center quality assessment using a continuously updatable, risk-adjusted technique (CUSUM)
American journal of transplantation, Vol.6(2), pp.313-323
2006
DOI: 10.1111/j.1600-6143.2005.01191.x
PMID: 16426315
Abstract
Access to timely, risk-adjusted measures of transplant center outcomes is crucial for program quality improvement. The cumulative summation technique (CUSUM) has been proposed as a sensitive tool to detect persistent, clinically relevant changes in transplant center performance over time. Scientific Registry of Transplant Recipients data for adult kidney and liver transplants (1/97 to 12/01) were examined using logistic regression models to predict risk of graft failure (kidney) and death (liver) at 1 year. Risk-adjusted CUSUM charts were constructed for each center and compared with results from the semi-annual method of the Organ Procurement and Transplantation Network (OPTN). Transplant centers (N = 258) performed 59 650 kidney transplants, with a 9.2% 1-year graft failure rate. The CUSUM method identified centers with a period of significantly improving (N = 92) or declining (N = 52) performance. Transplant centers (N = 114) performed 18 277 liver transplants, with a 13.9% 1-year mortality rate. The CUSUM method demonstrated improving performance at 48 centers and declining performance at 24 centers. The CUSUM technique also identified the majority of centers flagged by the current OPTN method (20/22 kidney and 8/11 liver). CUSUM monitoring may be a useful technique for quality improvement, allowing center directors to identify clinically important, risk-adjusted changes in transplant center outcome. © 2006 The American Society of Transplantation and the American Society of Transplant Surgeons.
Details
- Title: Subtitle
- Transplant center quality assessment using a continuously updatable, risk-adjusted technique (CUSUM)
- Creators
- D. A Axelrod - Dartmouth CollegeM. K Guidinger - Arbor Research Collaborative for HealthR. A Metzger - AdventHealth OrlandoR. H Wiesner - Mayo Clinic College of Medicine, Rochester, MN, USAR. L Webb - University of MichiganR. M Merion - University of Michigan
- Resource Type
- Journal article
- Publication Details
- American journal of transplantation, Vol.6(2), pp.313-323
- DOI
- 10.1111/j.1600-6143.2005.01191.x
- PMID
- 16426315
- NLM abbreviation
- Am J Transplant
- ISSN
- 1600-6135
- eISSN
- 1600-6143
- Publisher
- Blackwell
- Language
- English
- Date published
- 2006
- Academic Unit
- Surgery
- Record Identifier
- 9984322811102771
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