Biomedical subjects

James C Benneyan

Publications and source records attributed to James C Benneyan.

3 recordsLinked to original sources

PubMed2003

Risk-adjusted sequential probability ratio tests and longitudinal surveillance methods.

Regardless of the exact method employed, the application of statistical process controL SPRTs, or related longitudinal analysis methods can significantly improve the ability to monitor clinical processes and outcomes. Incorporation and adaptation of risk-adjustment and rare events into these methods represent important contributions to their use in health care. Fostering greater and more widespread use of these methods, however, remains a significant challenge. Hopefully studies such as those by Spiegelhalter et al. will lead to more awareness of their value for contributing to a safer health care system.

Humans↗

PubMed2002

Controlling methicillin-resistant Staphylococcus aureus: a feedback approach using annotated statistical process control charts.

OBJECTIVES: To investigate the benefit of a hospitalwide feedback program regarding methicillin-resistant Staphylococcus aureus (MRSA), using annotated statistical process control charts. DESIGN: Retrospective and prospective analysis of MRSA rates using statistical process control charts. PARTICIPANTS: Twenty-four medical, medical specialty, surgical, intensive care, and cardiothoracic care wards and units at four Glasgow Royal Infirmary hospitals. METHODS: Annotated control charts were applied to prospective and historical monthly data on MRSA cases from each ward and unit during a 46-month period from January 1997 through September 2000. Results were fed back from December 1999 and then on a regular monthly basis to medical staff, ward managers, senior managers, and hotel services. RESULTS: Monthly reductions in the MRSA acquisition rate started 2 months after the introduction of the feedback program and have continued to the present time. The overall MRSA rate currently is approximately 50% lower than when the program began and has become more consistent and less variable within departments throughout Glasgow Royal Infirmary. The control charts have helped to detect rate changes and manage resources more effectively. Medical and nursing staff and managers also report that they find this the most positive form of MRSA feedback they have received. CONCLUSIONS: Feedback programs that provide current information to front-line staff and incorporate annotated control charts can be effective in reducing the rate of MRSA.

Humans↗

PubMed2002

Binary cumulative sums and moving averages in nosocomial infection cluster detection.

Clusters of nosocomial infection often occur undetected, at substantial cost to the medical system and individual patients. We evaluated binary cumulative sum (CUSUM) and moving average (MA) control charts for automated detection of nosocomial clusters. We selected two outbreaks with genotyped strains and used resistance as inputs to the control charts. We identified design parameters for the CUSUM and MA (window size, k, alpha, Beta, p(0), p(1)) that detected both outbreaks, then calculated an associated positive predictive value (PPV) and time until detection (TUD) for sensitive charts. For CUSUM, optimal performance (high PPV, low TUD, fully sensitive) was for 0.1 < or = alpha < or = 0.25 and 0.2 < or = Beta < or = 0.25, with p(0) = 0.05, with a mean TUD of 20 (range 8-43) isolates. Mean PPV was 96.5% (relaxed criteria) to 82.6% (strict criteria). MAs had a mean PPV of 88.5% (relaxed criteria) to 46.1% (strict criteria). CUSUM and MA may be useful techniques for automated surveillance of resistant infections.

Cluster Analysis↗