Funnel plots and their emerging application in surgery

Annals of Surgery

Volumn 249, Issue 3, 2009, Pages 376-383

  Mayer, Erik K ^a   Bottle, Alex ^b   Rao, Christopher ^a   Darzi, Ara W ^a   Athanasiou, Thanos ^a  

^a ST MARY S HOSPITAL   (United Kingdom)

^b IMPERIAL COLLEGE LONDON   (United Kingdom)

Author keywords

[No Author keywords available]

Indexed keywords

CLINICAL ASSESSMENT; EVIDENCE BASED MEDICINE; FUNNEL PLOT; HEALTH CARE DELIVERY; HEALTH CARE QUALITY; HUMAN; MATHEMATICAL PARAMETERS; MORTALITY; OUTCOME ASSESSMENT; PATIENT MONITORING; PRIORITY JOURNAL; PUBLIC HEALTH; PUBLISHING; QUALITY CONTROL; REVIEW; RISK REDUCTION; STATISTICAL ANALYSIS; STATISTICAL MODEL; SURGEON; SURGERY; SURGICAL RISK; ARTICLE; GENERAL SURGERY; PERSONNEL MANAGEMENT; STANDARD; TREATMENT OUTCOME;

EMPLOYEE PERFORMANCE APPRAISAL; GENERAL SURGERY; HUMANS; MODELS, STATISTICAL; OUTCOME ASSESSMENT (HEALTH CARE); QUALITY ASSURANCE, HEALTH CARE; QUALITY OF HEALTH CARE; SURGICAL PROCEDURES, OPERATIVE; TREATMENT OUTCOME;

EID: 63449116831     PISSN: 00034932     EISSN: 15281140     Source Type: Journal    
DOI: 10.1097/SLA.0b013e31819a47b1     Document Type: Review

References (42)

1. Callcut RA, Breslin TM. Shaping the future of surgery: the role of private regulation in determining quality standards. Ann Surg. 2006;243:304-312.
2. Healthcare Commission. Heart Surgery in Great Britain. 2006. Available at http:// heartsurgery.healthcarecommission.org.uk/index.aspx. Accessed January, 2008.
3. Tekkis PP, McCulloch P, Steger AC, et al. Mortality control charts for comparing performance of surgical units: validation study using hospital mortality data. BMJ. 2003;326:786-788.
4. Marshall T, Mohammed MA, Rouse A. A randomized controlled trial of league tables and control charts as aids to health service decision-making. Int J Qual Health Care. 2004;16:309-315.
5. Benneyan JC, Lloyd RC, Plsek PE. Statistical process control as a tool for research and healthcare improvement. Qual Saf Health Care. 2003;12:458-464.
6. The Vascular Society of Great Britain and Ireland. Fourth National Vascular Dataset Report. 2004. Available at http://www.vascularsociety.org.uk/ committees/audit.asp. Accessed January, 2008.
7. Kunadian B, Dunning J, Roberts AP, et al. Cumulative funnel plots for the early detection of interoperator variation: retrospective database analysis of observed versus predicted results of percutaneous coronary intervention. BMJ. 2008;336:931-934.
8. Mason A, Goldacre MJ, Bettley G, et al. Using routine data to define clinical case-mix and compare hospital outcomes in urology. BJU Int. 2006;97:1145-1147.
9. Mason A, Goldacre M, Meddings D, et al. Use of case fatality and readmis-sion measures to compare hospital performance in gynaecology. BJOG. 2006;113:695-699.
10. Aylin P, Bottle A, Majeed A. Use of administrative data or clinical databases as predictors of risk of death in hospital: comparison of models. BMJ. 2007;334:1044.
11. Poloniecki J, Valencia O, Littlejohns P. Cumulative risk adjusted mortality chart for detecting changes in death rate: observational study of heart surgery. BMJ. 1998;316:1697-1700.
12. Steiner SH, Cook RJ, Farewell VT, et al. Monitoring surgical performance using risk-adjusted cumulative sum charts. Biostatistics. 2000;1:441-452.
13. Grigg OA, Farewell VT, Spiegelhalter DJ. Use of risk-adjusted CUSUM and RSPRT charts for monitoring in medical contexts. Stat Methods Med Res. 2003;12:147-170.
14. Spiegelhalter DJ. Handling over-dispersion of performance indicators. Qual Saf Health Care. 2005;14:347-351.
15. Houghton A. Variation in outcome of surgical procedures. Br J Surg. 1994;81:653-660.
16. The Leapfrog Group. Evidence-Based Hospital Referral. 2004. Available at http://www.leapfroggroup.org. Accessed January, 2008.
17. Birkmeyer JD, Finlayson EV, Birkmeyer CM. Volume standards for high-risk surgical procedures: potential benefits of the Leapfrog initiative. Surgery. 2001;130:415-422.
18. Birkmeyer JD, Dimick JB. Potential benefits of the new Leapfrog standards: effect of process and outcomes measures. Surgery. 2004;135:569-575.
19. The Bristol Royal Infirmary Inquiry. Crown Copyright, 2001. Available at http:// www.bristol-inquiry.org.uk/final-report/index.htm. Accessed January, 2008.
20. Spiegelhalter DJ. Funnel plots for comparing institutional performance. Stat Med. 2005;24:1185-1202.
21. Khuri SF, Daley J, Henderson W, et al. Relation of surgical volume to outcome in eight common operations: results from the VA National Surgical Quality Improvement Program. Ann Surg. 1999;230:414-29, discussion 429-432.
22. Christian CK, Gustafson ML, Betensky RA, et al. The volume-outcome relationship: don't believe everything you see. World J Surg. 2005;29:1241-1244.
23. Egger M, Smith GD. Meta-analysis bias in location and selection of studies. BMJ. 1998;316:61-66.
24. Dickersin K, Min YI, Meinert CL. Factors influencing publication of research results. Follow-up of applications submitted to two institutional review boards. JAMA. 1992;267:374-378.
25. Easterbrook PJ, Gopalan R, Berlin JA, et al. Publication bias in clinical research. The Lancet. 1991;337:867-872.
26. Sutton AJ, Duval SJ, Tweedie RL, et al. Empirical assessment of effect of publication bias on meta-analyses. BMJ. 2000;320:1574-1577.
27. Egger M, Davey Smith G, Schneider M, et al. Bias in meta-analysis detected by a simple, graphical test. BMJ. 1997;315:629-634.
28. Tang JL, Liu JL. Misleading funnel plot for detection of bias in meta-analysis. J Clin Epidemiol. 2000;53:477-484.
29. Sterne JA, Egger M. Funnel plots for detecting bias in meta-analysis: guidelines on choice of axis. J Clin Epidemiol. 2001;54:1046-1055.
30. Lau J, Ioannidis JP, Terrin N, et al. The case of the misleading funnel plot. BMJ. 2006;333:597-600.
31. Association of Public Health Observatories. Indications of public health in the English Regions. Vol. 1, 2003. pp. 36. Available at http://www.apho.org. uk/ resource/view.aspx?QN = IND-SERIES. Accessed March, 2008.
32. Department of Health. The NHS Plan: a plan for investment, a plan for reform. 2000. Available at http://www.dh.gov.uk/assetRoot/04/05/57/83/ 04055783.pdf. Accessed April, 2007.
33. Department of Health. National standards, local action: health and social care standards and planning framework 2005/06-2007/08. 2004. Available at http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/ PublicationsPolicy AndGuidance/DH-4086057. Accessed December, 2007.
34. Department of Health. The NHS Cancer plan: a plan for investment, a plan for reform. 2000. Available at: http://www.dh.gov.uk/en/ Publicationsandstatistics/ Publications/PublicationsPolicyAndGuidance/DH- 4009609. Accessed December, 2007.
35. National Patient Safety Agency. Clean Your Hands Campaign. Vol. 2007: National Patient Safety Agency. Available at: http://www.npsa.nhs.uk/ cleanyourhands. Accessed May, 2007.
36. Healthcare Commission. MRSA Bacteraemia. 2007/2008. Available at: http:// www.healthcarecommission.org.uk/nationaltargets2007-2008/newnationaltargets/ acuteandspecialisttrusts/indicators/mrsabacteraemiacfm. Accessed October, 2007.
37. Spiegelhalter DJ. Problems in assessing rates of infection with methicillin resistant Staphylococcus aureus. BMJ. 2005;331:1013-1015.
38. Association of Public Health Observatories. Available at: http://www.apho.org.uk/.
39. Hospital Episode Statistics Online. The Informtion Centre. Available at www.hesonline.nhs.uk/. Accessed April 2007.
40. Healthcare Commission. Performance Ratings. 2005. Available at http:// ratings2005.healthcarecommission.org.uk/. Accessed March 2007.
41. Department of Health. Hospital Activity Statistics-Diagnostics Statistics. Available at http://www.performance.doh.gov.uk/diagnostics/index. htm. Accessed June 2007.
42. South West Public Health Observatory. 3-year Funnel plots for PCTs in South West and Hampshire and Isle of Wight 2001-2003. Available at http:// www.swpho.nhs.uk/resource/item.aspx?RID=9400. Accessed May 2007.