Using a bubble chart to enhance adherence to quality-of-care guidelines for colorectal cancer patients

Tw, Chien; Lin, Yansong; Ch, Chang; Mt, Tsai; Uen, Y-H

doi:10.1111/j.1365-2354.2012.01334.x

Cited by 8 publications

(12 citation statements)

References 39 publications

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“…With an ICC value < 0.50 (e.g., 0.42 in 2009), there is only one stratum for group identification [28]. A bubble chart of SDs allows us to focus easily and quickly on a small number of key areas that require further investigation of unexpected outliers in performance [37]. …”

Section: Discussionmentioning

confidence: 99%

Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

Chien

Chou

Wang

et al. 2012

BMC Med Res Methodol

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BackgroundFew studies discuss the indicators used to assess the effect on cost containment in healthcare across hospitals in a single-payer national healthcare system with constrained medical resources. We present the intraclass correlation coefficient (ICC) to assess how well Taiwan constrained hospital-provided medical services in such a system.MethodsA custom Excel-VBA routine to record the distances of standard deviations (SDs) from the central line (the mean over the previous 12 months) of a control chart was used to construct and scale annual medical expenditures sequentially from 2000 to 2009 for 421 hospitals in Taiwan to generate the ICC. The ICC was then used to evaluate Taiwan’s year-based convergent power to remain unchanged in hospital-provided constrained medical services. A bubble chart of SDs for a specific month was generated to present the effects of using control charts in a national healthcare system.ResultsICCs were generated for Taiwan’s year-based convergent power to constrain its medical services from 2000 to 2009. All hospital groups showed a gradually well-controlled supply of services that decreased from 0.772 to 0.415. The bubble chart identified outlier hospitals that required investigation of possible excessive reimbursements in a specific time period.ConclusionWe recommend using the ICC to annually assess a nation’s year-based convergent power to constrain medical services across hospitals. Using sequential control charts to regularly monitor hospital reimbursements is required to achieve financial control in a single-payer nationwide healthcare system.

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Section: Discussionmentioning

confidence: 99%

Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

Chien

Chou

Wang

et al. 2012

BMC Med Res Methodol

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“…Microsoft Excel Visual Basic for Applications was used to program a module to plot the dispersion of effects on the two most effective indicators for comparison in groups (cancer types and stages) using a bubble chart (Chien et al . ). The marginal means of the difference values between post and prior scores on groups organised on the two coordination axes were in the range of −1 and 1 (a higher score indicates a stronger effect) along the respective axis for an indicator.…”

Section: Methodsmentioning

confidence: 97%

Effects of an intervention on nutrition consultation for cancer patients

Chien

Lin

et al. 2013

Eur J Cancer Care (Engl)

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We assessed whether cancer patients given a nutritional consultation by dietitians when discharged from the hospital experienced more health benefits than those not given a nutritional consultation. The McNemar test and the general linear model were used to examine the effect of nutrition intervention. A bubble chart was plotted to show the comparison between cancer groups. A total of 537 cancer patients discharged from a 1200-bed medical centre in Taiwan in 2011 were randomly divided into experimental and control groups. In the experimental group, nutritional status [evaluated using the Subjective Global Assessment (SGA) Classification technique], weight loss, and food intake recovery were significantly affected and returned to their usual levels, but in the control group, only food intake recovery was significantly affected. The effect of nutrition consultation intervention for cancer patients is thus evident. Significant positive effects were cancer-stage-dependent but not cancer-type-dependent. Future studies are recommended using the present study's methods to see whether the nutrition intervention effect occurs in cancer patients discharged from other hospitals throughout the world.

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“…Data from these patients' charts were obtained and approved by the Research Ethics Review Board of the Chi‐Mei Medical Center (registry no. C6218) (Chien et al., ).…”

Section: Methodsmentioning

confidence: 99%

“…A set of 13 core measures was used to assess adherence to the quality‐of‐care guidelines for patients with CRC. The 100% adherence rate criterion contributed to a relatively low hazard ratio of 0.36 (95% confidence interval, 0.14–0.85; p = .02) (Chien et al., ). The association between the adherence rate and survival indicated significant improvements for stage III patients compared with stage I patients.…”

Section: Methodsmentioning

confidence: 99%

“…On the other hand, many studies (Chien, Lin, Chang, Tsai, & Uen, ; Chung et al., ; Malin, Asch, Kerr, & McGlynn, ; Mandelblatt, Ganz, & Kahn, ; Spencer, Steinberg, Malin, Adams, & Litwin, ) who advocate patient quality of care have claimed that physician adherence to quality‐of‐care indicators improves cancer patients' treatment outcomes. Plotting objective graphical representations is required to help monitor physician performance, which improves the rate of adherence to quality‐of‐care guidelines for CRC patients.…”

Section: Introductionmentioning

confidence: 99%

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Using graphical representations to enhance the quality-of-care for colorectal cancer patients

et al. 2016

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The study was to enhance adherence to quality-of-care guidelines for colorectal cancer (CRC) patients through plotting graphical representations. Rasch analysis was performed to examine the unidimensional measurement of the 13 core indicators. An author-made Excel module was applied to plot the so-called Wright map and KIDMAP in education field to report physicians' adherence to the quality-of-life guidelines. We found that the scale of the quality-of-care guidelines for patients with colon cancer is unidimensional. A total of 15 (3.8%) and 14 (3.5%) persons' response patterns (i.e., Outfit MNSQs >2.0 and 4.0, respectively) are aberrantly dispersed from the majority of sample according to their estimated parameters of persons and indicators. It can be used for investigating the root cause of the 1ow measures and/or the most unexpected aberrant pattern of responses using Rasch analysis once any one indicator of unexpectedly aberrant treatment (p < .05) presents. The Rasch model can deal with these binary and/or missing data frequently seen in clinical settings. We confirm this computer module can contribute to ensuring that hospitals adhere to the treatment guidelines for patients with colon cancer.

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Using a bubble chart to enhance adherence to quality-of-care guidelines for colorectal cancer patients

Cited by 8 publications

References 39 publications

Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

Intraclass reliability for assessing how well Taiwan constrained hospital-provided medical services using statistical process control chart techniques

Effects of an intervention on nutrition consultation for cancer patients

Using graphical representations to enhance the quality-of-care for colorectal cancer patients

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