The use of the Cusum technique in the assessment of trainee competence in new procedures

Int J Qual Health Care. 2000 Oct;12(5):433-8. doi: 10.1093/intqhc/12.5.433.


Continuous quality assurance (QA) in health care has necessitated the adoption of statistical methods developed as industrial process monitoring techniques. One such statistical technique is the cumulative summation (Cusum) methodology, which can monitor continuously a production process and detect subtle deviations from a preset defined level of achievement. The method is practical, simple to apply, easy to introduce and has proved popular with trainees in some specialities. This article introduces the concepts of a sequential analysis, deals with the practical steps of setting up a data collection and monitoring performance for procedures in health care.

MeSH terms

  • Clinical Competence / statistics & numerical data*
  • Education, Medical*
  • Humans
  • Medical Audit / methods*
  • Medicine / standards
  • Models, Theoretical
  • Outcome and Process Assessment, Health Care / methods*
  • Outcome and Process Assessment, Health Care / statistics & numerical data
  • Quality Control
  • Specialization*
  • Total Quality Management / methods*
  • Treatment Failure