Patients as partners in clinical research: a proposal for applying quality improvement methods to patient care

Med Care. 1998 Aug;36(8 Suppl):AS13-20. doi: 10.1097/00005650-199808001-00003.


Objectives: The authors show the potential value of using statistical process control (SPC) methods to measure change in health status for patients with chronic conditions. Examples will be used to compare the strengths and weaknesses of these methods to randomized clinical trials (RCTs).

Methods: Run charts, control charts, and regression models are used to explain variations in patients' hypertension and diabetes.

Results: Significant improvements are shown in the examples given using the Western Electric rules.

Conclusions: These SPC methods can be used for self-management of chronic conditions. They provide a new set of tools for measuring health care outcomes.

MeSH terms

  • Chronic Disease*
  • Data Interpretation, Statistical
  • Diabetes Mellitus, Type 1 / prevention & control
  • Health Services Research / methods*
  • Health Status*
  • Humans
  • Hypertension / prevention & control
  • Medical Audit
  • Medical Records
  • Outcome and Process Assessment, Health Care / standards*
  • Patient Participation*
  • Randomized Controlled Trials as Topic
  • Regression Analysis
  • Research Design / standards
  • Self Care
  • Total Quality Management / organization & administration*