Monitoring the mean vector and the covariance ­matrix of multivariate processes with sample means and sample ranges

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Efeito da implementação de diretriz para profilaxia de tromboembolismo venoso em pacientes cirúrgicos

INTRODUÇÃO: Estratégias efetivas para profilaxia do tromboembolismo venoso (TEV) são amplamente disponíveis, mas são ainda subutilizadas, principalmente no nosso meio. OBJETIVO: Avaliar o efeito da implementação de diretriz para profilaxia do TEV, em pacientes cirúrgicos, sobre a conduta da equipe de saúde na prescrição dessa profilaxia. Método. Estudo retrospectivo pré-intervenção - pós-intervenção. Prontuários de 150 pacientes antes e 150 depois da implementação de uma diretriz para a profilaxia (AID e DID) foram sorteados dentre pacientes de mais de 40 anos internados para cirurgia maior abdominal ou ortopédica. Foram registrados dados demográficos, referência a risco de TEV no prontuário, prescrição de profilaxia para TEV e diagnóstico de TEV durante a internação. RESULTADOS: Não houve diferença entre os dois grupos, AID e DID, quanto aos dados demográficos e ao tempo de profilaxia (5,6 x 6,6 dias). A frequência de profilaxia AID x DID antes da cirurgia foi: profilaxia farmacológica (PF), 6% x 9%; meias de compressão graduada (MCG), 4% x 3%; compressão pneumática intermitente (CPI), 2% x 3%. Após cirurgia: PF 53% x 53%; MCG, 23% x 40% (P<0,05); CPI, 26% x 32% . No total, AP, foi prescrita profilaxia para 60,5% dos pacientes AID e para 66,5% DID, mas a profilaxia foi considerada adequada em 34% dos pacientes AID e em 32% DID. Conclusão. A adoção do protocolo, embora com maior a preocupação com a profilaxia, traduzida pelo aumento na prescrição de MCG, melhorou minimamente sua qualidade, indicando a necessidade de outras intervenções ativas e contínuas para aumentar a aderência ao mesmo.

Gráficos de controle X para processos robustos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

O uso da estatística de qui-quadrado no controle de processos

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Gráfico de controle MCMAX para o monitoramento simultâneo do vetor de médias e da matriz de covariâncias

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

O efeito da autocorrelação no planejamento das cartas de controle de x̄ e EWMA

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Caracterização de idosos internados em enfermaria de pronto-socorro quanto à vulnerabilidade social e programática

O aumento da população idosa acarretará grandes transformações socioeconômicas, repercutindo diretamente no setor saúde. O estudo objetivou caracterizar idosos hospitalizados quanto aos aspectos de vulnerabilidade social e programática. Trata-se de estudo quantitativo, realizado na Enfermaria de Adultos do Pronto-Socorro do Hospital das Clínicas de Botucatu - UNESP. Os dados foram coletados no período de maio a outubro de 2009, por meio de entrevistas e de informações constantes nos prontuários. A amostra foi constituída por 71 sujeitos, a média de idade foi de 74,30 anos, a maioria dos indivíduos reside com algum familiar e possui vínculo com um serviço de saúde, mas apenas oito frequentam alguma associação comunitária ou outro recurso de lazer social. Urge que o cuidado integralizado seja uma realidade no atendimento ao idoso, utilizando uma abordagem individual centrada na pessoa, e não na doença, atentando para suas vulnerabilidades e respeitando sua autonomia e dignidade.

AATS for the (X)over-bar chart with variable parameters

A Fortran computer program is given for the computation of the adjusted average time to signal, or AATS, for adaptive (X) over bar charts with one, two, or all three design parameters variable: the sample size, n, the sampling interval, h, and the factor k used in determining the width of the action limits. The program calculates the threshold limit to switch the adaptive design parameters and also provides the in-control average time to signal, or ATS.

Constrained optimization model for the design of an adaptive (X)over-bar chart

An economic-statistical model is developed for variable parameters (VP) (X) over bar charts in which all design parameters vary adaptively, that is, each of the design parameters (sample size, sampling interval and control-limit width) vary as a function of the most recent process information. The cost function due to controlling the process quality through a VP (X) over bar chart is derived. During the optimization of the cost function, constraints are imposed on the expected times to signal when the process is in and out of control. In this way, required statistical properties can be assured. Through a numerical example, the proposed economic-statistical design approach for VP (X) over bar charts is compared to the economic design for VP (X) over bar charts and to the economic-statistical and economic designs for fixed parameters (FP) (X) over bar charts in terms of the operating cost and the expected times to signal. From this example, it is possible to assess the benefits provided by the proposed model. Varying some input parameters, their effect on the optimal cost and on the optimal values of the design parameters was analysed.

An adaptive chart for monitoring the process mean and variance

Traditionally, an (X) over bar chart is used to control the process mean and an R chart is used to control the process variance. However, these charts are not sensitive to small changes in the process parameters. The adaptive ($) over bar and R charts might be considered if the aim is to detect small disturbances. Due to the statistical character of the joint (X) over bar and R charts with fixed or adaptive parameters, they are not reliable in identifing the nature of the disturbance, whether it is one that shifts the process mean, increases the process variance, or leads to a combination of both effects. In practice, the speed with which the control charts detect process changes may be more important than their ability in identifying the nature of the change. Under these circumstances, it seems to be advantageous to consider a single chart, based on only one statistic, to simultaneously monitor the process mean and variance. In this paper, we propose the adaptive non-central chi-square statistic chart. This new chart is more effective than the adaptive (X) over bar and R charts in detecting disturbances that shift the process mean, increase the process variance, or lead to a combination of both effects. Copyright (c) 2006 John Wiley & Sons, Ltd.

Synthetic control chart for monitoring the pprocess mean and variance

In this article, we consider the synthetic control chart with two-stage sampling (SyTS chart) to control the process mean and variance. During the first stage, one item of the sample is inspected; if its value X, is close to the target value of the process mean, then the sampling is interrupted. Otherwise, the sampling goes on to the second stage, where the remaining items are inspected and the statistic T = Sigma [x(i) - mu(0) + xi sigma(0)](2) is computed taking into account all items of the sample. The design parameter is function of X-1. When the statistic T is larger than a specified value, the sample is classified as nonconforming. According to the synthetic procedure, the signal is based on Conforming Run Length (CRL). The CRL is the number of samples taken from the process since the previous nonconforming sample until the occurrence of the next nonconforming sample. If the CRL is sufficiently small, then a signal is generated. A comparative study shows that the SyTS chart and the joint X and S charts with double sampling are very similar in performance. However, from the practical viewpoint, the SyTS chart is more convenient to administer than the joint charts.

The changing pattern of analgesic and anti-inflammatory drug use in cleft lip and palate repair

Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq)

Second, primary tumours in patients with mouth cancer

Over the last decades, technical-scientific advances of oncology have brought about an increased survival rate for cancer patients. As a result, oncologists have detected an increased number of patients presenting with other neoplasms. This research aimed to analyze factors related to demography and to the anatomic site in patients having a FPT of the mouth who developed a SPT. Medical charts of 848 patients neoplasm admitted for treatment at the Head and Neck Surgery Department of the Hospital do Cancer, Antonio Candido Camargo, Brazil, from January of 1984 to December, were analysed. of these, 12 6 developed a SPT. 49.21 % were from 51 to 65 years of age, while 83.33% were of the male gender and Caucasian. Regarding FPT site 38.89% were of the tongue, and 28.5% were of the floor of the mouth. The esophagus, excepting skin (13.49%), was more often subject to SPT (11.9%), of these 74.6% were metachronic, 15.87% simultaneous and 9.52% synchronous.

The non-central chi-square chart with two-stage samplings

In this paper, we consider the non-central chi-square chart with two stage samplings. During the first stage, one item of the sample is inspected and, depending on the result, the sampling is either interrupted, or it goes on to the second stage, where the remaining sample items are inspected and the non-central chi-square statistic is computed. The proposed chart is not only more sensitive than the joint (X) over bar and R charts, but operationally simpler too, particularly when appropriate devices, such as go-no-go gauges, can be used to decide if the sampling should go on to the second stage or not. (c) 2004 Elsevier B.V. All rights reserved.

Monitoring process mean and variability with one non-central chi-square chart

Traditionally, an (X) over bar -chart is used to control the process mean and an R-chart to control the process variance. However, these charts are not sensitive to small changes in process parameters. A good alternative to these charts is the exponentially weighted moving average (EWMA) control chart for controlling the process mean and variability, which is very effective in detecting small process disturbances. In this paper, we propose a single chart that is based on the non-central chi-square statistic, which is more effective than the joint (X) over bar and R charts in detecting assignable cause(s) that change the process mean and/or increase variability. It is also shown that the EWMA control chart based on a non-central chi-square statistic is more effective in detecting both increases and decreases in mean and/or variability.