Combined Shewhart-Cusum control chart for improved quality control in clinical chemistry

Westgard, J O; Groth, T; Aronsson, T; de Verdier, C H

doi:10.1093/clinchem/23.10.1881

Cited by 138Advanced Statistical Process MonitoringClinical Laboratory Practices and Quality ControlFault Detection and Control Systems

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Combined Shewhart-Cusum control chart for improved quality control in clinical chemistry

Westgard, J O, Groth, T, Aronsson, T, de Verdier, C H·1977·Clinical Chemistry

DOI 10.1093/clinchem/23.10.1881

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Abstract

We describe the adaptation of the decision limit cumulative sum method (cusum) to internal quality control in clinical chemistry. With the decision limit method, the cusum is interpreted against a numerical limit, rather than by use of a V-mask. The method can be readily implemented in computerized quality-control systems or manually on controls charts. We emphasize the manual application here and demonstrate how the technique can be implemented on existing Shewhart or Levey-Jennings control charts. This permits both cusum and Shewhart control rules to be used simultaneously on a single control chart and also minimizes the data calculations necessary for the cusum method. Computer simulation studies are used to determine the performance characteristics of several different cusum rules, alone and in combination with a Shewhart rule. These studies indicate that improvements in existing quality-control systems should be possible by addition of this simple cusum method and by use of a combined Shewhart-cusum control chart. This should be particularly advantageous when introducing the cusum method in laboratories with manual quality-control systems.

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Error approaches, including frequentist statistics, are widely used for quality control in laboratory medicine.
“Error approaches, including frequentist statistics, are widely used for quality control in laboratory medicine.20,22,73,74”
From Uncertainty in Measurement and Total Error (2017) · cites this paper as [73]

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“The method was first referenced by Westgard et al. (1977) and further developed by Lucas (1982).”
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Authors: Westgard, J. O., Groth, T., Aronsson, T., & de Verdier, C. H.
ORCID: Westgard, J O
Venue: Clinical Chemistry
Publisher: Oxford University Press (OUP)
Published: 1977-10-01
Volume: 23
Issue: 10
Pages: 1881-1887
ISSN: 0009-9147 (ISSN-L)
1530-8561
DOI: 10.1093/clinchem/23.10.1881
OpenAlex: W2136487613
Cited by: 138
References: 0
Citations by year: 2026: 2 · 2025: 3 · 2024: 5 · 2023: 2 · 2022: 2 · 2021: 4 · 2020: 9 · 2019: 4 · 2018: 5 · 2017: 6 · 2016: 3 · 2015: 6 · 2014: 2 · 2013: 5 · 2012: 6
FWCI: 3.20
Type: journal article
Language: en
Open access: closed
Licence: academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
Locations: Clinical Chemistry (publishedVersion)
PubMed (publishedVersion)
Topics: Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Advanced Statistical Process Monitoring
Health Sciences › Health Professions › Medical Laboratory Technology › Clinical Laboratory Practices and Quality Control
Physical Sciences › Engineering › Control and Systems Engineering › Fault Detection and Control Systems
Keywords: Shewhart control charts, CUSUM control chart, internal quality control, Levey-Jennings charts
MeSH terms: Chemistry, Clinical, Computers, Decision Making, Models, Theoretical, Probability, Quality Control

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Combined Shewhart-Cusum control chart for improved quality control in clinical chemistry

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