Abstract

BackgroundThe XmR chart is a powerful analytical tool in statistical process control (SPC) for detecting special causes of variation in a measure of quality. In this analysis a statistic called the average moving range is used as a measure of dispersion of the data. This approach is correct for data with natural underlying order, such as time series data. There is however conflict in the literature over the appropriateness of the XmR chart to analyse data without an inherent ordering.MethodsWe derive the maxima and minima for the average moving range in data without inherent ordering, and show how to calculate this for any data set. We permute a real world data set and calculate control limits based on these extrema.ResultsIn the real world data set, permuting the order of the data affected an absolute difference of 109 percent in the width of the control limits.DiscussionWe prove quantitatively that XmR chart analysis is problematic for data without an inherent ordering, and using real-world data, demonstrate the problem this causes for calculating control limits. The resulting ambiguity in the analysis renders it unacceptable as an approach to making decisions based on data without inherent order.ConclusionThe XmR chart should only be used for data endowed with an inherent ordering, such as a time series. To detect special causes of variation in data without an inherent ordering we suggest that one of the many well-established approaches to outlier analysis should be adopted. Furthermore we recommend that in all SPC analyses authors should consistently report the type of control chart used, including the measure of variation used in calculating control limits.

Highlights

  • The XmR chart is a powerful analytical tool in statistical process control (SPC) for detecting special causes of variation in a measure of quality

  • The most natural application of Statistical process control (SPC) in healthcare is to time series data - the natural ordering of the data in time is central to the correct application of the analysis

  • Real world example Taking a real world research example from a quality improvement initiative, running as part of the National Institute of Health Research (NIHR) Collaboration for Leadership in Applied Health Research and Care for Northwest London (CLAHRC NWL) we investigated the consequences of using an XmR chart analysis on data that possess no underlying order, but that are logically comparable

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Summary

Introduction

The XmR chart is a powerful analytical tool in statistical process control (SPC) for detecting special causes of variation in a measure of quality. In this analysis a statistic called the average moving range is used as a measure of dispersion of the data. This approach is correct for data with natural underlying order, such as time series data. Statistical process control (SPC) is an approach to quality improvement that has seen increasing use in healthcare since the early 1990s [1]. In this article we resolve objectively and quantitatively the question of whether it is acceptable to use control charts to analyse variation in data that does not have a natural ordering

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