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Exponentially weighted moving average chart as a suitable tool for nuchal translucency quality review
Martin Hynek1, Dagmar Smetanová, David Stejskal
1Gennet, Centre for Fetal Medicine and Reproductive Genetics, Prague, Czech Republic; Institute of Hygiene and Epidemiology, First Faculty of Medicine, Charles University, Prague, Czech Republic; Department of Gynecology and Obstetrics, Thomayer Hospital, Prague, Czech Republic.
The exponentially weighted moving average (EWMA) chart offers an efficient tool for nuchal translucency (NT) quality review. It promptly detects suboptimal performance and indicates when quality control returns to normal, outperforming traditional methods.
Area of Science:
- Medical Imaging Quality Control
- Statistical Process Control in Healthcare
Background:
- Nuchal translucency (NT) measurement is critical for first-trimester screening.
- Current quality review methods for NT measurements have limitations in promptly detecting performance issues.
Purpose of the Study:
- To design an exponentially weighted moving average (EWMA) chart for nuchal translucency (NT) quality review.
- To evaluate the performance of the EWMA chart against existing retrospective distribution-based methods and cumulative sum (CUSUM) charts.
Main Methods:
- Developed an EWMA model for NT quality review using simulation.
- Retrieved and analyzed 9338 NT measurements from routine first-trimester screening.
- Established NT distribution parameters, EWMA, and CUSUM charts for comparative analysis.
Main Results:
- Optimal EWMA settings were determined through simulation.
- Distribution-based methods failed to identify periods of poor performance.
- The EWMA chart demonstrated comparable performance to the CUSUM chart but offered faster detection of process return to control.
Conclusions:
- The EWMA chart is a universal, efficient tool for NT quality review.
- It provides prompt and effective detection of suboptimal performance.
- The EWMA chart is suitable for both long-term prospective and retrospective quality assessments.
