Monitoramento da sobrevivência de portadores de câncer de boca e orofaringe no RN via gráfico Rast Cusum

Abstract

Statistical process control techniques are commonly used in industrials problems and can also be applied in the health area, since quality in medical procedures are an integral part of day-to-day hospital structures. However, in this case, the population can not be regarded as homogeneous as goods in a production line. The application of the CEP in the health area must admit the existence of heterogeneity, taking into account particular characteristics of each patient with, for example, gender, age, and measures that reflect the general health conditions. In this sense, some authors propose monitoring survival time of patients, through a CUSUM (Cumulative Sum) chart, adjusted to incorporate the risk of each individual by a parametric regression model. This chart is called by the authors of RAST CUSUM, and the theoretical results were developed to monitor times until the occurrence of an event, even when they are subject to incomplete information (right censoring), considering for that the Weibull model, which is very used to model survival data. In this work the RAST CUSUM Weibull graph was used in a retrospective study, to monitoring the survival of patients with oral and oropharyngeal cancer, treated on the Northern Riograndense League of the câncer, from 2001 to 2013. The data of this work come from the data base of the hospital being registered beyond the dates of diagnosis and last visit to the institution, socio-demographic characteristics and clinics of patients, considered as potential risk factors for mean survival time of these individuals. As a result of the monitoring that considered the location and size of the tumor, type of the first treatment adopted and family history as risk factors, an increase of 20% in the mean survival time of the patients from 2005 was detected.