Patients as partners in clinical research: a proposal for applying quality improvement methods to patient care.
OBJECTIVE
The authors show the potential value of using statistical process control (SPC) methods to measure change in health status for patients with chronic conditions. Examples will be used to compare the strengths and weaknesses of these methods to randomized clinical trials (RCTs).


METHODS
Run charts, control charts, and regression models are used to explain variations in patients' hypertension and diabetes.


RESULTS
Significant improvements are shown in the examples given using the Western Electric rules.


CONCLUSIONS
These SPC methods can be used for self-management of chronic conditions. They provide a new set of tools for measuring health care outcomes.
Frances Payne Bolton School of Nursing, Case Western Reserve University, Cleveland, OH, USA.
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C
Solodky
H
H
Chen
P K
PK
Jones
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W
Katcher
D
D
Neuhauser
D002908:Chronic Disease; D003627:Data Interpretation, Statistical; D003922:Diabetes Mellitus, Type 1 / Q000517:prevention & control; D006302:Health Services Research / Q000379:methods*; D006304:Health Status; D006801:Humans; D006973:Hypertension / Q000517:prevention & control; D008485:Medical Audit; D008499:Medical Records; D010043:Outcome and Process Assessment, Health Care / Q000592:standards*; D010358:Patient Participation; D016032:Randomized Controlled Trials as Topic; D012044:Regression Analysis; D012107:Research Design / Q000592:standards; D012648:Self Care; D017749:Total Quality Management / Q000458:organization & administration*