Employing evolutionary artificial neural network in risk-adjusted monitoring of surgical performance

Various applications of control charts in the field of health-care monitoring and surveillance can be found in the literature. As one of the major categories, monitoring binary outcomes of cardiac surgeries with the aim of logistic regression model for the patients’ death probability has been extended by different researchers. For this aim, statistical control charts, such as cumulative sum (CUSUM) chart, are applied as a risk-adjusted method to monitoring patients’ mortality rate. However, employing machine learning techniques such as artificial neural network (ANN) has not been paid attention. So, this paper proposes a novel ANN-based control chart with a heuristic training approach to monitor binary surgical outcomes by control charts. Performance of the proposed approach is investigated and compared with existing studies, based on the average run lengths (ARL) criterion and the results demonstrated a superior performance of the proposed approach. Nevertheless, to demonstrate the application of the proposed approach, some real-life applications are also provided in this paper. Furthermore, robustness of the proposed method is investigated by considering Beta distribution for the death rate in addition to the logistic model.