TY - JOUR AU - Brown, Samuel M. AU - Benneyan, James C. AU - Theobald, Daniel A. AU - Sands, Kenneth AU - Hahn, Matthew T. AU - Potter-Bynoe, Gail A. AU - Stelling, John M. AU - O'Brien, Thomas F. AU - Goldmann, Donald A. T1 - Use of Binary Cumulative Sums and Moving Averages in Nosocomial Infection Cluster Detection T2 - Emerging Infectious Disease journal PY - 2002 VL - 8 IS - 12 SP - 1426 SN - 1080-6059 AB - Clusters of nosocomial infection often occur undetected, at substantial cost to the medical system and individual patients. We evaluated binary cumulative sum (CUSUM) and moving average (MA) control charts for automated detection of nosocomial clusters. We selected two outbreaks with genotyped strains and used resistance as inputs to the control charts. We identified design parameters for the CUSUM and MA (window size, k, α, β, p0, p1) that detected both outbreaks, then calculated an associated positive predictive value (PPV) and time until detection (TUD) for sensitive charts. For CUSUM, optimal performance (high PPV, low TUD, fully sensitive) was for 0.1 <α ≤0.25 and 0.2 <β <0.25, with p0 = 0.05, with a mean TUD of 20 (range 8–43) isolates. Mean PPV was 96.5% (relaxed criteria) to 82.6% (strict criteria). MAs had a mean PPV of 88.5% (relaxed criteria) to 46.1% (strict criteria). CUSUM and MA may be useful techniques for automated surveillance of resistant infections. KW - Cross-infection KW - disease surveillance KW - outbreak detection KW - cumulative sums KW - moving averages KW - United States DO - 10.3201/eid0812.010514 UR - https://wwwnc.cdc.gov/eid/article/8/12/01-0514_article ER - End of Reference