Question 12.32

12.32 Patient monitoring.

There is an increasing interest in the use of control charts in health care. Many physicians are directly involving patients in proactive monitoring of health measurements such as blood pressure, glucose, and expiratory flow rate. Patients are asked to record measurements for a certain number of days. The patient then brings the measurements to the physician who, in turn, will use software to generate control limits. The patient is then asked to plot future measurements on a chart with the limits. Consider data on a patient with hypertension. The data are 30 consecutive self-recorded home systolic measurements.

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  1. Construct a histogram of the systolic readings. How compatible is the histogram with the Normal distribution?
  2. Determine the mean and standard deviation estimates and that will be used in the construction of an chart.
  3. Compute the UCL and LCL of the chart.
  4. Construct the chart for the systolic series. Discuss the stability of the process.
  5. Moving forward, based on the plotted measurements, when would you suggest the patient call in to the physician's office? In general, list some benefits from patient-based control chart monitoring both from the patient's and physician's perspective.
  6. Why do you think physicians generally recommend only the use of the chart for their patients and not the chart?