The optimal control chart selection for monitoring COVID-19 phases: a case study of daily deaths in the USA

Abstract

Background Epidemiologists frequently adopt statistical process control tools, like control charts, to detect changes in the incidence or prevalence of a specific disease in real time, thereby protecting against outbreaks and emergent health concerns. Control charts have proven essential in instantly identifying fluctuations in infection rates, spotting emerging patterns, and enabling timely reaction measures in the context of COVID-19 monitoring. This study aims to review and select an optimal control chart in epidemiology to monitor variations in COVID-19 deaths and understand pandemic mortality patterns. An essential aspect of the present study is selecting an appropriate monitoring technique for distinct deaths in the USA in 7 phases, including pre-growth, growth, and post-growth phases. Methods Stage-1 evaluated control chart applications in epidemiology departments of 12 countries between 2000 and 2022. The study assessed various control charts and identified the optimal one based on maximum shift detection using sample data. This study considered at Shewhart (Javid Shabbir2, ) control charts and exponentially weighted moving average (EWMA) control chart with smoothing parameters were all investigated in this study. In Stage-2, we applied the EWMA control chart for monitoring because of its outstanding shift detection capabilities and compatibility with the present data. Daily deaths have been monitored from March 2020 to February 2023. Results Control charts in epidemiology show growing use, with the United States leading at 42% applications among top countries. During the application on COVID-19 deaths, the EWMA chart accurately depicted mortality dynamics from March 2020 to February 2022, indicating six distinct stages of death. The third and fifth waves were extremely catastrophic, resulting in a considerable loss of life. Significantly, a persistent sixth wave appeared from March 2022 to February 2023. The EWMA map effectively determined the peaks associated with each wave by thoroughly examining the time and amount of deaths, providing vital insights into the pandemic’s progression. The severity of each wave was measured by the average number of deaths. Conclusion The United States entered a seventh phase (6th wave) from March 2022 to February 2023, marked by fewer deaths. While reassuring, it remains crucial to maintain vaccinations and pandemic control measures. Control charts enable early detection of daily COVID-19 deaths, providing a systematic strategy for government and medical staff. Incorporating the EWMA chart for monitoring immunizations, cases, and deaths is recommended.

Global contribution of statistical control charts to epidemiology monitoring: A 23-year analysis with optimized EWMA real-life application on COVID-19

“…Furthermore, many applications contributed to monitoring COVID-19 variables during 2019 to 2023, but an analysis of how those studies contributed overall is also lacking. Furthermore, a debate and the need for a comprehensive analysis of all-time applications were felt to be fulfilled for the selection and application of optimum control charts [23] and their appropriateness in monitoring epidemiological phenomena. This article aims to contribute to the body of knowledge by thoroughly examining the applications of control charts in epidemiological surveillance and global trends in the past 2 decades.…”

“…cdc.gov/covid-data-tracker/#datatracker-home) the number of cases and deaths are still significant, and there is a significant positive correlation exists between number of cases and deaths in the USA situation. [23] Since, December 9, 2023, the JN.1 variant has surged, the number of cases rising again. The goal of this study is to extend the use of optimal control charts in epidemiology to monitor variations in COVID-19 deaths to better understand recent pandemic mortality patterns.…”

“…Waqas et al [23] Shewhart and EWMA chart Reproduction number, number of cases and deaths USA Boone et al [25] MEWMA chart SEIRD Qatar Imro'ah et al [66] I-MR and ARIMA chart Vaccinate rate Indonesia Alamri et al [67] MEWMA chart SEIRD model KSA Elhambakhsh et al [68] Hoteling T-square chart COVID symptoms…”

“…Exponentially weighted moving average (EWMA) control chart outperformed both the Shewhart and cumulative sum charts in monitoring deaths in the USA. Following the conclusions given in, [23] rather than reproducing the aforementioned methodology, we chose the EWMA chart to extend COVID-19 death wave monitoring in the USA. This decision was influenced by the EWMA chart's superior performance when compared to cumulative sum, which has known limits, [42] and Shewhart (X-bar, R and C) charts, which performed poorly for the USA situation.…”

“…[19][20][21][22] Furthermore, in the context of COVID-19 death monitoring by using control charts following studies proposed different charts and identified death patterns. [23][24][25][26][27] Medical information determines control chart classification. There may be continuous, count, or attribute-based data.…”