Limitations of procedural learning curves: reassessment of the clinical relevance of learning curve analysis in robotic right hemicolectomy
Learning curves in robotic right hemicolectomy (RRH) are assessed using cumulative sum (CUSUM) analysis. CUSUM was originally designed for industrial processes using external benchmarks. Medical applications rely on internal benchmarks, typically the cohort-specific median. This introduces circularity, obscures early d...