Defining poor and optimum performance in an IVF programme Castilla Alcalá, José Antonio Hernández, Juana Cabello, Yolanda La Fuente, Alejandro Pajuelo, Nuria Marqueta, Javier Coroleu, Buenaventura IVF league table outcome assessment quality of care At present there is considerable interest in healthcare administration, among professionals and among the general public concerning the quality of programmes of assisted reproduction. There exist various methods for comparing and analysing the results of clinical activity, with graphical methods being the most commonly used for this purpose. As yet, there is no general consensus as to how the poor performance (PP) or optimum performance (OP) of assisted reproductive technologies should be defined. METHODS Data from the IVF/ICSI register of the Spanish Fertility Society were used to compare and analyse different definitions of PP or OP. The primary variable best reflecting the quality of an IVF/ICSI programme was taken to be the percentage of singleton births per IVF/ICSI cycle initiated. Of the 75 infertility clinics that took part in the SEF-2003 survey, data on births were provided by 58. A total of 25 462 cycles were analysed. The following graphical classification methods were used: ranking of the proportion of singleton births per cycles started in each centre (league table), Shewhart control charts, funnel plots, best and worst-case scenarios and state of the art methods. RESULTS The clinics classified as producing PP or OP varied considerably depending on the classification method used. Only three were rated as providing ‘PP’ or ‘OP’ by all methods, unanimously. Another four clinics were classified as ‘poor’ or ‘optimum’ by all the methods except one. CONCLUSIONS On interpreting the results derived from IVF/ICSI centres, it is essential to take into account the characteristics of the method used for this purpose. 2025-01-20T08:20:49Z 2025-01-20T08:20:49Z 2008 journal article Castilla JA, Hernandez J, Cabello Y, Lafuente A, Pajuelo N, Marqueta J, Coroleu B; Assisted Reproductive Technology Register of the Spanish Fertility Society. Defing poor and optimuinm performance in an IVF programme. Hum Reprod. 2008 Jan;23(1):85-90. PMID: 18003623 https://hdl.handle.net/10481/99610 10.1093/humrep/dem361 eng open access Oxford University Press