Re: CIs for adjusted rates

2001-11-22 Thread Robert Chung

"Scheltema, Karen" wrote:
> I have complication rates for a given procedure.  I was thinking of using
> indirect standardization as a method of risk adjustment given that some
> doctors see more complex patients.  What I can't figure out is how I would
> go about calculating a 95% CI after the risk adjustment.  Any pointers would
> be greatly appreciated.
> 
> Karen Scheltema, M.A., M.S.

What's the variablility you're trying to model: variability in
the patient's risk of complications or variability in the
physician's case mix? Indirect standardization is set up to
handle the latter. Is this what you really want? You're going to
have to be clearer about the hypothesis that you're testing.

You didn't ask, but I would be surprised if you got exactly what
you expected out of complication data. They tend to be poorly
collected so it's hard to eliminate the influence of differential
coding practices.

--Robert Chung


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Re: CIs for adjusted rates

2001-11-21 Thread Dennis Roberts

At 08:35 AM 11/21/01 -0600, Scheltema, Karen wrote:
>I have complication rates for a given procedure.  I was thinking of using
>indirect standardization as a method of risk adjustment given that some
>doctors see more complex patients.  What I can't figure out is how I would
>go about calculating a 95% CI after the risk adjustment.  Any pointers would
>be greatly appreciated.

why not define a group of doctors or cases as ... less complex patients .. 
and more complex patients ... and do the confidence intervals separately 
(you might do one overall interval to see how it compares to the two 
separate ones ... perhaps there is little difference)

one problem i do see is that ... some doctors deal with both so, the two 
classes above (less complex, more complex) are not totally independent


>Karen Scheltema, M.A., M.S.
>Statistician
>HealthEast
>Research and Education
>1700 University Ave W
>St. Paul, MN 55104
>(651) 232-5212 (phone)
>(651) 641-0683 (fax)
>[EMAIL PROTECTED]
>
>
>
>
>=
>Instructions for joining and leaving this list and remarks about
>the problem of INAPPROPRIATE MESSAGES are available at
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_
dennis roberts, educational psychology, penn state university
208 cedar, AC 8148632401, mailto:[EMAIL PROTECTED]
http://roberts.ed.psu.edu/users/droberts/drober~1.htm



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CIs for adjusted rates

2001-11-21 Thread Scheltema, Karen

I have complication rates for a given procedure.  I was thinking of using
indirect standardization as a method of risk adjustment given that some
doctors see more complex patients.  What I can't figure out is how I would
go about calculating a 95% CI after the risk adjustment.  Any pointers would
be greatly appreciated.

Karen Scheltema, M.A., M.S.
Statistician
HealthEast
Research and Education
1700 University Ave W
St. Paul, MN 55104
(651) 232-5212 (phone)
(651) 641-0683 (fax)
[EMAIL PROTECTED]




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Instructions for joining and leaving this list and remarks about
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