Hospital Standardized Mortality Ratios: A Tale of Two Sites
Bibliographic record
Abstract
In 2008, Caritas Health Group (CHG), composed of the Edmonton area Catholic acute hospital sites, became part of Covenant Health, Alberta's largest faith-based healthcare provider. In 2005, Capital Health (CH)/CHG began its work with the Canadian Institute of Health Information (CIHI). It is one of eight pioneer health regions in Canada to test the methodology of the hospital standardized mortality ratio (HSMR) developed in the United Kingdom, through Sir Brian Jarman, director of the Dr. Foster Unit (DRF), at the Imperial College in London. This article focuses on understanding the UK's HSMR process and describing its use in two hospitals in the Edmonton area. The hospitals used raw mortality data and chart review processes following the introduction of the HSMR in Canada in order to better understand the intricacy of this measure. The article focuses on the in-house process that became a foundation for an in-depth exploratory use of the CIHI HSMR e-portal for hospital sites within the province of Alberta.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.056 | 0.131 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.018 | 0.014 |
| Science and technology studies | 0.003 | 0.014 |
| Scholarly communication | 0.013 | 0.011 |
| Open science | 0.003 | 0.007 |
| Research integrity | 0.002 | 0.007 |
| Insufficient payload (model declined to judge) | 0.004 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".