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Record W2905097242 · doi:10.5430/jha.v8n1p9

Indirect and direct standardization for evaluating transplant centers

2018· article· en· W2905097242 on OpenAlexvenueno aff
Kevin He

Bibliographic record

VenueJournal of Hospital Administration · 2018
Typearticle
Languageen
FieldEconomics, Econometrics and Finance
TopicHealthcare Policy and Management
Canadian institutionsnot available
Fundersnot available
KeywordsMedicineStandardizationConcordanceLogistic regressionConfoundingRanking (information retrieval)Kidney transplantRank correlationKidney transplantationQuartileEmergency medicineTransplantationStatisticsInternal medicineComputer scienceMathematics

Abstract

fetched live from OpenAlex

To assess the quality of health care, patient outcomes associated with medical providers are routinely monitored in order to identify poor (or excellent) provider performance. To avoid confounding by risk factors, both indirect and direct standardization have been used for comparing outcome rates or prevalence for different providers. There has been an ongoing debate as to which standardization method is more appropriate. To compare the performance of indirect and direct standardization for the purpose of ranking transplant centers, we analyzed post-transplant mortality using the national kidney transplant data. Included in our analysis were 116,601 patients (from 230 transplant centers) who underwent kidney transplantation between January 2006 and December 2012. Multivariate logistic regression model was used to model the 30-day mortality, which were estimates of failures (grant failure or death) in the 30 days after the transplant surgery. Concordance indexes, kappa coefficients and Spearman’s rank correlation coefficient were computed. The estimated values from these statistics for the indirect standardized method were similar to the direct standardization. The results suggest that both indirect and direct standardized methods provide similar ability to distinguish center effects.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Theoretical or conceptual · Consensus signal: none
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.424
Threshold uncertainty score0.249

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

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.

Opus teacher head0.050
GPT teacher head0.318
Teacher spread0.268 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designTheoretical or conceptual
Domainnot available
GenreEmpirical

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".

Quick stats

Citations2
Published2018
Admission routes1
Has abstractyes

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