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Activity Number: 139
Type: Contributed
Date/Time: Monday, July 30, 2012 : 8:30 AM to 10:20 AM
Sponsor: Section on Statistics in Epidemiology
Abstract - #305320
Title: Reliability-Adjusted Standardized Incidence Ratios Using Bayesian Analysis
Author(s): Jonathan R. Edwards*+
Companies: CDC
Address: 1600 Clifton Rd., Atlanta, GA, 30333, United States
Keywords: healthcare ; infection ; Bayesian
Abstract:

CDC's National Healthcare Safety Network (NHSN), used by CDC and its partners for surveillance of healthcare-associated infections (HAIs), provides standardized incidence ratios (SIRs) to participating hospitals to help promote healthcare quality. In 2011, the NHSN began reporting SIRs measuring central line-associated bloodstream infection (CLABSI) incidence to the Center for Medicaid and Medicare Services (CMS) to evaluate hospital reporting and performance. A CLABSI SIR is the ratio of the observed to expected CLABSI incidence where the later was estimated using a log linear marginal model based on hospital and unit-level factors. In 2011, there were 62,637 months of data summarizing CLABSI incidence reported to NHSN from 3,326 hospitals. Hospital-level CLABSI SIRs are prone to excessive variation depending on exposure volume and unmeasured factors. Empirical Bayesian analysis was used to produce adjusted SIRs that account for these sources of variability. Reliability-adjusted SIRs obtained by shrinking the observed CLABSI incidence toward the expected incidence given exposure volume and relevant factors are more comparable and stable to better measure quality performanc


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