Evidence map›Paper›PMID 31880314›Full record

ArticleHealth services research2020

Resurrecting immortal-time bias in the study of readmissions.

Lee A Hugar, Tudor Borza, Mary K Oerline, Brent K Hollenbeck, Ted A Skolarus, Bruce L Jacobs

Abstract readComparative Study
In one paragraph

Article in Health services research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Lee A HugarDepartment of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.ORCID 0000-0003-0004-6001
Tudor BorzaDow Health Services Research Division, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Mary K OerlineDow Health Services Research Division, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Brent K HollenbeckDow Health Services Research Division, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Ted A SkolarusDow Health Services Research Division, Department of Urology, University of Michigan, Ann Arbor, Michigan.
Bruce L JacobsDepartment of Urology, University of Pittsburgh Medical Center, Pittsburgh, Pennsylvania.

Funding

Major surgery in patients with Alzheimer's disease and related dementias: effects of technology and policyR01AG048071 · NIA · UNIVERSITY OF MICHIGAN AT ANN ARBOR · PI HOLLENBECK, BRENT K. · 2015 to 2019
$3.0M
NIA NIH HHS R01-AG-048071
6 · The paper itself

Abstract

objectiveTo compare readmission rates as measured by the Centers for Medicare and Medicaid Services and the American College of Surgeons National Surgical Quality Improvement Program (NSQIP) methods. DATA SOURCES: 20 percent sample of national Medicare data for patients undergoing cystectomy, colectomy, abdominal aortic aneurysm (AAA) repair, and total knee arthroplasty (TKA) between 2010 and 2014. STUDY

designRetrospective cohort study comparing 30-day readmission rates. DATA COLLECTION/EXTRACTION

methodsPatients undergoing cystectomy, colectomy, abdominal aortic aneurysm repair, and total knee arthroplasty between 2010 and 2014 were identified. PRINCIPAL

findingsCystectomy had the highest and total knee arthroplasty had the lowest readmission rate. The NSQIP measure reported significantly lower rates for all procedures compared to the CMS measure, which reflects an immortal-time bias.

conclusionsWe found significantly different readmission rates across all surgical procedures when comparing CMS and NSQIP measures. Longer length of stay exacerbated these differences. Uniform outcome measures are needed to eliminate ambiguity and synergize research and policy efforts.

Indexed as

AgedAged, 80 and overAortic Aneurysm, AbdominalArthroplasty, Replacement, KneeBiasColectomyFemaleHealth Care CostsHumansLength of StayMaleMedicareOdds RatioPatient DischargePatient ReadmissionQuality Improvementadministrative data useshealth policy/politics/law/regulationMedicareprogram evaluationquality of care/patient safetysurgery

Identifiers

PMID31880314
PMCPMC7080383

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.