Journal of clinical epidemiology
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Competing risks endpoints are frequently encountered in hematopoietic stem cell transplantation where patients are exposed to relapse and treatment-related mortality. Both cause-specific hazards and direct models for the cumulative incidence functions have been used for analyzing such competing risks endpoints. For both approaches, the popular models are of a proportional hazards type. ⋯ We argue that a complete understanding of the event dynamics requires that both hazards and cumulative incidence be analyzed side by side, and that this is generally the most rigorous scientific approach to analyzing competing risks data. That is, understanding the effects of covariates on cause-specific hazards and cumulative incidence functions go hand in hand. A case study illustrates our proposal.
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Review
Systematic reviews supporting practice guideline recommendations lack protection against bias.
To evaluate the quality of systematic reviews (SRs) affecting clinical practice in endocrinology. ⋯ Few recommendations in endocrinology are supported by SRs. The quality of SRs is suboptimal and is not acknowledged by guideline developers.
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Hospitals have strong incentives to decrease readmission rates. Not all hospital readmissions are potentially avoidable. Therefore, only a component of all hospital readmissions can be influenced by interventions designed to decrease them. In this study, we determined how effective interventions must be to attain specific reductions in hospital readmission rates. ⋯ These results highlight that relative reductions in the total number of readmissions are notably lower than that for potentially avoidable readmissions. This separation in relative reduction of all and potentially avoidable readmissions increases as the proportion of readmissions deemed potentially avoidable decreases. These results have important implications for health care planners and researchers.