Jove
Visualize
Contact Us
JoVE
x logofacebook logolinkedin logoyoutube logo
ABOUT JoVE
OverviewLeadershipBlogJoVE Help Center
AUTHORS
Publishing ProcessEditorial BoardScope & PoliciesPeer ReviewFAQSubmit
LIBRARIANS
TestimonialsSubscriptionsAccessResourcesLibrary Advisory BoardFAQ
RESEARCH
JoVE JournalMethods CollectionsJoVE Encyclopedia of ExperimentsArchive
EDUCATION
JoVE CoreJoVE BusinessJoVE Science EducationJoVE Lab ManualFaculty Resource CenterFaculty Site
Terms & Conditions of Use
Privacy Policy
Policies

Related Experiment Videos

Analysing differences in clinical outcomes between hospitals.

J M Simpson1, N Evans, R W Gibberd

  • 1School of Public Health, University of Sydney, NSW 2006, Australia. judys@health.usyd.edu.au

Quality & Safety in Health Care
|August 5, 2003
PubMed
Summary

Statistical methods like shrinkage estimators significantly reduce variation in severe intraventricular haemorrhage (IVH) rates among neonatal intensive care units (NICUs). Focusing on high-performing NICUs can prevent infant morbidity.

Related Concept Videos

You might also read

Related Articles

Articles linked to this work by shared authors, journal, and citation graph.

Sort by
Same author

Prenatal presentation of fetal bradycardia and long QT syndrome.

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology·2026
Same author

Indications for fetal echocardiography: also a need to define the examination and standards of practice.

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology·2025
Same author

Characterizing fetoplacental response to acute maternal hyperoxygenation in suspected coarctation of aorta using fetal cardiac MRI.

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology·2025
Same author

Interaction between clinicians and artificial intelligence to detect fetal atrioventricular septal defects on ultrasound: how can we optimize collaborative performance?

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology·2024
Same author

Sonographer interaction with artificial intelligence: collaboration or conflict?

Ultrasound in obstetrics & gynecology : the official journal of the International Society of Ultrasound in Obstetrics and Gynecology·2023
Same author

Measurement of the cardiac time intervals of the fetal ECG utilising a computerised algorithm: A retrospective observational study.

JRSM cardiovascular disease·2022

Area of Science:

  • Neonatal Medicine
  • Clinical Epidemiology
  • Healthcare Quality Improvement

Background:

  • Severe intraventricular haemorrhage (IVH) is a significant concern in preterm infants.
  • Hospital-level variations in severe IVH rates exist, necessitating investigation into contributing factors and statistical adjustment methods.

Purpose of the Study:

  • To analyze inter-hospital variability in severe (grades 3-4) IVH rates among preterm infants.
  • To compare the effectiveness of case mix adjustment versus shrinkage estimators in standardizing IVH rates across neonatal intensive care units (NICUs).

Main Methods:

  • Cross-sectional study utilizing pooled data from 24 NICUs in the Australian and New Zealand Neonatal Network (1995-1997).
  • Analysis of 5413 infants with gestational age 24-30 weeks.

Related Experiment Videos

  • Crude IVH rates were compared with rates adjusted for case mix (logistic regression) and sampling variability (shrinkage estimators).

    • Main Results:

    • Crude severe IVH rates varied widely across NICUs (2.9% to 21.4%).
    • Case mix adjustment paradoxically increased rate variability.
    • Shrinkage estimators effectively reduced inter-unit variation in severe IVH rates (IQR 6.3-7.5%).
    • One NICU showed a significantly higher adjusted rate, while another showed a significantly lower rate.

    Conclusions:

    • Shrinkage estimators are more effective than case mix adjustment in reducing outcome variation between hospitals.
    • Improving infant outcomes may be enhanced by focusing on best-performing NICUs to identify and disseminate successful practices.