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Controlling for Patient Risk in Volume-Outcome Studies—Reply
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In reply
We used the California CABG Mortality Reporting Program (CCMRP) risk prediction model to estimate expected surgical risk, primarily because it was an independently derived and previously reported tool for estimating in-hospital death following coronary artery bypass grafting.1 The concern by Ho is that the absence of hospital volume within this risk prediction model may have influenced our results owing to omitted variable bias. This is a valid and potentially important concern, and we evaluated for its presence in 2 ways. First, we used a generalized version of the Hausman specification test to compare coefficients in the original CCMRP risk prediction model with coefficients estimated from a similar model that included categories of hospital volume.2-3 (We performed these analyses on the subset of 27 355 patients in our study owing to a lack of publicly available data on the full study population originally used by CCMRP.) The omnibus comparison for . . . [Full Text of this Article]
AUTHOR INFORMATION
Brahmajee K. Nallamothu, MD, MPH;
Timothy P. Hofer, MD, MSc;
Steven J. Bernstein, MD
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