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Level‐adjusted funnel plots based on predicted marginal expectations: an application to prophylactic antibiotics in gallstone surgery
Author(s) -
Lindhagen Lars,
Darkahi Bahman,
Sandblom Gabriel,
Berglund Lars
Publication year - 2014
Publication title -
statistics in medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.996
H-Index - 183
eISSN - 1097-0258
pISSN - 0277-6715
DOI - 10.1002/sim.5677
Subject(s) - covariate , markov chain monte carlo , random effects model , statistics , econometrics , marginal distribution , data set , markov chain , funnel plot , computer science , set (abstract data type) , mathematics , monte carlo method , medicine , random variable , meta analysis , confidence interval , publication bias , programming language
Abstract Funnel plots are widely used to visualize grouped data, for example, in institutional comparison. This paper extends the concept to a multi‐level setting, displaying one level at a time, adjusted for the other levels, as well as for covariates at all levels. These level‐adjusted funnel plots are based on a Markov chain Monte Carlo fit of a random effects model, translating the estimated model parameters to predicted marginal expectations. Working within the estimation framework, we accommodate outlying institutions using heavy‐tailed random effects distributions. We also develop computer‐efficient methods to compute predicted probabilities in the case of dichotomous outcome data and various random effect distributions. We apply the method to a data set on prophylactic antibiotics in gallstone surgery. Copyright © 2014 John Wiley & Sons, Ltd.

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