A study was recently reported concerning the frequency of adverse events during inpatient hospital admissions (Bates, et al, New England Journal of Medicine 2023; 388: 142-153). A random sample of 2809 patients admitted to 11 Massachusetts hospitals were assessed. Nine nurses performed a review of the admissions to identify possible adverse events. An adverse event was defined as an “unintended physical injury resulting from or contributed to by medical care that requires additional monitoring, treatment, or hospitalization, or that results in death”. At least one adverse event was identified among 663 of the 2809 admissions. a. Suppose another hospital (not in the study) wants to compare its adverse event experience with the experience reported in the paper. In a preliminary study, it finds based on chart review among the 1st 10 inpatients, that 3 patients experienced 1 adverse event. What is the probability of observing at least 3 patients out of 10 with 1 adverse event, if the adverse event prevalence in the 11 Massachusetts hospitals holds for this hospital? b. Write down a computer command to calculate the probability in part (a). Specify the name of the command and all parameters needed to compute the quantity in part (a). You can specify the computer command and parameters in one and only one of Excel, Stata, or R. Suppose there is a network of hospitals that institute an educational intervention to reduce the number of adverse events among inpatients. After administering the intervention, they find by chart review that of the first 1000 patients, 200 have 1 or more adverse events. c. What is the probability of observing ≤200 adverse events among the 1000 inpatients if the published study adverse event rate among 11 Massachusetts hospitals holds for this network of hospitals? Hint: Use an approximation. d. What is the smallest number of adverse events among the 1000 patients that would have been compatible with the previously published adverse event rate? Hint 1: Determine the smallest number of adverse events (y) such that Pr Y≤y ≥0.05. Hint 2: Report y as an integer
3. A study was recently reported concerning the frequency of adverse events during inpatient hospital admissions (Bates, et al, New England Journal of Medicine 2023; 388: 142-153). A random sample of 2809 patients admitted to 11 Massachusetts hospitals were assessed. Nine nurses performed a review of the admissions to identify possible adverse events. An adverse
a. Suppose another hospital (not in the study) wants to compare its adverse event experience with the experience reported in the paper. In a preliminary study, it finds based on chart review among the 1st 10 inpatients, that 3 patients experienced 1 adverse event. What is the
b. Write down a computer command to calculate the probability in part (a). Specify the name of the command and all parameters needed to compute the quantity in part (a). You can specify the computer command and parameters in one and only one of Excel, Stata, or R.
Suppose there is a network of hospitals that institute an educational intervention to reduce the number of adverse events among inpatients. After administering the intervention, they find by chart review that of the first 1000 patients, 200 have 1 or more adverse events.
c. What is the probability of observing ≤200 adverse events among the 1000 inpatients if the published study adverse event rate among 11 Massachusetts hospitals holds for this network of hospitals?
Hint: Use an approximation.
d. What is the smallest number of adverse events among the 1000 patients that would have been compatible with the previously published adverse event rate?
Hint 1: Determine the smallest number of adverse events (y) such that Pr Y≤y ≥0.05.
Hint 2: Report y as an integer
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