Biostatistics Commons^™

Are (The Log-Odds Of) Hospital Mortality Rates Normally Distributed In Ontario? Implications For Studying Variations In Outcomes Of Medical Care, Peter C. Austin

Peter Austin

Objective: Hierarchical regression models are used to examine variations in outcomes following the provision of medical care across providers. These models frequently assume a normal distribution for the provider-specific random effects. Poincaré said, “Everyone believes in the normal law, the experimenters because they imagine it a mathematical theorem, and the mathematicians because they think it an experimental fact”. Our objective was to examine the appropriateness of this assumption when examining variations in mortality.

Study design and setting: We used Bayesian model selection methods to compare hierarchical regression models in which the provider-specific random effects were either a normal distribution or …