Letters Standardised mortality ratios

Authors’ reply

BMJ 2009; 338 doi: http://dx.doi.org/10.1136/bmj.b1750 (Published 29 April 2009) Cite this as: BMJ 2009;338:b1750
  1. Mohammed A Mohammed, senior lecturer1,
  2. Jonathan J Deeks, professor of health statistics1,
  3. Alan Girling, senior research fellow1,
  4. Gavin Rudge, data scientist1,
  5. Martin Carmalt, consultant physician2,
  6. Andrew J Stevens, professor of public health and epidemiology1,
  7. Richard J Lilford, professor of clinical epidemiology1
  1. 1Unit of Public Health, Epidemiology and Biostatistics, University of Birmingham, Birmingham B15 2TT
  2. 2Royal Orthopaedic Hospital, Birmingham B31 2AP
  1. M.A.Mohammed{at}bham.ac.uk

We are very encouraged that our work has now led Aylin and colleagues to agree that hospital standardised mortality ratios “could potentially be affected by several factors, including data quality, admission thresholds, discharge strategies, and underlying levels of morbidity in the population.”1 Dr Foster must publish these caveats alongside its hospital standardised mortality ratios. Such caveats will also counter the popular misconception that hospital standardised mortality ratios measure the number of avoidable deaths. And while Sherlaw-Johnson and colleagues suggest that …

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