Document Detail

Reliability of league tables of in vitro fertilisation clinics: retrospective analysis of live birth rates.
MedLine Citation:
PMID:  9614016     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To determine to what extent institutions carrying out in vitro fertilisation can reasonably be ranked according to their live birth rates.
DESIGN: Retrospective analysis of prospectively collected data on live birth rate after in vitro fertilisation.
SETTING: 52 clinics in the United Kingdom carrying out in vitro fertilisation over the period April 1994 to March 1995.
MAIN OUTCOME MEASURE: Estimated adjusted live birth rate for each clinic; their rank and its associated uncertainty.
RESULTS: There were substantial and significant differences between the live birth rates of the clinics. There was great uncertainty, however, concerning the true ranks, particularly for the smaller clinics. Only one clinic could be confidently ranked in the bottom quarter according to this measure of performance. Many centres had substantial changes in rank between years, even though their live birth rate did not change significantly.
CONCLUSIONS: Even when there are substantial differences between institutions, ranks are extremely unreliable statistical summaries of performance and change in performance, particularly for smaller institutions. Any performance indicator should always be associated with a measure of sampling variability.
E C Marshall; D J Spiegelhalter
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Publication Detail:
Type:  Journal Article; Multicenter Study    
Journal Detail:
Title:  BMJ (Clinical research ed.)     Volume:  316     ISSN:  0959-8138     ISO Abbreviation:  BMJ     Publication Date:  1998 Jun 
Date Detail:
Created Date:  1998-07-01     Completed Date:  1998-07-01     Revised Date:  2013-04-17    
Medline Journal Info:
Nlm Unique ID:  8900488     Medline TA:  BMJ     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1701-4; discussion 1705     Citation Subset:  AIM; IM    
MRC Biostatistics Unit, Institute of Public Health, Cambridge CB2 2SR.
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MeSH Terms
Birth Rate*
Fertilization in Vitro / standards*,  statistics & numerical data
Great Britain
Outcome and Process Assessment (Health Care)*
Prospective Studies
Retrospective Studies
Sensitivity and Specificity
Comment In:
BMJ. 1998 Dec 5;317(7172):1593-4   [PMID:  9836679 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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