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Do people living in rural and urban locations experience differences in harm when admitted to hospital? A cross-sectional New Zealand general practice records review study
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  • Published on:
    Incorrect data analyses by Atmore et al 2021.

    Atmore et al (2021) have reported findings from a general practice patient records review in New Zealand.1 Main research question was to compare harms between rural and urban locations. Sampling design was a stratified sampling design with unequal probabilities of selection from strata.2 Authors reported “weights developed from the SHARP study data were applied to enable generalisability of results to the NZ population”. Analyses include Chisquare test, Fishers exact test, independent sample t-test, Mann-Whitney test, Wald test, Poisson regression, and ordinal logistic regression. Some of these procedures cannot accommodate any type of weights, some can accommodate frequency weights but not sampling weights. So, with these procedures authors either may not have used sampling weights or may have incorrectly used them as frequency weights. Closer look at the presented results shows most, if not all, percentages reported are simply the simple percentages observed in data, ignoring sampling weights. In stratified sampling designs, researchers can observe any desired strata-specific percentage by altering the strata-specific sampling fraction of participants, therefore not using sampling weights or incorrectly using them to compare outcomes between strata almost always invalidate results. Further, authors have interpreted main effects from the regression models ignoring interaction effects. For these reasons, the results presented in the Atmore et al paper are unreliable, and t...

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    Conflict of Interest:
    None declared.