In this issue, Paddock et al 9 address a seemingly straightforward question-what precisely does it mean to be a performance outlier? Using Hospital Compare data, the authors demonstrate an apparently contradictory finding. When directly compared one to another, some individual hospitals in a given performance tier may not be statistically significantly different than individual hospitals in adjacent tiers, even when those tier assignments were made
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Shahian et al. (2015) studied this question.
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