Letters Section Editor: Robert M. Golub, MD, Senior Editor.
To the Editor: Dr Pine and colleagues1 studied the enhancement of claims data to improve risk adjustment of hospital mortality. However, when comparing risk-adjusted hospital outcomes, adjustment for variables that are documented inconsistently between hospitals may introduce bias even though this adjustment may improve the discriminative power of the predictive model. This concern was not addressed in the article.
Heller G, Schnell R. Hospital Mortality Risk Adjustment Using Claims Data. JAMA. 2007;297(18):1983–1984. doi:10.1001/jama.297.18.1983