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What to do with outliers?
  1. G Parry1,
  2. E Draper2,
  3. P McKinney3
  1. 1Health Services Research, University of Sheffield, Sheffield, UK
  2. 2Department of Epidemiology and Public Health, University of Leicester, Leicester, UK
  3. 3Paediatric Epidemiology Group, University of Leeds, Leeds, UK
  1. Correspondence to:
 Dr G Parry
 Health Services Research, University of Sheffield, Sheffield, UK;g.parry{at}

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The paper by Spiegelhalter is a valuable contribution to the literature on presenting and displaying performance related outcome measures.1 It provides further methodological guidance on identifying service providers whose performance falls outside control limits using funnel plot methodology. When reporting on performance it is important to have procedures in place which should be followed when outliers are identified. These issues have been considered by the Paediatric Intensive Care Audit Network (PICANet) who use the funnel plot methodology for reporting risk adjusted mortality from all paediatric intensive care units (PICU) in England and Wales. Before producing these funnel plots for the latest …

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