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Shaw et al 1 are correct in pointing out that the use of a single year's mortality data as a baseline comparator could introduce bias to our findings. They and Van Schalkwyk2 are also right to highlight the national reduction in hospital mortality rates over the past decade. However, we did not rely solely upon the overall mortality reduction to come to the conclusion that there was an association between the timing of the introduction of an electronic physiological surveillance system (EPSS) and the reduced mortality at the two study hospitals.3
Both Shaw et al and Van Schalkwyk appear to ignore the significance of the main findings of our study. The reductions in annual observed deaths are concentrated in specific years (Portsmouth 2006 and 2009, years 2 and 5 after baseline; Coventry 2009, year 3 after baseline).3 Also, …
Competing interests None.
Provenance and peer review Not commissioned; internally peer reviewed.