Crude mortality rates were higher in sepsis cases that failed versus passed SEP-1, but there was no difference after adjusting for clinical characteristics and severity of illness. Delays in antibiotic administration were associated with higher mortality but only accounted for a small fraction of SEP-1 failures. SEP-1 may not clearly differentiate between high- and low-quality care, and detailed risk adjustment is necessary to properly interpret associations between SEP-1 compliance and mortality.

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We compared sepsis "time zero" and Centers for Medicare and Medicaid Services (CMS) SEP-1 pass rates among 3 abstractors in 3 hospitals. Abstractors agreed on time zero in 29 of 80 (36%) cases. Perceived pass rates ranged from 9 of 80 cases (11%) to 19 of 80 cases (23%). Variability in time zero and perceived pass rates limits the utility of SEP-1 for measuring quality.

Objective The Combined Analysis of Psychiatric Studies (CAPS) project conducted extensive review and regularization across studies of all schizophrenia linkage data available as of 2011 from the NIMH-funded Center for Collaborative Genomic Studies on Mental Disorders, also known as the Human Genetics Initiative (HGI). Here we reanalyze the data using statistical methods tailored to accumulation of evidence across multiple, potentially highly heterogeneous, sets of data. Method Data were subdivided based on contributing study, major population group, and presence or absence within families of schizophrenia with a substantial affective component. The Posterior Probability of Linkage (PPL) statistical framework was used to sequentially update linkage evidence across these data subsets (omnibus results). Results While some loci previously implicated using the HGI data were also identified in our omnibus analysis (2q36.1, 15q23), others were not. Several loci were found that had not been previously reported in the HGI samples, but which are supported by independent linkage and/or association studies (3q28, 12q23.1, 11p11.2, Xq26.1). Not surprisingly, differences were seen across population groups. Of particular interest are signals on 11p15.3, 11p11.2, and Xq26.1, for which families with substantial affective component support linkage while the remaining families give evidence against linkage. All three of these loci overlap with loci reported in independent studies of bipolar disorder or mixed bipolar-schizophrenia samples. Conclusions Public data repositories provide the opportunity to leverage large, multi-site data sets for studying complex disorders. Analysis with a statistical method specifically designed for such data enables us to extract new information from an existing data resource.

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