Volume 53 | Number 4 | August 2018

Abstract List

Jeanette W. Chung, Karl Y. Bilimoria, Jonah J. Stulberg M.D., Ph.D., M.P.H., Christopher M. Quinn M.S., Larry V. Hedges Ph.D.

Objective/Study Question

To estimate and compare sample average treatment effects () and population average treatment effects () of a resident duty hour policy change on patient and resident outcomes using data from the Flexibility in Duty Hour Requirements for Surgical Trainees Trial (“ Trial”).

Data Sources/Study Setting

Secondary data from the National Surgical Quality Improvement Program and the Trial (2014–2015).

Study Design

The Trial was a cluster‐randomized pragmatic noninferiority trial designed to evaluate the effects of a resident work hour policy change to permit greater flexibility in scheduling on patient and resident outcomes. We estimated hierarchical logistic regression models to estimate the of a policy change on outcomes within an intent‐to‐treat framework. Propensity score‐based poststratification was used to estimate .

Data Collection/Extraction Methods

This study was a secondary analysis of previously collected data.

Principal Findings

Although estimates suggested noninferiority of outcomes under flexible duty hour policy versus standard policy, the noninferiority of a policy change was based on estimates due to imprecision.


Propensity score‐based poststratification can be valuable tools to address trial generalizability but may yield imprecise estimates of when sparse strata exist.