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SEQIC Indicator 7 - Delayed Arrival to Definitive Care

Source: R/seqic_7.R
seqic_indicator_7.Rd

[Experimental]

Computes SEQIC Indicator 7, which measures the proportion of trauma patients arriving at the definitive care facility trauma centers (level I–IV) more than 180 minutes after injury. This indicator identifies delays in definitive care.

Usage

seqic_indicator_7(
  data,
  level,
  included_levels = c("I", "II", "III", "IV"),
  unique_incident_id,
  time_from_injury_to_arrival,
  transfer_out_indicator,
  groups = NULL,
  calculate_ci = NULL,
  ...
)

Arguments

data

A data frame containing trauma incident records.

level

Column indicating the trauma center designation level (e.g., I, II, III, IV).

included_levels

Character vector indicating what facility levels to include in the analysis. Defaults to c("I", "II", "III", "IV").

unique_incident_id

Unique identifier for each record.

time_from_injury_to_arrival

Column name representing the time in minutes from injury occurrence to arrival at the trauma center. Numeric type.

transfer_out_indicator

Column name indicating whether the patient was transferred out of the initial trauma center to definitive care. Logical, character, or factor type. Values representing "No" (e.g., FALSE, "No") indicate no transfer out.

groups

Additional columns passed as a vector of strings to dplyr::summarize() via the .by argument for grouped summaries. Defaults to NULL.

calculate_ci

If NULL, 95% confidence intervals will not be calculated for the performance estimates. Otherwise, options of "wilson" or "clopper-pearson" can be supplied to utilize the corresponding methods to calculate the confidence intervals for the proportions. Defaults to NULL.

...

Arguments passed on to nemsqar::nemsqa_binomial_confint

conf.level

Numeric value between 0 and 1 indicating the confidence level. Defaults to 0.95 (95% confidence interval).

correct

Logical, indicating whether to apply continuity correction for Wilson intervals. Defaults to TRUE.

Value

A tibble summarizing SEQIC Indicator 7 results. Includes numerator, denominator, and proportion. 95% confidence intervals are included if requested.

Details

This function:

  • Filters the dataset to trauma center levels I through IV.

  • Deduplicates the dataset by unique_incident_id.

  • Creates a logical flag for arrivals occurring more than 180 minutes after injury.

  • Identifies definitive care records where the patient arrived greater than 180 minutes after the time of injury.

  • Returns a summarized tibble with the number of such cases (numerator), total eligible records (denominator), and the proportion.

  • Optionally includes 95% confidence intervals if calculate_ci is specified.

Note

The user must ensure all columns are correctly passed and that time values are numeric and measured in minutes.

Author

Nicolas Foss Ed.D., MS

Examples

# Packages
library(dplyr)
library(traumar)

# Create test data for Indicator 7
test_data <- tibble::tibble(
  id = as.character(1:10),
  trauma_level = rep(c("I", "II", "III", "IV", "V"), times = 2),
  time_to_arrival = c(200, 100, 220, 150, 400, 181, 90, 179, 240, 178),
  transfer_out = c("No", "No", "No", "No", "Yes", "No", "No", "No", "No",
  "No")
)

# Run the indicator function
traumar::seqic_indicator_7(
  data = test_data,
  level = trauma_level,
  unique_incident_id = id,
  time_from_injury_to_arrival = time_to_arrival,
  transfer_out_indicator = transfer_out
)
#> # A tibble: 1 × 4
#>   data              numerator_7 denominator_7 seqic_7
#>   <chr>                   <int>         <int>   <dbl>
#> 1 population/sample           4             8     0.5