TABLE 4: Sensitivity analyses.

Each included a random intercept for ED and a volume term. Analyses were not adjusted for patient features. The effect of volume is reported as the change in delayed diagnosis frequency per twofold increase in volume.

			Annual ED volume of children		Annual volume of pediatric appendicitis
Cohort	Patients	Delayed diagnosis, n (%)	Effect of volume, % (95% CI)	SD of ED random intercept	Effect of volume, % (95% CI)	SD of ED random intercept
Main analysis	93136	3293 (3.5)	−6.9 (−11.3, −2.2)	1.00 (0.92, 1.08)	−24.1 (−27.0, −21.0)	0.82 (0.75, 0.89)
Index transfers excluded	83135	3250 (3.9)	−5.7 (−10.1, −0.9)	0.96 (0.89, 1.04)	−22.4 (−25.3, −19.3)	0.80 (0.73, 0.87)
Age ≥ 5 years	89390	3012 (3.4)	−7.9 (−12.3, −3.1)	1.00 (0.92, 1.08)	−24.6 (−27.5, −21.5)	0.82 (0.75, 0.89)
Females only	37064	1542 (4.2)	−10.0 (−14.9, −4.7)	0.94 (0.85, 1.05)	−25.0 (−28.2, −21.6)	0.75 (0.66, 0.84)
Males only	56072	1751 (3.1)	−5.8 (−11.1, 0.1)	1.06 (0.97, 1.17)	−23.6 (−27.0, −19.8)	0.88 (0.79, 0.97)
Public payer only	45648	1891 (4.1)	−8.0 (−13.1, −2.3)	0.99 (0.90, 1.09)	−24.1 (−27.4, −20.6)	0.80 (0.72, 0.89)
Private payer only	41547	1138 (2.7)	−13.9 (−18.8, −8.5)	0.98 (0.86, 1.10)	−26.0 (−29.6, −22.3)	0.78 (0.67, 0.89)
AR/FL excluded	73574	2552 (3.5)	−5.8 (−11.1, −0.0)	1.03 (0.94, 1.13)	−24.2 (−27.8, −20.4)	0.86 (0.78, 0.94)
Delay > 0% likely	93136	5298 (5.7)	−4.0 (−8.0, 0.3)	0.92 (0.86, 0.99)	−22.2 (−24.8, −19.5)	0.74 (0.68, 0.80)
Delay ≥ 50% likely	93136	3865 (4.1)	−5.1 (−9.5, −0.4)	0.99 (0.91, 1.06)	−23.2 (−26.0, −20.2)	0.81 (0.74, 0.88)
Delay ≥ 90% likely	93136	1340 (1.4)	−3.3 (−9.1, 3.2)	1.06 (0.95, 1.17)	−21.3 (−25.1, −17.2)	0.88 (0.79, 0.99)

CI: confidence interval, ED: emergency department, SD: standard deviation