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Secondly, there was lack of uniformity when it came to peripheral hospitals attached to training hospitals, with some trainees entering procedures performed at those sites separately e.g. entries were present for Chapel Allerton Hospital attached to Leeds General Infirmary but no entries were found for St . Lukes Hospital attached with Bradford Royal Infirmary.
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This situation is likely because this group only represents 20% of all residents entering their PGY4 year, less than half of the number of residents entering procedure-based specialties.
We used 2 external data validation techniques to check the completeness of entered procedures.
The entered procedures could be reviewed and edited on the handheld computer screen.
Completeness of entered procedures was validated in 2 ways: (1) by comparison with the number of reimbursements for arthroplasty surgeries (Vektis database), and (2) by comparison with data from hospital information systems (HISs).
Then, from pull-down menus, the following data were entered: procedures performed (up to four per patient); follow-up call ('yes' or 'no'); and patient status ('stable, 'unstable adult medical'unstableble adult surgical', unstable pediatric medical', or 'unstable pediatric surgical').
Multivariable analysis was performed using a Cox proportional hazards model with an enter procedure.
Unconditional logistic regression analysis with enter procedure was used to select the predictors and adjust confounding variables.
Predictors of higher peak strain were assessed in multiple linear regression analyses using an enter procedure with collinearity diagnostics.
Multivariable analyses were performed using a two-sided Cox proportional hazards model with enter procedure of all risk predictors considered (Table 2).
A logistic regression was carried out to determine the association between comorbidities and use of strong opiates (enter procedure and Wald statistics).
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