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We began the discussion by reviewing causal mediationanalysis and summarizing the exchange we had on thepages of Psychological Methods (2014)We ended with a consensus regarding the importance ofcausal mediation and the conditions for identifying of NaturalDirect and Indirect Effects, from randomized as wellas observational studies. Have we forgotten any assumption?b. Are these assumptions consistent?c.
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Methods: We used segmented regression to compare rates of MRSA and MSSA bacteraemia in the pre intervention, implementation, and post intervention phases for combined intervention packages in eight acute hospitals.Findings: Most of the change in MSSA and MRSA rates occurred during the implementation phase. During this phase, there were significant downward trends in MRSA rates for seven of eight acute hospital groups; in four, this was a steeper quarter on quarter decline compared with the pre intervention phase, and, in one, an upward trend in the pre intervention phase was reversed. Regarding MSSA, there was a significant positive effect in four hospital groups: one upward trend during the pre intervention phase was reversed, two upward trends plateaued, and in one hospital group an indeterminate trend decreased significantly.
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