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Package {bewrs}


Type: Package
Title: Bayesian Early-Warning Risk Surveillance for Healthcare Performance Monitoring
Version: 0.1.1
Description: Provides Bayesian early-warning surveillance methods for monitoring healthcare performance and patient safety outcomes. The package draws on risk-adjusted monitoring frameworks developed by Steiner et al. (2000) <doi:10.1093/biostatistics/1.4.441>, Spiegelhalter et al. (2003) <doi:10.1002/sim.1546>, Cook et al. (2011) <doi:10.1136/bmjqs.2008.031831>, and Neuburger et al. (2017) <doi:10.1136/bmjqs-2016-005511>. The package implements Bayesian predictive modelling, risk-adjusted monitoring, early-warning signal detection, and graphical tools for continuous quality improvement and healthcare performance assessment.
License: GPL-3
Encoding: UTF-8
RoxygenNote: 7.3.3
Depends: R (≥ 4.2.0)
Imports: ggplot2, pROC
Suggests: testthat (≥ 3.0.0)
Config/testthat/edition: 3
URL: https://github.com/zerish12/bewrs
BugReports: https://github.com/zerish12/bewrs/issues
NeedsCompilation: no
Packaged: 2026-06-20 15:22:09 UTC; muhammadzahirkhan
Author: Muhammad Zahir Khan [aut, cre]
Maintainer: Muhammad Zahir Khan <zahirstat007@gmail.com>
Repository: CRAN
Date/Publication: 2026-06-24 10:00:07 UTC

Compute Dynamic BEWRS

Description

Computes the Bayesian Dynamic Early-Warning Risk Score using current posterior underperformance probability, persistence, and deterioration.

Usage

compute_dynamic_bewrs(
  up,
  persistence,
  deterioration,
  alpha = 0,
  beta_up = 1,
  beta_persistence = 1,
  beta_deterioration = 1
)

Arguments

up

Numeric vector of posterior underperformance probabilities.

persistence

Numeric vector measuring persistence of elevated risk.

deterioration

Numeric vector measuring recent deterioration.

alpha

Intercept parameter.

beta_up

Coefficient for logit-transformed posterior risk.

beta_persistence

Coefficient for persistence.

beta_deterioration

Coefficient for deterioration.

Value

Numeric vector of Dynamic BEWRS probabilities.

Examples

compute_dynamic_bewrs(
  up = c(0.2, 0.5, 0.8),
  persistence = c(0.1, 0.4, 0.7),
  deterioration = c(0.0, 0.1, 0.2)
)

Compute Expected Value of Intervention

Description

Computes the Expected Value of Intervention (EVI) as the reduction in expected loss from no action to the selected intervention.

Usage

compute_evi(loss_no_action, loss_intervention)

Arguments

loss_no_action

Numeric vector of expected loss under no action.

loss_intervention

Numeric vector of expected loss under intervention.

Value

Numeric vector of EVI values.

Examples

compute_evi(c(10, 5, 2), c(7, 4, 3))

Select optimal intervention

Description

Selects the intervention with the lowest expected loss.

Usage

optimal_intervention(loss_matrix)

Arguments

loss_matrix

Numeric matrix or data.frame of expected losses. Rows represent observational units and columns represent intervention options.

Value

A data.frame containing optimal action and minimum expected loss.

Examples

losses <- data.frame(
  no_action = c(10, 5, 2),
  monitor = c(8, 4, 3),
  review = c(7, 6, 4)
)
optimal_intervention(losses)

Plot calibration curve

Description

Plot calibration curve

Usage

plot_calibration(observed, predicted, groups = 10)

Arguments

observed

Binary observed outcome, coded 0/1.

predicted

Predicted probabilities.

groups

Number of quantile groups.

Value

A ggplot object.


Plot risk group event rates

Description

Plot risk group event rates

Usage

plot_risk_groups(observed, risk_group)

Arguments

observed

Binary observed outcome, coded 0/1.

risk_group

Ordered risk group factor.

Value

A ggplot object.


Stratify Dynamic BEWRS risk

Description

Classifies risk probabilities into Low, Watchlist, High, and Critical groups.

Usage

risk_stratify(risk, cutoffs = c(0.25, 0.5, 0.75))

Arguments

risk

Numeric vector of predicted risk probabilities.

cutoffs

Numeric vector of three cutoffs. Default is c(0.25, 0.50, 0.75).

Value

Ordered factor of risk categories.

Examples

risk_stratify(c(0.1, 0.4, 0.6, 0.9))

Validate BEWRS predictions

Description

Computes AUC, Brier score, calibration intercept, and calibration slope.

Usage

validate_bewrs(observed, predicted)

Arguments

observed

Binary vector of observed outcomes, coded 0/1.

predicted

Numeric vector of predicted probabilities.

Value

A data.frame containing validation metrics.

Examples

validate_bewrs(c(0, 1, 1, 0), c(0.1, 0.8, 0.7, 0.3))

These binaries (installable software) and packages are in development.
They may not be fully stable and should be used with caution. We make no claims about them.
Health stats visible at Monitor.