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Technical specifications. Washington (District of Columbia): Agency for Healthcare Research and Quality."},{"key":"ref32","doi-asserted-by":"crossref","first-page":"23","DOI":"10.1017\/S0965539501000122","article-title":"Classification of caesarean sections","volume":"12","author":"M Robson","year":"2001","journal-title":"Fetal Matern Med Rev"},{"key":"ref33","doi-asserted-by":"crossref","first-page":"1185","DOI":"10.1002\/sim.1970","article-title":"Funnel plots for comparing institutional performance","volume":"24","author":"DJ Spiegelhalter","year":"2005","journal-title":"Stat Med"},{"key":"ref34","doi-asserted-by":"crossref","unstructured":"Subramanian SV, Jones K, Duncan C (2003) Multilevel methods for public health research. In: Kawachi I, Berkman L, eds. Neighborhoods and health. New York: Oxford University Press.","DOI":"10.1093\/acprof:oso\/9780195138382.003.0004"},{"key":"ref35","unstructured":"Rasbash J, Charlton C, Browne WJ, Healy M, Cameron B (2009) MLwiN version 2.1. 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