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Dr. Lindenauer, Steingrub, and Rothberg conceived the study. Dr. Lindenauer acquired the data. Drs. Lindenauer, Rothberg, Steingrub, Nathanson, and Pekow analyzed and interpreted the data. Dr. Lindenauer drafted the manuscript. Drs. Rothberg, Nathanson, Pekow, and Steingrub critically reviewed the manuscript for important intellectual content. Drs. Nathanson and Pekow performed the statistical analyses. Dr. Pekow accepts full responsibility for its accuracy.; Drs. Lindenauer, Rothberg, Nathanson, and Pekow have not disclosed any potential conflicts of interest. Dr. Rothberg is the recipient of a clinical scientist development award from the Doris Duke Charitable Foundation. Dr. Steingrub participates on the speaker's bureau of Eli Lilly & Company. Dr. Nathanson, through his company OptiStatim LLC, was paid by the investigators with funding from the Division of Critical Care Medicine at Baystate Medical Center to assist in conducting the statistical analyses in this study.; Financial support was received from Division of Critical Care Medicine, Baystate Medical Center, Springfield, MA. 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