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biostatistics
Biostatistics A Foundation For Analysis In The Health Sciences 10th Edition Wayne W. Daniel, Chad L. Cross - Solutions
Amateur and professional singers were the subjects of a study by Grape et al. (A-2). The researchers investigated the possible beneficial effects of singing on well-being during a single singing lesson.One of the variables of interest was the change in cortisol as a result of the signing lesson.
In a study by Zuckerman and Heneghan (A-3), hemodynamic stresses were measured on subjects undergoing laparoscopic cholecystectomy. An outcome variable of interest was the ventricular end diastolic volume (LVEDV) measured in milliliters. A portion of the data appear in the following table.Baseline
Fifteen patient records from each of two hospitals were reviewed and assigned a score designed to measure level of care. The scores were as follows:Hospital A: 99, 85, 73, 98, 83, 88, 99, 80, 74, 91, 80, 94, 94, 98, 80 Hospital B: 78, 74, 69, 79, 57, 78, 79, 68, 59, 91, 89, 55, 60, 55, 79 Would you
The following serum albumin values were obtained from 17 normal and 13 hospitalized subjects:Serum Albumin (g/100 ml) Serum Albumin (g/100 ml)Normal Subjects Hospitalized Subjects Normal Subjects Hospitalized Subjects 2.4 3.0 1.5 3.1 3.4 4.0 3.8 1.5 3.5 3.2 2.0 1.3 4.5 3.5 3.5 3.1 3.5 3.4 1.5 5.0
Cranor and Christensen (A-4) studied diabetics insured by two employers. Group 1 subjects were employed by the City of Asheville, North Carolina, and group 2 subjects were employed by Mission–St. Joseph’s Health System. At the start of the study, the researchers performed the Mann–Whitney
One of the purposes of a study by Liu et al. (A-5) was to determine the effects of MRZ 2/579(a receptor antagonist shown to provide neuroprotective activity in vivo and in vitro) on neurological deficit in Sprague–Dawley rats. In the study, 10 rats were to receive MRZ 2/579 and nine rats were to
The purpose of a study by researchers at the Cleveland (Ohio) Clinic (A-6) was to determine if the use of Flomax® reduced the urinary side effects commonly experienced by patients following brachytherapy (permanent radioactive seed implant) treatment for prostate cancer. The following table shows
The weights at autopsy of the brains of 25 adults suffering from a certain disease were as follows:Weight of Brain (grams)859 1073 1041 1166 1117 962 1051 1064 1141 1202 973 1001 1016 1168 1255 904 1012 1002 1146 1233 920 1039 1086 1140 1348 Can one conclude from these data that the sampled
IQs of a sample of 30 adolescents arrested for drug abuse in a certain metropolitan jurisdiction were as follows:IQ 95 100 91 106 109 110 98 104 97 100 107 119 92 106 103 106 105 112 101 91 105 102 101 110 101 95 102 104 107 118 Do these data provide sufficient evidence that the sampled population
For a sample of apparently normal subjects who served as controls in an experiment, the following systolic blood pressure readings were recorded at the beginning of the experiment:162 177 151 167 130 154 179 146 147 157 141 157 153 157 134 143 141 137 151 161 Can one conclude on the basis of these
In a study of healthy subjects grouped by age (Younger: 19–50 years, Seniors: 65–75 years, and Longeval: 85–102 years), Herrmann et al. (A-8) measured their vitamin B-12 levels (ng/L). All elderly subjects were living at home and able to carry out normal day-to-day activities. The following
The following are outpatient charges ð Þ $100 made to patients for a certain surgical procedure by samples of hospitals located in three different areas of the country:Area I II III$80.75 $58.63 $84.21 78.15 72.70 101.76 85.40 64.20 107.74 71.94 62.50 115.30 82.05 63.24 126.15 Can we conclude at
A study of young children by Flexer et al. (A-9) published in the Hearing Journal examines the effectiveness of an FM sound field when teaching phonics to children. In the study, children in a classroom with no phonological or phonemic awareness training (control) were compared to a class with
Refer to Example 13.8.1. Another variable of interest to Lacroix et al. (A-7) was the number of alveolar cells in three groups of subjects exposed to air, benzaldehyde, or acetaldehyde. The following table gives the information for six guinea pigs in each of the three treatment groups.Number of
The following table shows the pesticide residue levels (ppb) in blood samples from four populations of human subjects. Use the Kruskal–Wallis test to test at the .05 level of significance the null hypothesis that there is no difference among the populations with respect to average level of
Hepatic g-glutamyl transpeptidase (GGTP) activity was measured in 22 patients undergoing percutaneous liver biopsy. The results were as follows:Subject Diagnosis Hepatic GGTP Level 1 Normal liver 27.7 2 Primary biliary cirrhosis 45.9 3 Alcoholic liver disease 85.3 4 Primary biliary cirrhosis 39.0 5
The following table shows the scores made by nine randomly selected student nurses on final examinations in three subject areas:Subject Area Student Number Fundamentals Physiology Anatomy 1 98 95 77 2 95 71 79 3 76 80 91 4 95 81 84 5 83 77 80 6 99 70 93 7 82 80 87 8 75 72 81 9 88 81 83 Test the
Fifteen randomly selected physical therapy students were given the following instructions: “Assume that you will marry a person with one of the following handicaps (the handicaps were listed and designated by the letters A to J). Rank these handicaps from 1 to 10 according to your first, second,
Ten subjects with exercise-induced asthma participated in an experiment to compare the protective effect of a drug administered in four dose levels. Saline was used as a control. The variable of interest was change in FEV1 after administration of the drug or saline. The results were as follows:Dose
The following table shows 15 randomly selected geographic areas ranked by population density and age-adjusted death rate. Can we conclude at the .05 level of significance that population density and age-adjusted death rate are not mutually independent?Rank by Rank by Area Population Density
The following table shows 10 communities ranked by decayed, missing, or filled (DMF) teeth per 100 children and fluoride concentration in ppm in the public water supply:Rank by Rank by Community DMF Teeth per 100 Children (X)Fluoride Concentration(Y) Community DMF Teeth per 100 Children (X)Fluoride
The purpose of a study by Nozawa et al. (A-10) was to evaluate the outcome of surgical repair of pars interarticularis defect by segmental wire fixation in young adults with lumbar spondylolysis. The authors cite literature indicating that segmental wire fixation has been successful in the
Refer to Exercise 13.10.3. Nozawa et al. (A-10) also calculated the Japanese Orthopaedic Association score for measuring back pain (JOA). The results for the 20 subjects along with the duration of follow-up are shown in the following table. The higher the number, the lesser the degree of
Butz et al. (A-11) studied the use of noninvasive positive-pressure ventilation by patients with amyotrophic lateral sclerosis. They evaluated the benefit of the procedure on patients’ symptoms, quality of life, and survival. Two variables of interest are PaCO2, partial pressure of arterial
Seventeen patients with a history of congestive heart failure participated in a study to assess the effects of exercise on various bodily functions. During a period of exercise the following data were collected on the percent change in plasma norepinephrine (Y) and the percent change in oxygen
Define nonparametric statistics.
What is meant by the term distribution-free statistical tests?
What are some of the advantages of using nonparametric statistical tests?
What are some of the disadvantages of the nonparametric tests?
Describe a situation in your particular area of interest where each of the following tests could be used.Use real or realistic data and test an appropriate hypothesis using each test.(a) The sign test(b) The median test(c) The Wilcoxon test(d) The Mann–Whitney test(e) The Kolmogorov–Smirnov
The following are the ranks of the ages (X) of 20 surgical patients and the dose (Y) of an analgesic agent required to block one spinal segment.Rank of Age in Years (X)Rank of Dose Requirement(Y)Rank of Age in Years (X)Rank of Dose Requirement(Y)1 1 11 13 2 7 12 5 3 2 13 11 4 4 14 16 5 6 15 20 6 8
Otani and Kishi (A-12) studied seven subjects with diabetic macular edema. They measured the foveal thickness ð Þ mm in seven eyes pre- and post-unilateral vitrectomy surgery. The results are shown in the following table:Subject Pre-op Foveal Thickness ðmmÞ Post-op Foveal Thickness ðmmÞ1 690
The subjects of a study by J. Jose and S. R. Ell (A-13) were 303 healthy volunteers who selfassessed their own nasal flow status by indicating whether their nasal airway was (1) totally clear,(2) not very clear, (3) very blocked, or (4) totally blocked. Following the self-assessment, an InCheck
Ten subjects with bronchial asthma participated in an experiment to evaluate the relative effectiveness of three drugs. The following table shows the change in FEV1 (forced expired volume in 1 second) values (expressed as liters) 2 hours after drug administration:Drug Drug Subject A B C Subject A B
One facet of the nursing curriculum at Wright State University requires that students use mathematics to perform appropriate dosage calculations. In a study by Wendy Gantt (A-14), undergraduate nursing students were given a standardized mathematics test to determine their mathematical aptitude
The following are the PaCO2 (mm Hg) values in 16 patients with bronchopulmonary disease:39, 40, 45, 48, 49, 56, 60, 75, 42, 48, 32, 37, 32, 33, 33, 36 Use the Kolmogorov–Smirnov test to test the null hypothesis that PaCO2 values in the sampled population are normally distributed with m ¼ 44 and
The following table shows the caloric intake (cal/day/kg) and oxygen consumption VO2 (ml/min/kg)in 10 infants:Calorie Intake (X) VO2(Y)Calorie Intake (X) VO2(Y)50 7.0 100 10.8 70 8.0 150 12.0 90 10.5 110 10.0 120 11.0 75 9.5 40 9.0 160 11.9 Test the null hypothesis that the two variables are
Mary White (A-15) surveyed physicians to measure their opinions regarding the importance of ethics in medical practice. The measurement tool utilized a scale from 1 to 5 in which a higher value indicated higher opinion of the importance of ethics. The ages and scores of the study subjects are shown
Dominic Sprott (A-16) conducted an experiment with rabbits in which the outcome variable was the fatty infiltration in the shoulder mass (PFI, measured as a percent). At baseline, 15 rabbits had a randomly chosen shoulder muscle detached. The shoulder was then reattached. Six weeks later, five
The purpose of a study by Damm et al. (A-17) was to investigate insulin sensitivity and insulin secretion in women with previous gestational diabetes (GDM). Subjects were 12 normal-weight glucose-tolerant women (mean age, 36.6 years; standard deviation, 4.16) with previous gestational diabetes and
Gutin et al. (A-18) compared three measures of body composition, including dual-energy x-ray absorptiometry (DXA). Subjects were apparently healthy children (21 boys and 22 girls) between the ages of 9 and 11 years. Among the data collected were the following measurements of bodycomposition
The concern of a study by Crim et al. (A-19) was the potential role of flow cytometric analysis of bronchoalveolar lavage fluid (BALF) in diagnosing acute lung rejection. The investigators note that previous studies suggested an association of acute lung rejection with increases in CD8þ
Ichinose et al. (A-20) studied the involvement of endogenous tachykinins in exercise-induced airway narrowing in patients with asthma by means of a selective neurokinin 1-receptor antagonist, FK-888. Nine subjects (eight male, one female) ages 18 to 43 years with at least a 40 percent fall in the
Transforming growth factor a (TGFa), according to Tomiya and Fujiwara (A-21), is alleged to play a role in malignant progression as well as normal cell growth in an autocrine manner, and its serum levels have been reported to increase during this progression. The present investigators have
The objective of a study by Sakhaee et al. (A-22) was to ascertain body content of aluminum (A1)noninvasively using the increment in serum and urinary Al following the intravenous administration of deferoxamine (DFO) in patients with kidney stones and osteoporotic women undergoing longterm
The purpose of a study by Dubuis et al. (A-23) was to determine whether neuropsychological deficit of children with the severe form of congenital hypothyroidism can be avoided by earlier onset of therapy and higher doses of levothyroxine. Subjects consisted of 10 infants (ages 3 to 24 days) with
Kuna et al. (A-24) conducted a study concerned with chemokines in seasonal allergic rhinitis.Subjects included 18 atopic individuals with seasonal allergic rhinitis caused by ragweed pollen.Among the data collected on these subjects were the following eosinophil cationic protein (ECP) and histamine
The purpose of a study by Kim et al. (A-25) was to investigate the serial changes in Lp(a) lipoprotein levels with the loss of female sex hormones by surgical menopause and with estrogen replacement therapy in the same women. Subjects were 44 premenopausal women who underwent a transabdominal
Velthuis et al. (A-26) conducted a study to evaluate whether the combination of passively immobilized heparin-coating and standard heparization can reduce complement activation in patients undergoing cardiac surgical intervention. The investigators note that heparin-coated extracorporeal circuits
Heijdra et al. (A-27) state that many patients with severe chronic obstructive pulmonary disease(COPD) have low arterial oxygen saturation during the night. These investigators conducted a study to determine whether there is a causal relationship between respiratory muscle dysfunction and nocturnal
The three objectives of a study by Wolkin et al. (A-28) were to determine (a) the effects of chronic haloperidol treatment on cerebral metabolism in schizophrenic patients, (b) the relation between negative symptoms and haloperidol-induced regional changes in cerebral glucose utilization, and
The purpose of a study by Maltais et al. (A-29) was to compare and correlate the increase in arterial lactic acid (La) during exercise and the oxidative capacity of the skeletal muscle in patients with chronic obstructive pulmonary disease (COPD) and control subjects (C). There were nine subjects
Control subjects had a mean age of 54 years with a standard deviation of
Among the data collected were the following values for the activity of phosphofructokinase (PFK), hexokinase (HK), and lactate dehydrogenase (LDH) for the two groups:PFK HK LDH C COPD C COPD C COPD 106.8 49.3 2.0 2.3 241.5 124.3 19.6 107.1 3.2 1.4 216.8 269.6 27.3 62.9 2.5 1.0 105.6 247.8 51.6 53.2
Torre et al. (A-30) conducted a study to determine serum levels of nitrite in pediatric patients with human immunodeficiency virus type 1 (HIV-1) infection. Subjects included 10 healthy control children (six boys and four girls) with a mean age of 9.7 years and a standard deviation of 3.3. The
California State Assembly Bill 2071 (AB 2071) mandated that patients at methadone clinics be required to undergo a minimum of 50 minutes of counseling per month. Evan Kletter (A-32)collected data on 168 subjects who were continuously active in treatment through the Bay Area Addiction Research and
understand time-to-event data and how censored observations can be handled statistically.
be able to develop and use survival curves to make conclusions.
be able to statistically compare survival curves.
understand how to develop models designed to handle time-to-event data.
Fifty-three patients with medullary thyroid cancer (MTC) were the subjects of a study by Dottorini et al. (A-2), who evaluated the impact of different clinical and pathological factors and the type of treatment on their survival. Thirty-two of the patients were females, and the mean age of all
Banerji et al. (A-3) followed non–insulin-dependent diabetes mellitus (NIDDM) patients from onset of their original hyperglycemia and the inception of their near–normoglycemic remission following treatment. Subjects were black men and women with a mean age of 45.4 years and a standard deviation
If available in your library, read the article, “Impact of Obesity on Allogeneic Stem Cell Transplant Patients: A Matched Case-Controlled Study,” by Donald R. Fleming et al. [American Journal of Medicine, 102 (1997), 265–268] and answer the following questions:(a) How was survival time
If available in your library, read the article, “Improved Survival in Patients with Locally Advanced Prostate Cancer Treated with Radiotherapy and Goserelin,” by Michel Bolla et al. [New England Journal of Medicine, 337 (1997), 295–300], and answer the following questions:(a) How was survival
Fifty subjects who completed a weight-reduction program at a fitness center were divided into two equal groups. Subjects in group 1 were immediately assigned to a support group that met weekly.Subjects in group 2 did not participate in support group activities. All subjects were followed for a
In a study examining time-to-onset of cancer after exposure to UV light in rats, age (months) was used as a covariate in a Cox regression model. In the model, the parameter estimate for weight was .19 and had a p-value of .021. Provide an interpretation of this parameter estimate in terms of the
In the study described in Exercise 14.5.1, the researchers were also interested to know if there was a difference between gender in the time it took to develop cancer. For gender, the parameter estimate was .77 and had a p-value of 0.014. Provide an interpretation of this parameter estimate in
The intent of a study by Weaver et al. (A-4) was to assess whether occult lymph node metastases are important indicators of disease recurrence or survival in breast cancer patients. The data below provide some of the pertinent results of a Cox regression model for these data.(a) Calculate the
Describe in words the concept of data censoring.
Define the following:(a) Hazard ratio(b) Hazard function(c) Probability distribution function(d) Survival function(e) Kaplan–Meier estimate
Explain the concepts underlying the Cox regression model.
What is the difference between right censoring and left censoring? Provide an example of each.
Discuss why it is often preferable to use a nonparametric test for comparisons of survival curves.
Why is Cox regression called a “proportional hazards” model?
If the probability distribution function at time 5 is equal to .25 and the survival function at time 5 is equal to .15, what is the hazard function at time 5?
If we find that a measurement in the time interval between time 2 and 10 results in a probability distribution function estimate of 0.03, what is the estimated change in the cumulative distribution function?
Using the data from question 8, what is the estimated change in the survival function?
Explain why the cumulative distribution function and the survival function are mirror images of one another.
The objective of a study by Lee et al. (A-5) was to improve understanding of the biologic behavior of gastric epithelioid stromal tumors. They studied the clinical features, histologic findings, and DNA ploidy of a series of the tumors to identify factors that might distinguish between benign and
Girard et al. (A-6) conducted a study to identify prognostic factors of improved survival after resection of isolated pulmonary metastases (PM) from colorectal cancer. Among the data collected were the following regarding number of resected PM, survival, and outcome for 77 patients who underwent a
In a study by Alicikus et al. (A-7), long-term control of prostate cancer receiving radiotherapy was examined in patients after 10 years. The authors using Cox regression analysis to analyze these data, which resulted in the data summarized in the table below. For these data:(a) Calculate the
understand how to correctly state a null and alternative hypothesis and carry out a structured hypothesis test.
understand the concepts of type I error, type II error, and the power of a test.
be able to calculate and interpret z, t, F, and chi-square test statistics for making statistical inferences.
understand how to calculate and interpret p values.c
Escobar et al. (A-3) performed a study to validate a translated version of the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire used with Spanish-speaking patients with hip or knee osteoarthritis. For the 76 women classified with severe hip pain, the 7.2.1
A study by Thienprasiddhi et al. (A-4) examined a sample of 16 subjects with open-angle glaucoma and unilateral hemifield defects. The ages (years) of the subjects were:62 62 68 48 51 60 51 57 57 41 62 50 53 34 62 61 Source: Phamornsak Thienprasiddhi, Vivienne C. Greenstein, Candice S. Chen,
The purpose of a study by Luglie et al. (A-5) was to investigate the oral status of a group of patients diagnosed with thalassemia major (TM). One of the outcome measures was the decayed, missing, and filled teeth index (DMFT). In a sample of 18 patients the mean DMFT index value was 10.3 with a
A study was made of a sample of 25 records of patients seen at a chronic disease hospital on an outpatient basis. The mean number of outpatient visits per patient was 4.8, and the sample standard deviation was
Can it be concluded from these data that the population mean is greater than four visits per patient? Let the probability of committing a type I error be .05. What assumptions are necessary?
In a sample of 49 adolescents who served as the subjects in an immunologic study, one variable of interest was the diameter of skin test reaction to an antigen. The sample mean and standard deviation were 21 and 11 mm erythema, respectively. Can it be concluded from these data that the population
Nine laboratory animals were infected with a certain bacterium and then immunosuppressed. The mean number of organisms later recovered from tissue specimens was 6.5 (coded data) with a standard deviation of .6. Can one conclude from these data that the population mean is greater than 6?Let a ¼
A sample of 25 freshman nursing students made a mean score of 77 on a test designed to measure attitude toward the dying patient. The sample standard deviation was 10.Do these data provide sufficient evidence to indicate, at the .05 level of significance, that the population mean is less than 80?
We wish to know if we can conclude that the mean daily caloric intake in the adult rural population of a developing country is less than 2000. A sample of 500 had a mean of 1985 and a standard deviation of 210.Let a ¼ :05.
A survey of 100 similar-sized hospitals revealed a mean daily census in the pediatrics service of 27 with a standard deviation of 6.5. Do these data provide sufficient evidence to indicate that the population mean is greater than 25? Let a ¼ :05.
Following a week-long hospital supervisory training program, 16 assistant hospital administrators made a mean score of 74 on a test administered as part of the evaluation of the training program. The sample standard deviation was 12.Can it be concluded from these data that the population mean is
A random sample of 16 emergency reports was selected from the files of an ambulance service.The mean time (computed from the sample data) required for ambulances to reach their destinations was 13 minutes. Assume that the population of times is normally distributed with a variance of 9.Can we
The following data are the oxygen uptakes (milliliters) during incubation of a random sample of 15 cell suspensions:14.0, 14.1, 14.5, 13.2, 11.2, 14.0, 14.1, 12.2, 11.1, 13.7, 13.2, 16.0, 12.8, 14.4, 12.9 Do these data provide sufficient evidence at the .05 level of significance that the population
Can we conclude that the mean maximum voluntary ventilation value for apparently healthy college seniors is not 110 liters per minute? A sample of 20 yielded the following values:132, 33, 91, 108, 67, 169, 54, 203, 190, 133, 96, 30, 187, 21, 63, 166, 84, 110, 157, 138 Let a ¼ :01. What assumptions
The following are the systolic blood pressures (mm Hg) of 12 patients undergoing drug therapy for hypertension:183, 152, 178, 157, 194, 163, 144, 114, 178, 152, 118, 158 Can we conclude on the basis of these data that the population mean is less than 165? Let a ¼ :05.What assumptions are necessary?
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