Question: 5. A study was done to determine if pre-operation warming of patients reduces the incidence of infection after surgery. Volunteer subjects were randomly assigned to

5. A study was done to determine if pre-operation warming of patients reduces the incidence of infection after surgery. Volunteer subjects were randomly assigned to the following treatments: Standard (no warming), Local Warming (heating pad used to warm the area immediately around the site of the incision for 30 minutes prior to surgery) and Systemic Warming (patient's entire body wrapped in heating blanket for 30 minutes prior to surgery). While 139 patients were assigned to each group, some patients dropped out of the post-operative assessment. Two weeks after surgery, a single trained observer who was unaware of the patients assignment to treatment groups assessed the surgical wounds for presence and severity of infection using the ASEPSIS scale (increasing numbers indicate increasingly severe infection). The table below presents the results. Do the results of this study provide sufficient evidence to conclude that the incidence and severity of post-operative infection differed among the groups that received different treatments? (Based on: Melling, AC, Bagar, A, Scott, EM, and Leaper DJ. 2001. Effects of preoperative warming on the incidence of wound infection after clean surgery: a randomized controlled trial. The Lancet 358: 876-880). ASEPSIS Row Treatment V 0 -10 11 - 20 21 - 30 > 30 Totals Standard 113 7 9 8 137 Exp. (E-O)/E Local Warming 128 4 3 136 Exp (E-0)2/E Systemic Warming 125 3 3 135 Exp. (E-O)/E Column Totals 366 15 15 12 408 C. Compute the overall proportions of individuals in each ASEPSIS class for all treatment groups combined and enter these values in the spaces provided in the Table above. d. Compute the Expected Values and enter them in the cells of the Table above c. Compute the (O-E)2/E values and enter them in the cells of the Table above. 1 . For the ASEPSIS class that has the largest sum of (O-E,/E values across the three treatment groups, perform a Tukey-style unplanned multiple comparisons test to determine which of the treatment groups differ with regards to the proportion of patients in that ASEPSIS class. Note: If you were doing this analysis using a computer, you should use the sub-set X2 analysis to determine which ASEPSIS classes had significant differences among the three treatment groups. Since you are doing this by 12.6 hand, we will simply do the multiple comparisons test for the one ASEPSIS class most likely to have different proportions of individuals among the three groups
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