Question: When evaluating research reports in health care, a popular tool is the Assessment of Multiple Systematic Reviews (AMSTAR). AMSTAR, which incorporates 11 items (questions), has

When evaluating research reports in health care, a popular tool is the Assessment of Multiple Systematic Reviews (AMSTAR). AMSTAR, which incorporates 11 items (questions), has been widely accepted by professional health associations. A group of dental researchers have revised the assessment tool and named it R-AMSTAR (The Open Dentistry Journal, Vol. 4, 2010). The revised assessment tool was validated on five systematic reviews (named R1, R2, R3, R4, and R5) on rheumatoid arthritis. For each review, scores on the 11 R-AMSTAR items (all measured on a 4-point scale) were obtained. The data, saved in the RAMSTAR file, are shown in the accompanying table.

a. One goal of the study was to compare the mean item scores of the five reviews. Set up the null and alternative hypotheses for this test.
b. Examine the data in the table and explain why a randomized block ANOVA is appropriate to apply.
c. The SAS output for a randomized block ANOVA of the data (with Review as treatments and Item as blocks) appears below. Interpret the p -values of the tests shown.
d. The SAS printout also reports the results of a Tukey multiple-comparison analysis of the five Review means. Which pairs of means are significantly different? Do these results agree with your conclusion in part c?
e. The experiment wise error rate used in the analysis in part d is .05. Interpret this value.

Review tem1 Item 2 Item 3 item 4 Item 5 Item 6 tem 7 Item 8 Item 9 Item 10 Item 11 R1 R2 R3 R4 RS 4.0 2.0 4.0 4.0 4.0 3.0 3.5 3.5 3,5 3.5 3.5 3.5 4.0 3.5 3.5 4.0 3.5 3.5 4.0 2.5 4.0 4.0 3.5 2.5 3.5 1.5 1.5 1.0 1.0 1.0 1.0 1.0 4.0 2.0 3.5 3.5 3,0 4.0 2.0 The ANOVA Procedure Dependent Variable: SCORE Sum of 46.01818182 20.68181818 66.70000000 Mean Square F Value Pr F Model 3.28701299 6.36 .0001 40 0.51704545 Corrected Total 54 R-Square Coeff Var Root 1MSE SCORE Mean 0.689928 24.79513 0.719059 2.900000 Anova SS Mean Square F Value P>F REVIEH ITEN 2.51818182 43.50000000 0.62954545 4.35000000 1.22 8.41 0.3186 .0001 Means uith the sane letter are not signif icantly different Tukey Group ing 3.1818 3.0455 2.8636 2.8636 2.5455 N REVIEH 11 RS 1 R2 11 R3 11 R4 11 R1

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