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P-value:
probability of false positives in the study result
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Null Hypothesis:
will be 0 for the difference in groups; while the null will be 1 for OR, HR, RR
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Mean:
the average, this will be the middle of the bell shaped curve
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Median:
the value that divides a series of numbers in half when they are listed in order, this will be used for skewed data that does not conform to the bell shaped curve
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Mode:
the most frequently occurring number in a series
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Standard deviation:
found using the patient population, square root of the variance, (the average sum squared difference from the mean); measurement of participant variability, measurement in the variability of data, how spread out it is
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Interquartile Range:
the interquartile range (IQR), also called the mid-spread or middle fifty, is a measure of statistical dispersion, being equal to the difference between the third and first quartiles. IQR = Q3 − Q1
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Skewed distribution:
non-normal bell curve
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Normal distribution:
normal bell curve, symmetric around the mean with the mean as the peak of the curve going out toward but never reaching 0
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Standard error of the mean:
found with the clinical data, the spread of the sampled means for the data gathered, the measure of the precision/variability of the measurement (SD)
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Confidence Interval:
“the neighborhood of the truth” An estimated range of values around a point estimate. Example: The 95% confidence interval says there is a 95% chance that the actual value found is within the C.I. Precision of study results, range of values that is likely to contain the population parameter
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**Type 1 error is considered worse because….?
it would lead to unnecessary treatment of patients**
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Type I error:
stating there is a difference in groups when there isn’t one , incorrectly rejecting the null hypothesis AKA failure to accept the null, will result in false positives
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Type II error:
stating that there is no difference in groups where there is one, incorrectly accepting the null hypothesis AKA failure to reject the null, will result in false negatives
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Power:
the probability to correctly reject the null hypothesis when you should. Mathematically defined as 1-Type II error rate, depends on: sample size, difference between groups and type 1 error
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Clinical significance:
Is the study result of practical interest? Do other findings matter?
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Chi-square test:
comparison of categorical data for large sample chosen, may be used to compare groups…test whether observed frequencies are different from expected frequencies in a data table
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Fisher's exact test:
categorical for small sample chosen (>5 subjects)
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The t-test:
a statistical test used to detect the difference in two means, two groups, and factor in variability in data commonly used for continuous data, comparison of 2 different groups
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The paired t-test:
a t-test for used when comparing two means that are within the same group Ex. The mean at the beginning of a study and the mean at the end of the study, comparison of dependent groups
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Wilcoxon test:
a test for statistical significance of data that is not on a normal bell curve distribution (non-parametric), used for paired data–used for group comparisons, rank testing
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Mann-Whitney U test:
a test for statistical significance of data that is not on a normal bell curve distribution (non-parametric), used for unpaired data –used for group comparisons, rank testing
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ANOVA (analysis of variance):
A way to analyze groups of means to see if they are equivalent or not; if the ANOVA model fits the data well, and if a statistically significant difference is detected then post-testing is conducted
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Post-hoc testing:
- compare the group pairs, done in the second stage of statistical analysis…three types:
- • Tukey-used if the groups are unequal in size
- • Bonferroni-for both equal and unequal groups
- • Scheffé-very conservative to minimize type 1 error
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Linear regression:
explains the differences in means. A calculation of the line of best fit passing through a set of data, which will allow for prediction about direction and amount variables change
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Multiple linear regression:
explains the differences in means, in addition to explaining the differences in groups it can also be adjusted for age, gender, smoking, cancer etc…
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Logistic regression:
allows for comparison of differences in odds between groups, results are an odds ratio which is a slight over estimate of relative risk
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Multiple logistic regression:
in addition to explaining differences in OR between groups, they also adjust for age, gender, smoking, cancer etc…
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Parametric tests:
t-test, ANOVA, regression
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Non-parametric tests:
for ranking: Wilcoxon, Mann-Whitney; for categorical data: Chi-square, Fisher’s exact
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Temporality:
cause must come before effect
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Repeatability:
the effects must be repeatable
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Biological Gradient:
the does response effect—small dose and small response v. big dose and bigger response
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Reversibility:
de-challenge v. re-challenge aka the interventional effect
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Plausibility:
Does what’s happening makes sense according to biological knowledge at the time
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Numbers Needed to Treat (NNT):
the number of patients who would need to be treated in order to prevent one additional bad outcome
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Numbers Needed to Harm (NNH):
the number of patients who would need to be treated in order for one bad outcome to occur
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Absolute Risk (AR):
- •Mainly used with RCT
- •Probability of disease in the exposed group minus the probability of disease in the unexposed group
- •Represents the excess risk due to exposure to the factor under investigation
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Interpretation of Relative Risks (RR), their confidence intervals, and the type of study that reports them:
- • RR is used to assess the influence of treatment/prevention strategies of potential hazards upon the prevalence of a given condition in a given population
- • RR will typically be used in cohort studies
- • RR is the probability of disease in the exposed group divided by the probability of disease in the unexposed group
- • RR >1 there is a positive association with the risk of disease
- • RR<1 there is a negative risk association with the risk of disease
- • RR=1 there is no association with the risk of disease
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Interpretation of Odds Ratios (OR), their confidence intervals, and the type of study that reports them:
- • OR is used to assess how exposure to something effects disease
- • Used with case control studies
- • OR >1 those who are exposed are more likely to be diseased
- • OR<1 those who are exposed are less likely to be diseased
- • OR=1 there is no association with exposure and disease
- • If 1 is included within the confidence interval then the results are not considered statistically significant
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Interpretation of Hazard Ratios (HR), their confidence intervals, and the type of study that reports them:
- • An estimation of harm given an exposure to a specific hazard
- • RR is the hazard of disease occurrence in the exposed group divided by the hazard of disease in the unexposed group over time (RR/time)
- • Used to assess the potential hazards of upon the nearness of an event
- • Used in studies looking for longer survivals due to a harmful or beneficial exposure
- • HR >1 there is a positive association
- • HR<1 there is a negative risk association
- • HR=1 there is no association
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Cross-Sectional Design:
assess health status and exposure level of subjects at a point in time
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Case Control:
retrospective observational study comparing diseased and non-diseased groups
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Cohort:
prospective observational study comparing diseased and non-diseased groups
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RCT:
prospective experimental design where the sample is broken into 2+ groups who are then put into categories such as treatment, placebo, alternative treatment, double dosage etc.
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What Kind of Study is good for Diagnosis:
Cross-Sectional analytic study
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What Kind of Study is good for Harm:
Cohort Study, population based case control
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What Kind of Study is good for Prognosis:
Cohort study
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What Kind of Study is good for Treatment:
RCT, systematic review
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