Joseph Park Biostatistics: Confidence Intervals, Significance, and Type I Errors 4/5/2011 95% Confidence Interval 5% significance 99%

Confidence Interval 1% significance

Confidence Interval An estimation of the true population mean derived from a sample population. We are 95% confident that the true population mean lies between _________ and _________.

Significance level The level of how likely an event has occurred due to chance (tails of the graph). Calculated by: = 1- p where is significance level and p is the percent confidence in decimal. E.g. 95% p = ______ = 1 p = 1 - ______ = _____________. It is 5% likely that the change in relative risk in the sample population was due to chance.

Testing the hypothesis: Null Hypothesis H0: RR = 1.0 Alternative Hypothesis H1: RR 1.0 If confidence interval includes the null hypothesis, cannot reject the null hypothesis. o Therefore, the results of the study are __________________. If confidence interval does not include the null hypothesis, reject the null hypothesis. o Therefore, the results of the study are __________________.

Lower significance levels indicate higher degrees of accuracy in hypothesis testing. Generally, 5% or 1% significance is the accepted level. Higher values will increase the chance of Type I and II Errors. Type I Error An error made when the null hypothesis is not rejected in favor of the alternative which is correct, i.e. a false positive. E.g. At 99%, if we concluded that heavy drinkers do not have a higher relative risk for cirrhosis when they actually do have an increased relative risk, then we made a Type I Error.

Type II Error An error made when the null hypothesis is rejected in favor of the alternative when the alternative is actually false. E.g. At 95%, if we concluded that heavy drinkers do have a higher relative risk for cirrhosis when they actually do not, then we made a Type II Error.

Practice Questions: 1. The GWU Cardiology Department performed a study of MI patients and how increased LDL levels might affect that relative risk of MI. The data concluded that there is an increase in RR for MI for patients with LDL > 100. The high LDL patients had a RR of 1.12 (95% CI: 0.98 1.26). Are the results of the study statistically significant? Why?

2. A later follow-up was performed on the study from question 1, and it concluded that the RR for MI for patients with LDL > 100 is actually 1.18 (95% CI: 1.08 1.28). It stated that there was a significant increase of MI for patients with LDL levels over 100. Assuming that the newer study is now a true representation of the population, what type of error occurred in question 1?

3. A retrospective study of patient BMIs from hospitals all over the US shows that the percent of obese patients increased 18% (1% significance: 6% - 30%) from the years 2000 2010. Can this study conclude an increase in amount of obese patients in the last decade? Why?

4. A student published a paper claiming breaking results that shows a significant correlation between intravenous caffeine and decreased migraine symptoms in post menstrual female patients. The students clinical trial study showed a 28% decrease in migraine symptoms following IV caffeine a confidence interval of (95% CI: 1%-55%). Are his claims accurate?

5. What if it the results from question 3 were presented as a 90% CI: 1% - 55%? Why or why not?

6. In a recent asthma study, patients treated with a new bronchodilator showed a 29% increase in FEV1 and a 33% increase in FEV1/FVC. The data resulted in a rejection of the null hypothesis (H0 = 0% increase in lung FEV function). According to the calculations below, does the new type of bronchodilator effectively treat asthma? = 0.10 or 10% FEV1 CI 90%: 29% 18 FEV1/FVC CI 90%: 33% 16 a. b. c. d. Yes, the results are significant because there was an average increase in FEV1 and FEV1/FVC. Yes, because the null hypothesis was rejected. No, the bronchodilator actually decreases lung function. Not enough information, the test should be done at 5% or lower significance.