Posted: February 12th, 2015
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Homework on 2 sample tests.
You continue work on the treatment of severe xerostomia (low salivary flow rates) in head/neck cancer patients treated receiving radiation. In addition to the data you already collected on the pre-post efficacy of the new lozenge, Drool, new data are now available showing salivary flow and subjective ratings of dryness before and after treatment on the standard of care, a product called WetMouth. As before, abnormal flow is defined as < 1 mL/min, and subjective reports of xerostomia were obtained from a 10-point VAS anchored by ‘worst dry mouth imaginable (0)’ and ‘no problem with dry mouth (9)’. Using the ‘dry mouth 2-sample’ data file to answer the following:
Biostatistic homework 5
1a. xerostomia rate =72%
H0 : Xerostomia rate in this sample is equal to national rate (0.75) in head and neck cancer patients
HA : Xerostomia rate in this sample is less than national rate (0.75) in head and neck cancer patients
α=0.05
Assumptions: data is normally distributed; observations are independent
Test statistic : Student’s t-test
From the output, t=-32733, p=0.7463>0.5, we do not reject the null hypothesis . We do not have enough evidence from these data to reject the null and accept the alternative hypothesis that the xerostomia rate in this sample is less than that of the national rate (0.75) at 5% level of significance. The observed differences between the sample xerostomia rate (0.72) and the national xerostomia rate (0.75) is due to chance.
1b. xerostomia rate =72%
Assumptions: data is normally distributed; observations are independent
H0 : Xerostomia rate in this sample is equal to the national rate (0.55) in head and neck cancer patients
HA : Xerostomia rate in this sample is less than national rate (0.55) in head and neck cancer patients
α=0.01
Test statistic: Student’s t-test
From the output, t=1.8549, p=0.0759 <0.10, we reject the null hypothesis. We have enough evidence from these data to reject the null and accept the alternative hypothesis that the xerostomia rate in this sample is less than that of the national rate (0.55) at 1% level of significance.
2a. Median baseline xerostemia =2
H0 : Median Xerostomia rating in this sample is equal to the national rate (3) in head and neck cancer patients
HA : Median Xerostomia rating in this sample is less than national rate (3) in head and neck cancer patients
α=0.05
Assumptions: data is normally distributed; observations are independent
Test statistic: Student’s t-test
From the output, t=-3.61158, p=0.0014 <0.05, we reject the null hypothesis. We have enough evidence from these data to reject the null and accept the alternative hypothesis that the median xerostomia rating in this sample is less than the population rating at 5% level of significance.
2b. M(SD) rating is 2±1.38 at baseline. Comparing this to the national median (3) It supports the median test.
Descriptive statistics for follow up rating
The post treatment (follow up rating) rating have a higher mean (mean=2.6) than the baseline ratings (mean=2). The baseline ratings have a higher spread ( std=1.38, variance=1.92) than the follow-up(std=1.15, variance=1.33), which shows a larger spread of data for baseline ratings.
Both the baseline and post treatment rating are somewhat slightly positively skewed with baseline rating slightly higher (skewness = 0.614 and 0.529 respectively). Both the baseline and the post treatment are platykurtic (kurtosis=0.053 and -0.240 respectively. There are no outliers in both distributions. Both distributions are somewhat normally distributed.
3a.
H0 : Drool does not increase subjective ratings of xerostomia in head and neck cancer patients
HA : Drool increases subjective ratings of xerostomia in head and neck cancer patients
α=0.05
Assumptions: data is normally distributed; observations are independent , one variable is a continuous variable (ratings) and another is a categorical variable (baseline or post-treatment)
Test statistic: Student’s t-test: 2-sample ttest
From the output, pooled t=2.94 p=0.0074< 0.05, we reject the null hypothesis. We have enough evidence from these data to reject the null and accept the alternative hypothesis that Drool significantly increases subjective ratings of xerostomia at 5% level of significance.
H0 : Drool does not increase subjective ratings of xerostomia in head and neck cancer patients
HA : Drool increases subjective ratings of xerostomia in head and neck cancer patients
α=0.05
Assumptions: data is normally distributed; observations are independent
Test statistic: Student’s t-test:
From the output, t=11.26 p<0.0001< 0.05, we reject the null hypothesis. We have enough evidence from these data to reject the null and accept the alternative hypothesis that Drool significantly increases subjective ratings of xerostomia at 5% level of significance.
Assuming interval measures will keep us from getting an exaggerated effect of Drool in increasing subject ratings of xerostomia. Therefore comparing with the baseline helps us establish the true effect of Drool.
Descriptive statistics of follow up flow
Follow up saliva flow is higher than baseline flow (mean=1.2 ml/min compared to 0.82 ml/min). Baseline flow has a higher standard deviation (std=0.310) compared to follow up flow (std=0.204) which shows a higher spread of data for baseline flow.
The baseline flow is positively skewed (skewness=2.49) and leptokurtic (kurtosis=4.56) while the follow up flow is somewhat slightly positively skewed (skeweness=0.529) and is platykurtic (kurtosis=-0.24). There were no obvious outliers but the baseline flow data seems not to be normally distributed.
4a. Assuming data is normally distributed;
H0 : Drool does not increase flow of saliva in head and neck cancer patients
HA : Drool increases flow of saliva in head and neck cancer patients
α=0.05
Assumptions: data is normally distributed; observations are independent
From the output, t=29.39 p<0.0001< 0.05, we reject the null hypothesis. We have enough evidence from these data to reject the null and accept the alternative hypothesis that Drool significantly increases flow of saliva at 5% level of significance.
4b. Assuming the data is not normally distributed :
H0 : Drool does not increase flow of saliva in head and neck cancer patients
HA : Drool increases flow of saliva in head and neck cancer patients
α=0.05
From the output, t=12.96 p<0.0001< 0.05, we reject the null hypothesis. We have enough evidence from these data to reject the null and accept the alternative hypothesis that Drool significantly increases flow of saliva at 5% level of significance.
If the data is not normally distributed, the efffect of Drool on saliva flow is significanlty reduced as shown by the two t-values.
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