Week 9, Week 10 and Week 11

WEEK 9: P-VALUE AND CONFIDENCE INTERVALS ANALYSIS

P-Value:
 Probability that the result was due to chance/random error
 α level will determine whether can or can’t reject Ho (typically 0.05)
o p > 0.05: can’t reject Ho = not significantly different
o p < 0.05: reject Ho = significantly different
 Check powerpoint for example

P-Value: Interpret the Results

 2% probability that EP group improved their walking distance by 50m more than usual
care group; due to chance

Limitations:
 50 metres, p=0.02
 Not likely the one and only TRUE effect
 How precise is it?
 Important to the patient?

Confidence Interval (CI):

 Is a range of values within one can be confident the “true” effect lies
 Average is in the middle of the range

Assumptions of CI & P-Value:

 Sample must be:
o Randomly selected
o Independent
o Normally distributed
 Can be assessed statistically

Reporting the Results: Options

 Subtract
 350m – 300m = 50m
 Divide (Ratio)
 "350m" /"300m" " = 1.17"
 Check the powerpoint

Reporting the Results:

 If there was no difference between the 2 groups
 300m – 300m = 0
 "300m" /"300m" " = 1"
 Check the powerpoint

Statistical Significance & CI:

 If subtracting the results…
  Statistically significant:
o CI without zero
o p-value <0.05
o CI contains 0
o P-value >0.05

Statistical Significance & CI:

 If using ratios (dividing results)
 Statistically significant:
o CI without 1
o p-value <0.05
o CI contains 1
o p-value >0.05

P-value and CI Example: Effect of education on 6MWD

 Difference = 15 m, p-value = 0.57
o The probability that the results emerged by chance
o Interpretation:

P-value and CI Example: Effect of education on 6MWD

 Confidence interval = -10 to 40 m / 0.97 to 1.05
o Range of values that is likely to include the TRUE mean difference in 6MWD
following education
o Interpretation:

Clinical Importance:
 Minimal clinical important difference (MCID)
o The smallest difference in score corresponding to the smallest difference
perceived by the average patient that would mandate, in the absence of
troublesome side effects and excessive cost, a change in patient management
(Jaeschke et al 1989)

How do I know the Value is Precise?

 1.Look at your point estimate.
 2.Look at the upper and lower bound of the CI.
 3.Decide if that interval is narrow enough.

How do I know the Value is Precise?

 In our EP example: 50m (82 to 18)
 1. The point estimate (average distance) is 50m
 2. The improved distance can be as low as 18m or as high as 82m (95% of the time)
 3. Do you believe this interval to be narrow?

Introduction:
 Now you have your data:
o Enter data correctly
o Choose the appropriate statistics

2
 o Interpret the statistical results
o Incorporate results into a study report
 Use of computer software helps
o Statistics: Minitab, SPSS, SAS, R (https://www.r-project.org/)
o Graphs: SigmaPlot, Excel
o References: Endnote, RefWorks

Study Example: Chronic Neck Pain

 Does isometric exercises or a sleeping neck pillow support help chronic neck pain?
 Main outcome measure: Northwick Park Neck Pain Questionnaire (NPQ)

What Kind of Variable is:

 Gender
 Age
 NPQ

Graphs:
 What information can you get:
o Distribution
o Comparisons
o Unusual stuff
 Some Graphs to look at:
o Bar Graph – let’s do this “live”
o Histogram, Stem-and-Leaf Plot
 Look at the powerpoint for further examples

Types of Graphs:
 Bar Graph
 Stem-and-Leaf Plot
 Histogram
 Skewness
 Kurtosis
o Leptokurtic- high slump
o Platykurtic- low slump
 Boxplot
 Scatterplot
 Slope and intercept
 Check powerpoint for the examples

Describe Your Data Numerically

 Descriptive statistics
o Central tendency
o Measure of variation / dispersion
 Comparative statistics

3
Correlation:


Regression:


Test Your Hypothesis:

 Hypothesis testing: draw an inference about the population from which the sample of
data was collected
o 1.Compute test stat
o 2.Compute a p-value from test stat
o 3.Compare p-value to criterion standard α
o 4.Interpret

Write Your Report:

 Common format (IMRaD)
o Introduction: PICOST
o Methods: W5H, reliability, validity, and responsiveness
o Results: CONSORT flow chart and check sheet, tables, graphs and descriptive
stats
and
o Discussion: interpret findings, and how they relate to the literature, study
strengths and weaknesses

Chapter Summary:
 Types of data
o Nominal, ordinal, interval, ratio
o Discrete versus continuous
 Graph your data
o Pareto chart, stem-and-leaf display, boxplot, scatterplot
 Describe data numerically
o One group or two groups of data, three- and five-number reports, correlation and
regression
 Create confidence intervals for your data
 Test your hypothesis