Biostatistics Flashcards

1
Q

What is continuous data?

A

numerical data in which the magnitude from one value to the next is equal (HR, age, height, degrees C and F)

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2
Q

What is discrete/categorical data?

A
  1. Nominal- arbitrary order (gender, mortality, ethnicity, marital status)
  2. Ordinal- logical order but magnitude from one value to the next is not equal (1-10 pain scale, NYHA functional class
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3
Q

What are measures of central tendency?

A

a typical value that describes all the possible values and likelihoods that a random variable can take in a given range:
1. mean
2. median
3. mode

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4
Q

What is mean and when is it preferred?

A
  1. average value
    2.continuous data that is normally distributed
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5
Q

What is median and when is it preferred?

A
  1. middle value
  2. ordinal or continuous data that is skewed
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6
Q

What is mode and when is it preferred?

A
  1. most frequent value
  2. nominal data
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7
Q

How is the variability of data (spread) described?

A
  1. range
  2. standard deviation
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8
Q

What is the range?

A

difference between the highest and lowest values

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9
Q

What is standard deviation?

A

indicates how spread out the data is and to what degree the data is dispersed away from the mean (highly dispersed data have a larger SD)

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10
Q

What are the characteristics of Gaussian (normal) distribution?

A
  1. large sets of continuous data
  2. normal/symmetrical bell-shaped curve
  3. mean, median, and mode are the same value at the center point of the curve
  4. 68% of data fall within 1 SD of the mean; 95% of data fall within 2 SD of the mean
  5. half of the values are on the right and the other half on the left with a small number of data in the tails
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11
Q

What are the characteristics of a skewed distribution?

A
  1. not symmetrical
  2. data is skewed toward outliers (extreme high value is skewed right and extreme lows are skewed left)
  3. 68% of values do not fall within 1 SD of the mean, median, and mode
  4. mean, median and mode are not the same value
  5. usually occurs when the number of values (sample size) is small and/or there are outliers
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12
Q

What are the characteristics of outliers?

A
  1. in a small population outliers have a large effect on the mean
  2. median is a better measure of central tendency
  3. distortion from outlier is decreased by increasing the population
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13
Q

What is a variable?

A

any data point that can be measured or counted

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14
Q

What is an independent variable?

A

variable that is changed (manipulated) by the researcher to determine its effect on the dependent variable (the outcome)

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15
Q

What are examples of dependent variables?

A
  1. A1c
  2. cholesterol values
  3. mortality
    the outcome of an independent variable
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16
Q

What are examples of independent variables?

A
  1. drug/dose regimen
  2. patients included (age,gender, comorbid conditions)
17
Q

What is a null hypothesis?

A

Ho: hypothesis that the researcher is trying to disprove or reject (drug X does not treat HF better than drug y); not statistically significant difference

18
Q

What is an alternative hypothesis?

A

Ha: hypothesis researcher is trying to prove or accept ( drug x treats HF better than drug y); statistically significant

19
Q

What is the alpha level?

A

standard for maximum permissible error margin and threshold for rejecting the null hypothesis; usually 0.05 (5%)

20
Q

What is a p-value?

A

calculated based on statistical test data and compared to alpha; when the p-value is < 0.05 the results are statistically significant and the null hypothesis is rejected

21
Q

What is a confidence interval?

A
  1. includes data on statistical significance and precision of results
  2. CI= 1- alpha
  3. when alpha is 0.05 the study reports a 95% confidence interval
  4. when alpha is 0.01 the study reports a 99% CI
22
Q

What type of confidence interval has high precision?

A

narrow CI;
ARR 0.12 (0.95 CI 0.06-0.15, 6%-15%) we are 95% confident that the true value of the ARR for the general population lies somewhere within the range of 6-15%

23
Q

What type of confidence interval has poor precision?

A

Wide CI;
ARR 0.12 (0.95 CI 0.06-0.35, 6%-35%) we are 95% confident that the true value of the ARR for the general population lies somewhere within the range of 6-35%

24
Q

What is a type 1 error?

A

False positive: null hypothesis (no change in drug x and drug y) was rejected in error and alternative (drug x is better that drug y) was accepted incorrectly;
95% CI= 1- alpha (0.05) the probability of making a type 1 error is <5% and we are 95% confident that the result is correct and not due to chance

25
Q

What is a type II error?

A

Probability of a false negative (Beta): null hypothesis (no change in drug x and drug y) is accepted in error and the alternative hypothesis (drug x is better that drug y) is rejected incorrectly; usually set at 0.1 or 0.2 (the risk of type II error is 10% or 20%); risk of type II error is increased with small sample size

26
Q

What is study power?

A

the probability that a test will reject the null hypothesis correctly (the power to avoid a type II error;
Power= 1-Beta if Beta is set at 20% the study has 80% power; as power increases chance of type 2 error decreases

27
Q

How is study power determined?

A
  1. number of outcomes collected
  2. difference in outcome rates between groups
  3. significance (alpha) level
28
Q

What is risk?

A

the probability that an event (how likely it is to occur) when an intervention is given;
Risk= # subjects with unfavorable event/ total # of subjects

29
Q

What is relative risk?

A

ratio of risk in the in the exposed group (treatment) divided by risk in the control group;
RR= risk in tx group/ risk in control group

30
Q

How is RR interpreted?

A

RR=1 (100%) equal risk between intervention and control groups, intervention had no effect
RR<1 (<100%) lower risk (reduced risk) of the outcome in the treatment group, patients treated with metoprolol were 57% as likely to have progression to disease as placebo treated patients
RR>1 increased risk of the outcome in the treatment group

31
Q

What is relative risk reduction?

A

indicates how much the risk is reduced in the treatment group compared to the control group, calculated after RR;
RRR= (% risk in control group-% risk)/ % risk in the control) or 1-RR;
(RR+RRR=100%) 1-0.57= 0.43 metoprolol patients were 43% less likely to have HF progression than placebo patients

32
Q

What is absolute risk reduction?

A

includes the reduction in risk and the incidence rate, most useful for clinicians
ARR= (% risk in control group)-(% risk in treatment group)

33
Q

How is absolute risk reduction interpreted when ARR=12%?

A
  1. 12 out of 100 patients benefit from the treatment
  2. for every 100 patients treated with metoprolol 12 fewer patients will have HF progression