Evidence Based Medicine Flashcards
1
Q
Allows us to draw from the sample, conclusions about the general population
A
Statistics
2
Q
An efficient way to draw conclusions when the cost of gathering all of the data is impractical
A
Taking Samples
3
Q
Assume that an infinitely large population of values exists and that your sample was randomly selected from a large subset of that population. Now use the rules of probability to
A
Make inferences about the general population
4
Q
States that the sampling distribution of the mean of any independent, random variable will be normal or nearly normal, if the sample size is large enough
A
The Central limit theorem
5
Q
What does the Central Limit Theorem say?
A
The sampling distribution of the mean of any independent, random variable will be normal or nearly normal, if the sample size is large enough
6
Q
If samples are large enough, the sample distribution will be
A
Bell shaped (Gaussian)
7
Q
Statistics come in what two basic flavors?
A
Parametric and Non-parametric
8
Q
A class of statistical procedures that rely on assumptions about the shape of the distribution (i.e. normal distribution) in the underlying population and about the form or parameters (i.e. mean and std. dev) of the assumed distribution
A
Parametric Statistics
9
Q
A class of statistical procedures that does not rely on assumptions about the shape or form of the probability distribution from which the data were drawn
A
Non-parametric Statistics
10
Q
Summarize the main features of the data without testing hypotheses or making any predictions
A
Descriptive statistics
11
Q
Descriptive statistics can be divided into what two classes?
A
Measures of location and measures of dispersion
12
Q
A typical or central value that best describes the data
A
Measures of location
13
Q
What are the measures of location?
A
- ) Mean
- ) Median
- ) Mode
14
Q
Describe spread (variation) of the data around that central value
A
Measures of dispersion
15
Q
What are the measures of dispersion?
A
- ) Range
- ) Variance
- ) Std. Dev
- ) Std. Error
- ) Confidence Interval
16
Q
No single parameter can fully describe the distribution of data in the
A
Sample
17
Q
The sum of the data points divided by the number of data points
- More commonly referred to as “the average”
- Data must show a normal distribution
A
Mean
18
Q
What are often better measures of location if the data is not normally distributed?
A
Median and Mode
19
Q
The value which has half the data smaller than that point and half the data larger
A
Median
20
Q
When choosing the median for odd number of data points, you first
A
Rank the order, then pick the middle #
21
Q
When choosing the median for even number of data points, you
A
- ) Rank the numbers
- ) Find the middle two numbers
- ) Add the two middle numbers and divide by 2
22
Q
Less sensitive for extreme data points and is thus useful for skewed data
A
Median
23
Q
The value of the sample which occurs most frequently
A
Mode
24
Q
The mode is a good measure of
A
Central Tendency
25
Not all data sets have a single mode, some data sets can be
bi-modal
26
On a box plot, 50% of the data falls between Q1 (25th percentile) and Q3 (75th percentile), the area encompassing this 50% is called the
Interquartile range (= Q3-Q1)
27
Used to display summary statistics
Box plots
28
To find the quartiles, put the list of numbers in order, then cut the list into four equal parts, the quartiles are at the
Cuts
29
The second quartile is equal to the
Median
30
Do not provide information on the spread or variability of the data
Measures of location
31
Describe the spread or variability within the data
Measures of dispersion
32
Two distinct samples can have the same mean but completely different levels of
Variability
33
The difference between the largest and the smallest sample values
-Depends only on extreme values and provides no information about how the remaining data is distributed
Range
34
Is the range a reliable measure of the dispersion of the whole data set?
No
35
The average of the square distance of each value from the mean
Variance
36
Makes the bigger differences stand out, and makes all of the numbers positive, eliminating the negatives, which will reduce the variance
Squaring the Variance
37
When calculating the variance, what is the difference between using N vs. N-1 as the denominator?
N gives a biased estimate of variance, where as (N-1) gives an unbiased estimate
38
In the calculation for variance, what does N represent?
N = size of population (biased)
39
In the calculation for variance, what does (N-1) represent?
(N-1) = size of the sample (unbiased)
40
The most common and useful measure of dispersion
Standard deviation
41
Tells us how tightly each sample is clustered around the mean
Standard deviation
42
When samples are tightly bunched together, the Gaussian curve is narrow and the standard deviation is
Small
43
When the samples are spread apart, the Gaussian curve is flat and the standard deviation is
Large
44
Means and standard deviations should ONLY be used when data are
Normally distributed
45
How can we determine if the data are normally distributed?
Calculate the mean plus or minus twice the standard deviation. If either value is outside of the possible rage, than the data is unlikely to be normally distributed
46
Approximately what percentage of data lies within:
1. ) 1 standard deviation of the mean
2. ) 2 Standard deviations of the mean
3. ) 3 Standard deviations of the mean
1. ) 68.3%
2. ) 95.4%
3. ) 99.7%
47
If data is skewed, we should use
Median
48
What are two more sophisticated, yet more complex, methods of determining normality?
D'Agostino & Pearson omnibus and Shapiro-Wilk Normality tests
49
D'Agostino & Pearson omnibus and Shapiro-Wilk Normality tests are not very
Useful
50
What we want is a test that tells us whether the deviations from the Gaussian ideal are severe enough to invalidate statistical methods that assume a
-Normality tests don't do this
Gaussian distribution
51
How can we determine whether our mean is precise?
Find the Standard Error
52
A measure of how far the sample mean is away from the population mean
Standard error
53
The standard error of the mean (SEM) gets smaller as
Sample size gets larger
54
If the scatter in data is caused by biological variability and you want to show that variability, use
Standard Deviation (SD)
55
If the variability is caused by experimental imprecision and you want to show the precision of the calculated mean, use
Standard Error of the mean (SEM)
56
Say we aliquot 10 plates each with a different cell line and measure the integrin expression of each, would we want to use SD or SEM?
SD
57
Say we aliquot 10 plates of the same cell line and measure the integrin expresion of each, would we want to use SD or SEM?
SEM
58
An estimate of the range that is likely to contain the true population mean
-combine the scatter in any given population with the size of that population
Confidence intervals
59
Generates an interval in which the probability that the sample mean reflects the population mean is high
Confidence intervals
60
Means that there is a 95% chance that the confidence interval you calculated contains the true population mean
95% confidence interval
61
If zero is included in a confidence interval for a change in a disease due to a drug, then it means we can not exclude the possibility that
There was no true change
62
An observation that is numerically distant from the rest of the data
An outlier
63
Can be caused by systematic error, flaw in the theory that generated the data point, or by natural variability
An outlier
64
What is one popular method to test for an outlier?
The Grubbs test
65
How do we use the Z value obtained by the Grubbs test to test for an outlier?
Compare the Grubbs test Z with a table listing the critical value of Z at the 95% probability level. If the Grubbs Z is greater than the value from the table, then you can delete the outlier
66
To test for an outlier, we compare the Grubbs test Z with a table listing the critical value of Z at the 95% probability level. If the Grubbs Z is greater than the value from the table, then the P value is
Less than 5% and we can delete the outlier
67
What constitutes "good quality" data
Data must be: reliable and valid
68
What measurements assess data reliability?
Precision, accuracy, repeatability, and reproducibility
69
In order for the data to be valid, it must be
Compared to a "gold standard," generalisable, and credible
70
The degree to which repeated measurements under unchanged conditions show the same results
Precision
71
High precision results in lower
SD
72
The degree of closeness of measurements of a quantity to that quantity's true value
Accuracy
73
High accuracy reflects the true
Population mean
74
Repeatability is the same as
Precision
75
The ability of an entire experiment or study to be duplicated either by the same researcher or by someone else working independently
-The cornerstone of research
Reproducibility
76
The extent to which a concept, conclusion, or measurement is well-founded and corresponds accurately to the real world
Validity
77
Assuming that data collected on small samples are indicative of the population, sampling errors (bias, size, etc), and instrument errors are all threats to
Validity
78
The generalizability of a study is called it's
External validity
79
Thalidomide was tested on rodents and showed no effects on limb malformations. However, the effects on humans were very pronounced. This is an error in
External validity
80
Many studies using single cell lines are no longer
Acceptable
81
Are the methodologies acceptable? Do the investigators have the required expertise? Who paid for the research? What is the reputation of the investigators an the institution? These are all questions that challenge
Credibility
82
Caused by inherently unpredictable fluctuations in the readings of a measurement apparatus or in the experimenter's interpretation of the instrumental reading
Random Error
83
Random error can occur in either
Direction
84
Error that is predictable, and typically constant or proportional to the true value
Systematic Errors
85
Caused by imperfect calibration of measurement instruments or imperfect methods of observation
Systematic Error
86
Systematic error typically occurs only in one
Direction
87
Say you measure the mass of a ring three times using the same balance and get slightly different values of 17.46 g, 17.42 g, and 17.44 g. This is an example of
Random error
-can be minimized by taking more data
88
Say the electronic scale you use reads 0.05 g too high for all of your measurements because it is improperly tare throughout your experiment. This is an example of?
Systematic error
89
If the sample size is too low, the experiment will lack
Precision
90
Time and resources will be wasted, often for minimal gain, if the sample size is
Too large
91
Calculates how many samples are enough
Power analysis
92
The calculation of power requires which three pieces of information?
1. ) A research hypothesis
2. ) The variability of the outcomes measured
3. ) An estimate of the clinically relevant difference
93
Will determine how many control and treatment groups are required
A research hypothesis
94
What is the best option for showing the variability of the outcomes measured?
SD
95
A difference between groups that is large enough to be considered important
Clinically relevant difference
-set as 0.8 SD
96
What is the affect on sample size (n) for the following scenarios:
1. ) More variability in the data
2. ) Less variability in the data
3. ) To detect small differences between groups
1. ) Higher n required
2. ) Fewer n required
3. ) Higher n required
97
What is the affect on sample size (n) for the following scenarios:
1. ) To detect large differences between groups
2. ) Smaller α used
3. ) Less power (smaller β)
1. ) Fewer n required
2. ) Higher n required
3. ) Fewer n required
98
An important part of the study design
Statistics
99
What is the null hypothesis (Ho)
Ho: µ1 = µ2
```
Ho = null hypothesis
µ1 = mean of population 1
µ2 = mean of population 2
```
100
Is presumed true until statistical evidence in the form of a hypothesis test proves otherwise
Null hypothesis
101
We want to compare our null hypothesis to the alternative hypothesis being tested. To do this, we must select the probability threshold, below which the null hypothesis will be rejected. This is called the
Significance level (α)
-Common values are 0.05 and 0.01
102
Once our significance level has been selected, we need to compute from the observations the
Observed value (tobs) of the test statistic (T)
103
Once we have calculated tobs, we need to decide whether to
Reject Null hypothesis in favor of alternative or not
104
The incorrect rejection of a true null hypothesis (false positive)
Type I error
105
Incorrectly retaining a false null hypothesis (false negative)
Type II error
106
What are the two ways to compare a sample mean to a population mean?
1. ) z statistic: used for large samples (n > 30)
| 2. ) t statistic: used for small samples (n less than 30)
107
Any statistical test for which the distribution of the test statistic can be approximated by a normal distribution.
z statistic
108
Because of the central limit theorem (CTL), many test statistics are approximately normally distributed for
Large samples (n > 30)
109
Very similar to the z statistic and uses the same formula
t statistic
110
When a statistic is significant, it simply means that the statistic is
-does not mean it is biologically important or interesting
Reliable
111
Indicates strong evidence against the null hypothesis
-so we reject the null hypothesis
A small p-value (typically p
112
Indicates weak evidence against the null hypothesis
-so we fail to reject the null hypothesis
A large p-value (typically p > 0.05)
113
P-values close to the cutoff (0.05) are considered to be marginal (could go either way), thus we should always
Report our p-value so readers can draw their own conclusions
114
Can strongly influence whether the means are different
Variability
115
Most useful when comparing two means and N
Students t-test
116
The degreesof freedom are very important in a
Students t-test
117
Given two data sets, each characterized by it's mean, SD, and number of samples, we can determine whether the means are significant by using a
t-test
118
A t-test is nothing more than a
Signal-to-noise ration
119
The degree of freedom is important in a t-test. How do we find degrees of freedom?
d.o.f. = N-1, but we have more than one N, so for a t-test, d.o.f. = 2N - 2
120
Will test either if the mean is significantly greater than x or if the mean is significantly less than x, but not both
One-tailed t-test
121
Provides more power to detect an effect in one direction by not testing the effect in the other direction
One-tailed t-test
122
Will test both if the mean is significantly greater than x and if the mean is significantly less than x
Two-tailed t-test
123
In a one-tailed t-test, the mean is considered significantly different from x if the test statistic is in either the
Top 5% or the bottom 5%, resulting in a p-value of less than 0.05
124
In a two-tailed t-test, the mean is considered significantly different from x if the test statistic is in the
Top 2.5% or bottom 2.5%, resulting in a p-value less than 0.05
125
If tcalc > than ttable, than we must
Reject the null hypothesis and conclude that the sample means are significantly different
126
We must reject the null hypothesis and conclude that the sample means are significantly different if
tcalc > than ttable
127
The observed data are from the same subject or from a matched subject and are drawn from a population with a normal distribution
Paired t-test
128
The observed data are from two independent, random samples from a population with a normal distribution
Unpaired t-test
129
If we are measuring glucose concentration in diabetic patients before and after insulin injection, we perform a
Paired t-test
130
If we are measuring the glucose concentration of diabetic patients versus non-diabetic patients, we perform an
Unpaired t-test
131
If you have more than two groups, than you must make more than two
Comparisons
132
If you set a confidence level at 5% and do repeated t-tests on more than 2 groups, you will eventually get a
Type I error
-i.e. reject the null hypothesis when you should not have
133
The more comparisons we have to make, the higher the
α value must be
134
Instead of doing multiple t-tests when we have more than two means to compare, we can do an
Analysis of Variance (ANOVA)
135
To compare three or more means, we must use an
Analysis of Variance (ANOVA)
136
In ANOVA, we don't actually measure variance, we measure a term called
"Sum of squares"
137
For ANOVA, what are the three sum of squares that we need to measure?
1. ) Total sum of squares
2. ) Between-group sum of squares
3. ) Within-group sum of squares
138
Total scatter around the grand mean
Total sum of squares
139
Total scatter of the group means with respect to the grand mean
Between-group sum of squares
140
The scatter of the scores
Within-group sum of squares
141
ANOVA and t-test are both essentially just
Signal-to-noise ratios
142
To calculate the sums of squares, we first need to calculate
1. ) Group means
| 2. ) Grand mean
143
If Fcalc > Ftable,
We must reject the null hypothesis and conclude that the sample means are significantly different
144
We must reject the null hypothesis and conclude that the sample means are significantly different if
Fcalc > Ftable
145
When we have one measurement variable and one nominal variable, we use
One-Way ANOVA
146
When we have one measurement variable and two nominal variables, we use
Two-way ANOVA
147
If we measure glycogen content for multiple samples of the heart, lungs, liver, etc. We perform a
One-way ANOVA
148
If we measure a response to three different drugs in both men and women, we use a
Two-way ANOVA
149
Only tells us that the smallest and largest means differ from one another
ANOVA
150
ANOVA only tells us that the smallest and largest means differ from one another, if we want to test the other means, we have to run
Post hoc multiple comparisons tests
151
Post hoc tests are only used if the null hypothesis is
Rejected
152
Test whether any of the group means differ significantly
Post hoc tests
153
Don't suffer from the same issues as performing multiple t-tets. They all apply different corrections to account for the multiple comparisons
Post hoc tests
154
When normal distributions can not be assumed, we must consider using a
Non-parametric test
155
Make fewer assumptions about the distribution of the data
Non-parametric tests
156
Less powerful, meaning it is difficult to detect small diferences
Non-parametric tests
157
Useful when the outcome variable is a rank score, one or a few variables are off-scale, or you're sure that the data is non Gaussian (ex: response to drugs)
Non-parametric tests
158
What is the non-parametric alternative to the two-sample t-test?
Mann-Whitney U test
159
The Mann-Whitney U test does not use actual measurements, but rather it uses
Ranks of the measurements used
160
In the Mann-Whitney U test, data can be ranked from
Highest to lowest, or lowest to highest
161
Let's say we want to test the two tailed null hypothesis that there is no difference between the heights of male and female students. What is
1. ) Ho
2. ) Ha
3. ) U1
4) U2
1,) male and female students are the same height
2. ) male and female students are not the same height
3. ) U statistic for men
4. ) U statistic for women
162
How do we analyze the Mann-Whitney U test?
Compare the smaller of the two U statistics to a table of U values. If Ucalc is less than U table than we reject the null hypothesis
163
The extent to which two variables have a linear relationship with eachother
Correlation
164
Useful because they can indicate a predictive relationship that can be exploited in practice
Correlations
165
Correlation is used to understand which two things?
1. ) Whether the relationship is positive or negative
| 2. ) The strength of the relationship
166
A measure of the linear correlation between two variables, X and Y, which has a value between +1 and -!, where 1 is total positive correlation, -1 is total negative correlation, and 0 is no correlation
Pearson Correlation Coefficient (r)
167
The goal of linear regression is to adjust the values of slope and intercept to find the line that best predicts
Y from X
168
It's goal is to minimize the sum of the squares of the vertical distances of the points from the line
Linear Regression
169
Linear regression does not test whether your data are
Linear
170
A unitless fraction between 0.0 and 1.0 that measures the goodness-of-fit of your linear regresion
-only useful in the positive direction
r^2
171
An r^2 value of zero means that
Knowing X did not help you predict Y (and vice-versa)
