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KCUMB Epidemiology - Erin > EXAM III Material > Flashcards

EXAM III Material Flashcards

1
Q

Define Population

A

All individuals

DIFFERENT from study population (the final group of individuals selected for a study)

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2
Q

Define Sample and state when it’s useful to be used

A

A subset or portion of the full population

“representatives”

Useful when studying the complete population is not feasible

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3
Q

Study measurements of human studies are collected based on:

A

Desired “variables”

Dependent variable(s) outcome variable

Independent variables

In which comparisons will be made = Statistical analysis

and inferences will be made about the sample-derived measurements and their comparisons (in relation to Null Hypothesis) & to the full population of similar subjects (generalizability)

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4
Q

Define Null Hypothesis

A

A research prospective which states that there will be no true difference b/w the groups being compared

Most conservative and commonly utilized

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5
Q

What statistical references can be taken by the researcher in a null hypothesis?

A

Superiority

Noninferiority

Equivalency

Don’t always have to show superiority; sometimes equivalency is good enough

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6
Q

What are the 2 key attributes of data measurement/variables in which help to determine the statistical test?

A

Magnitude/Dimensionality - i.e. pain level scale, satisfaction, fanciness

Consistency of scale/fixed interval - equal, measurable spacing between units - i.e. date, time, months, age groups, etc.

A 3rd one is rational/absolute zero

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7
Q

What are the 3 categories for data/variables based on the answers to the two key attributes of magnitude and consistency of scale?

A

Nominal/Dichotomous/Binary; Non-Ranked named categories

Ordinal/Ranked Categories; equal-distance

Interval/Ratio (order & magnitude & equal intervals-of-scale (units))

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8
Q

Define the nominal category for data/variables

A

Has No magnitude, No consistency of scale, No rational zero

Dichotomous, Non-ranked, Categorical

Simply labeled variables without quantitative characteristics

Descrete = Whole Numbers

No mean - cannot interpret mean

i.e. male/female, hair color, eye color, etc.

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9
Q

Define ordinal level of data measurement and list examples

A

Yes Magnitude

No Consistency of scale

No Rational Zero

Descrete = whole numbers

May calculate Mean; must be careful tho

i.e. pain level scale, ranking, satisfaction

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10
Q

Define Ratio/Interval level of measurement and list examples

A

Yes Magnitude

Yes Consistency of Scale

N/Y Rational Zero (N = Interval, Y = Ratio)

Continous = Fractional Numbers

Can calculate mean, median, standard dev.

i.e. age, number of living siblings, anything physiological measured (BP, lipid panel, etc.)

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11
Q

What type of data measurement is applicable while having a Parametric test (normally distributed shape of data distribution)

A

Interval

MMM are essentially equal

Equal dispersion of curve “tails” to both sides of MMM

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12
Q

What does it mean to have a positively skewed graph?

A

When the tail points to the right

Mean > Median

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13
Q

What does it mean to have a negatively skewed graph?

A

When the tail points to the left

Mean < Median

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14
Q

Define skewness, what is the value depicting a symmetric, normal distribution?

A

A measure of the asymmetry of a distribution

Value of 0 = perfectly normal, symmetric, equal MMM

The further from 0, the more the data is skewed

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15
Q

Define kurtosis and what (+) and (-) kurtosis means

A

A measure of the extent to which observations cluster around the mean

How well the values cluster around the mean/middle

(+) = more cluster within the graph/bell shape

(-) = less cluster within the graph/bell shape

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16
Q

What are the required assumptions of interval data for proper selection of a parametric test?

A

Normally distributed

Equal variable = Levene’s Test; used to determine if the interval data is equal; within the SBSS test

Randomly-derived and Independent

ALL must be true in order to pick Interval measurement

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17
Q

What question does Confidence Interval address?

A

What is the plausible range of possible difference or relationship within which I believe the true difference or relationship may lie?

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18
Q

What question does the p value address from a statistical test?

A

What is the single measurement value most likely to represent the true (yet unknown) difference or relationship between the groups being compared and what is the probability the difference has occurred by chance?

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19
Q

p value is attributed to Type I or Type II error?

A

Type I error = False Positive

When a test detects the presence of disease when in fact the person does not have the disease

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20
Q

Define p value

A

The probability of making a Type I error if the Null Hypothesis is rejected.

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21
Q

What does is mean when a graph has a kurtosis value of 0?

A

A perfect cluster of obversations at the mean of the bell shaped curve = a normal distribution

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22
Q

Which type of data(s) are discrete and why?

A

Nominal and Ordinal

Variables are discrete because they do not have a scale and you cannot have something in between the variables, not continuous

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23
Q

What is a Levene’s test and why is it used?

A

A test that is done when you need to determine if the data has magnitude and a balanced scale

Tells us if the data is interval data, if there are equal variances

Asses for equal variances b/w groups

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24
Q

What requirements must be met before choosing a Parametric test?

A

Interval data must be:

Normally distributed (bell-shaped curve)

Contain equal variances

Randomly-derived and independent

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25
Q

What type of stat test is used for non-parametric tests?

A

Descriptive Stats and Graphs

Data is transformed into a standardized value

(z-score or log)

These are stat tests that does not

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26
Q

Define Power (1-beta)

A

The ability of a study design/methodology/selected test statistic to detect a true difference if one truly exists b/w group-comparisons and the level of accuracy in correctly accepting/rejecting the Null Hypothesis (analogous to sensitivity in screenings)

Value is traditionally set at 20%

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27
Q

How does the sample size impact the power of stat significance?

A

The larger the sample size, the greater the likelihood/ability of detecting a difference if one truly exists

Increase in Power

Must add in anticipated drop-outs or loss to follow-ups

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28
Q

In determining sample sizes, would you need a larger and smaller number of samples when the differences between groups are smaller?

A

Need a greater number (N)

Due to the fact that there is a small difference, it will be harder to find differences in a small group, therefore you need more samples

Add in anticipated drop-outs or loss to follow-ups

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29
Q

What is another word for a type I error rate?

A

p value

If < 0.05 it is statistically significant

Determined before a study begins

Low p values allow more confidence and have a less risk of Type I error

by chance alone

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30
Q

Define Type I Error and state another term for it

A

alpha

Rejecting the Null Hypothesis when it is actually true and you should have accepted it

There is really NO TRUE DIFFERENCES b/w groups but you in error reject the null hypothesis, thereby stating that you believe there’s a difference b/w the groups when in fact, there really isn’t!

= False Positives

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31
Q

Define Type II Error and state another term for it

A

Beta

Not rejecting the Null Hypothesis when it is actually false and you should have rejected it

When there really IS A TRUE DIFFERENCE b/w the groups being compared but you in error do not reject the null and state that there is no difference when there actually is

= False Negative

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32
Q

What are the most common selected confidence interval values?

A

90%, 95%, 99%

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33
Q

Explain the interpretation of a 95% CI

A

We are 95% confident that the “true” difference (0) or relationship (1) between the groups is contained within the CI range

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34
Q

List the common types of measures of central tendency

A

Mean, Median, Mode

Outliers

Minimum and maximum range

Interquartile Range

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35
Q

Define the two measures of variation/spread/dispersion of data

A

Variance (from the mean) - the difference in each individual measurement value and the groups’ mean

Stardard Deviation - The square root of variance value

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36
Q

What are the 3 population percentages comprised within 1, 2, and 3 SDs around the mean of a normally distributed dataset?

A

1 = 68%

2 = 95%

3 = 99%

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37
Q

Differentiate between dependent and independent data and list the common terms used for dependent data

A

Dependent data is when you have data from the same/paired groups = before/after, pre/post, beginning/end, start/finish

Independent data is when you have data from different groups

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38
Q

What 4 questions must you ask yourself in while determining a correct stat test to use?

A
  1. What type of data is being collected/evaluated?

Nominal/Ordinal/Interval

  1. What type of comparison/assessment is desired?

Correlation, Survival, Regression = stop here

Frequencies, Proportions, Counts = proceed to Qs 3 and 4

  1. How many groups are being compared?
  2. Is the data independent or dependent?
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39
Q

What is a Correlation test, when would you want to use it, what do they tell you and whatare the types of correlation tests for the 3 data types?

A

Provides a quantitative measure of the strength and direction

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40
Q

When is a partial correlation test used?

A

When you are performing a correlation test and want to control for confounding variables

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41
Q

What is a contingency coefficient test and what type of data is it used for?

A

A correlational test that determines the strength and relationship between variables

Nominal Data

42
Q

What type of test is a Spearman/Kendall Correlation test and what type of data is it useful for?

A

A Correlational test used to provide a quantitative measure of the strength and direction of a relationship between variables

Ordinal Data

43
Q

What type of test is a Pearson Correlation test and what type of data is it useful for? What happens when you have a p-value > 0.05?

A

A type of stat test that measures the correlation quantitatively of strength and direction of a relationship between groups

Interval Data

If there is a sig. p value, you can say that there is a linear correlation

44
Q

What are survival tests, what are they used for, how can the data be represented as and what are the tests for each of the 3 data types?

A

Used to measure an event occurrence/proportion of events/time-to-an event

All can be represented as a Kaplan-Meier Curve

Nominal = Log Rank Test

Ordinal = Cox Proportional Hazard Test

Interval = Kaplan-Meier Test

45
Q

What type of test is a log-ranked test and what type of data is it used for?

A

A type of survival test that compares the occurrence/proportion of events/time-to-an event between groups

Nominal Data

46
Q

What type of test is a Cox-Proportional Hazard Test and what type of data is it used for?

A

A type of Survival test used to compare a proportion of events/occurrence/time-to-an event between groups

Ordinal Data

Able to represent data on a Kaplan-Meier Curve

47
Q

What type of stat test is the Kaplan-Meier Test and what type of data is it used for?

A

A type of survival test used to compare a proportion of event/occurrence/time-to-an-event between groups

Interval Data

48
Q

What is a regression test and what are the 3 types of test under each data category?

A

Tests done to measure the relationship/association between variables by making a prediction about the dependent variable outcome by going back to old data

Able to calculate OR

Nominal = Logistic Regression

Ordinal = Multinominal Logistic Regression

Interval = Linear Regression

49
Q

What type of data is used for a logistic regression test?

A

A regression test that allows you to test the relationships/associations by going back to old data and making a prediction about the dependent variable outcome

Nominal Data

50
Q

What type of data is a Multinominal Regression Test used for?

A

A type of regression test used to measure the relationship/association of groups by going back to old data and making a prediction of the dependent variable/outcome

Ordinal Data

51
Q

What type of data is used for a Linear Regression Test?

A

A type of regression test that measures the relationship/association of groups by going back to old data and making a prediction of the dependent variable/outcome

Interval Data

52
Q

What type of tests are used for nominal data when you have 2 groups? (for dependent and independent data)

A

(before/after, pre/post, start/finish)

Dependent/Paired data = McNemar Test

Independent data = Pearson’s Chi-Squared and Fisher’s Exact (able to handle small numbers)

53
Q

What type of tests are used for nominal data when you have 3 or more groups? (for dependent and independent data)

A

Independent Data = Chi-square and Fisher’s Exact

Dependent/Paired Data = Cochran

All are under the category of Bonferroni Test of Inequality - Conservative method of adjusting the p value for the # of comparisons that are being made

54
Q

What is the Bonferroni test of inequality and which tests fall under that category?

A

Bonferroni Correction

Conservative method that adjusts the p value for the number of comparisons being made

55
Q

What is a Pearson’s Chi-square test? What type of data is it used for?

A

A chi-squared test done when you have Nominal Data with 2 groups that contain independent data

56
Q

What is a Chi-square test and what type of data is it used for? What must occur if you have a finding that is statistically significant?

A

A test done with Nominal data with Independent data of 3+ groups

If p-value is stat. significant, must perform a post-hoc analysis test to determine which groups are different

More likely to have a type I error if performing multiple chi-squared tests

May perform a Bonferroni test of inequality to adjust the p value for the number of comparisons that are being made

57
Q

What is a Fisher’s Exact test and what type of data does it use?

A

Test done using nominal data with Independent data done with 3+ groups

You have an expected cell count of less than 5

This test is able to handle small numbers

58
Q

What is a McNemar test and what type of data does it utilize?

A

Test done with nominal data when you have 2 Groups with dependent data.

dependent/paired = _(_before/after, pre/post, start/finish)

59
Q

What is a Cochran Q test and what type of data does it utilize? What is its relation with the chi-squared test?

A

Test done with nominal data with dependent/related data done on 3+ groups

If there is a p-value that is stat. significant, must perform a post-hoc analysis to determine which group is different

May use a Bonferroni test of inequality/Bonferroni correction; a conservative approach that adjusts the p-value for the number of comparisons that are being made

60
Q

What are the 2 tests that are performed with independent variables that contain ordinal data?

A

Mann-Whitney test

Kruskal-Wallis test - post-hoc test if sig. p value is found

Both are used for interval data that does not meet the parametric requirements

Both compare the median value between groups

61
Q

What are the 2 tests that are used when you have dependent/paired variables with ordinal data?

A

Wilcoxon Signed Rank test

Friedman test - If p-value is sig. must perform a post-hoc test to see which group is different

Both tests compare the median between groups

Both tests are used with interval data that does not meet parametric requirements

62
Q

What tests are used when you have 2 groups with ordinal data? (independent and paired data)

A

Independent data = Mann-Whitney test (3+ groups, p-value sig. = post-hoc test to find where difference lies)

Dependent/Related data = Wilcoxon Signed Rank (pre/post, before/after, start/finish)

Both tests compare the median values

Both tests used for interval data that does not meet parametric requirements

63
Q

What type of tests are used when you have ordinal data with 3 or more groups? (independent and related data)

A

Independent = Kruskal-Wallis

Dependent = Friedman

Both tests compare the median values

Both tests must perform a post-hoc test if you find a sig. p-value

Used for interval data that does not meet parametric requirements

64
Q

What are the characteristics of stat tests that require a post-hoc test?

A

When the test has 3 or more groups and you have a statistically significant p-value

65
Q

What post-hoc tests are used when you have nominal and ordinal data with 3 or more groups? (3)

A

Student-Newman-Keul Test - compares all pairwise comparisons possible; groups must be equal in size

Dunnett Test - compares all pairwise comparisons possible against a single control; groups must be equal in size

Dunn Test - compares all pairwise comparisons possible; groups do not have to be equal

66
Q

What is a Dunn test and when is it useful?

A

A post-hoc test used when you have ordinal data with 3 or more groups (independent OR paired/related)

Compares all pairwise comparisons possible

Groups do not have to be equal in size; as opposed to Dunnett and Student-Newman-Keul test

67
Q

What is a Student-Newman-Keul test and what is it useful for?

A

A post-hoc test done when you have a significant p-value with ordinal data with 3 or more groups and you need to determine where the difference lies.

Compares all pairwise comparisons possible and groups must be equal in size; as opposed to the Dunn Test

68
Q

What is a Dunnett test and what is it useful for?

A

A post-hoc test done when you have a significant p-value and must find where the difference lies when you have 3 or more groups with ordinal data.

Compares all pairwise comparisons against a single control and all groups must be equal in size

69
Q

What are the possible tests when you have interval data with independent variables? (5)

A

Analysis of Variance (ANOVA) - 3+ groups

Analysis of Co-Variance (ANCOVA) - 3+ groups

Multiple Analysis of Variance (MANOVA) - 3+ groups

Multpile Analysis of Co-Variance (MANCOVA) - 3+ groups

Student T-test - 2 groups

70
Q

What is a Student T-test? When is it useful?

A

Test performed when you have interval data with 2 groups with independent data

Compares the means of all groups, along with intra- and inter-group variations against a single dependent variable

71
Q

What is a Analysis of Variance (ANOVA) test and what is it useful for?

A

Test used when you have interval data when you have 3 or more groups with independent variables

Compares the means of all groups along with the inter- and intra- group variations against a single dependent variable

Able to use with 2 groups as well

72
Q

What is a Multiple Analysis of Variance (MANOVA) and what is it useful for?

A

Test done when you have interval data with 3 or more groups that have independent data against multiple dependent variables

Compares the means of all groups and the inter- and intra- group comparisons

Must use a post-hoc test if p-value is stat. sig.

73
Q

What is an Analysis of Co-Variance (ANCOVA) and what is it useful for?

A

A test done when you have interval data with 3 or more groups containing independent variables

Compares the means of all groups along with inter- and intra- group variations against a single dependent variable while controlling for the co-variance of confounders

74
Q

What is a Multiple Analysis of Co-Variance (MANCOVA) test and what is it useful for?

A

Test used when you have interval data with 3 or more groups with independent variables

Compares the means of groups along with inter- and intra- group comparisons against multiple dependent variables while controlling for the co-variance of confounders

75
Q

What tests are useful when you have interval data with 2 groups? (independent and dependent/related)

A

Independent = ANOVA, MANOVA, Student t-test

Dependent/Related = Repeated Measures ANOVA, Repeated Measures MANOVA, or Paired t-test

76
Q

What tests are useful when you have interval data with 3 or more groups? (independent and dependent variables)

A

Independent = ANOVA or MANOVA

Dependent/Related = Repeated measures of ANOVA or Repeated measures of MANOVA

77
Q

What are the 3 tests that are useful when you have interval data with dependent/related variables?

A

Repeated Measures ANOVA

Repeated Measures MANOVA

Paired t-test

78
Q

What is a paired t-test and what is it useful for?

A

A test done when you have interval data with 3 or more groups with dependent/related data

Compares the mean values between groups that are related

79
Q

What is a Repeated Measure ANOVA and what is it useful for?

A

Repeated Measure Analysis of Variance

Useful when you have interval data with 3 or more groups containing dependent/related/paired data

Compares the means of all groups along with inter- and intra-group variations of related data against a single dependent variable

Able to control for confounders

If confounder is present = Repeated Measures ANCOVA or Repeated Measures MANCOVA —> if sig. p-value = Bonferroni test or Scheffe or Dunn or Student-Newman-Keul or Dunnett test

80
Q

What is a repeated measure MANOVA test and what is it useful for?

A

Repeated Measure Multiple Analysis of Variance

Useful when you have interval data with 3 or more groups with dependent/paired/related variables

Compares the means of all groups along with inter- and intra- group variations of related data against multiple dependent variables

Able to control for confounders; however if a confounder is present, must perform a post-hoc test; Repeated Measures ANCOVA or Repeated Measures MANCOVA

If p-value is sig. = Bonferroni test/Tukey/Scheffe/Dunn/Student-Newman-Keul/Dunnett tests

81
Q

What are the post-hoc tests that are performed when you have interval data with 3 or more groups comparisons?

A

Tukey/Scheffe Test

Bonferroni Test

Dunn/Dunnett Test

Student-Newman-Keul Test

82
Q

What is a Tukey/Scheffe Test? What is it useful for?

A

A post hoc test performed when you have 3 or more groups with interval data

Compares all pairwise comparisons possible

All groups must be equal in size

Tukey - slightly more conservative than Student-Newman-Keul Test

Scheffe - is less affected by violations in normality and homogeneity of variances

83
Q

What is a kappa statistic?

A

An agreement that is made between evaluators (apart of the validation/assessment committee); consistency of “decisions”, “determinations”

+1 = observers classify everyone the same way

0 = no relationship at all between the observers classifications above the agreement that would be expected by chance

-1 = observers classify everyone exactly opposite of each other

(+) = good agreement

(-) = poor agreement

84
Q

What is a kappa interpretation and what are the values that are associated with it?

A

Used with a kappa statistic which is an agreement between evaluators

+1 = observers classify everyone the same way

0 = no relationship at all between the observers classifications above the agreement that would be expected by chance

-1 = observers classify everyone exactly opposite of each other

(+) = good agreement

(-) = poor agreement

85
Q

What checklists are used for Interventional studies? (2)

A

Consort Checklist - CONsolidated Standards Of Reporting Trials

PRISMA Checklist - Preferred Reporting Items for Systemiatic reviews and Meta-Analyses

86
Q

What type of study is the consort checklist used for? What type of trials is it used for?

A

Consort - randomized (clinical) trials = interventional studies

CONsolidated Standards Of Reporting Trials

Extension Documents - design extensions for non-inferiority and equivalence trials

Cluster and Pragmatic Trials - broadly defined as randomized, controlled trial whose purpose is to inform decisions about clinical practice. A philosophy as a continumm, not a dichotomy

87
Q

What are the extension documents utilized for consort checklists for interventional studies?

A

Design extensions for non-inferiority and equivalence trials

Cluster Trials

Pragmatic Trials

88
Q

What is a PRISMA checklist and what type of study is it used for?

A

Systematic reviews of multiple randomized trials

Preferred Reporting Items for Systematic reviews and Meta-Analyses

89
Q

What type of checklist is utilized for observational studies; cohort, case-control, cross-sectional? (3)

A

STROBE - STrengthening the Reporting of OBservational studies in Epidemiology

STROBE-ME - Molecular Epidemiology Studies

STREGA - STrengthening the Reporting of Genetic Association studies

90
Q

What type of studies are useful for the STROBE checklist?

A

STrengthening the Reporting of OBservational studies in Epidemiology

Useful for Observational Studies; Case-control, Cohort and Cross-sectional

91
Q

What type of study is the STROBE-ME checklist useful for?

A

STregthening the Reporting of OBservational studies in Epidemiology-Molecular Epidemiology studies

Useful for Observational Studies; Case-control, Cohort and Cross-sectional

92
Q

What type of study is the STREGA checklist useful for?

A

STrengthening the Reporting of Genetic Association studies

Useful for Observational Studies; Case-control, Cohort and Cross-sectional

93
Q

What checklists are useful for Non-Randomized studies? (5)

A

GRIPS - Genetic Risk Prediction Studies

QUADAS-2 - QUality Assessment of studies of Diagnostic Accuracy in Systematic reviews

REMARK - REporting recommendations for tumor MARKer prognostic studies

STARD - STAndards for the Reporting of Diagnostic accuracy studies

TREND - Transparent Reporting of Evaluations with Non-randomized Designs (large populations)

94
Q

What is a TREND checklist and what is it useful for?

A

Transparent Reporting of Evaluations with Non-randomized Designs

Useful for non-randomized studies

95
Q

What is the REMARK checklist and what type of study is it useful for?

A

REporting recommendations for tumor MARKer prognostic studies

Useful for non-randomized studies​

96
Q

What is a GRIPS checklist and what type of study is it useful for?

A

Genetic Risk Prediction Studies

Useful for non-randomized studies​

97
Q

What is a STARD checklist and what type of study is it useful for?

A

STAndards for the Reporting of Diagnostic accuracy studies

Useful for non-randomized studies​

98
Q

What is a QUADAS-2 checklist and what type of study is it useful for?

A

QUality Assessment of studies of Diagnostic Accuracy in Systematic reviews

Useful for non-randomized studies​

99
Q

Where exactly can each checklist that is useful for all studies be located for future use?

A

Equator Network website

100
Q

What is NCT and what is its purpose and where can it be found?

A

Number of Clinical Trials

A number assigned by clinicaltrials.gov once research protocol is submitted prior to study initiation

The purpose is to reduce publication bias

101
Q

What type of data can be located in clinicaltrials.gov and how was it developed?

A

ICMJE-acceptable public registry that offers up to date data info for locating interventional studies that are starting/in progress

NIH developed site with the FDA through its national library of medicine (NLM)

KCUMB Epidemiology - Erin (3 decks)

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