HYPOTHESIS TESTING Null Hypothesis and Research Hypothesis ?
MedI 7 Hypothesis Testing
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Transcript of MedI 7 Hypothesis Testing
1
Developing and testing a hypothesis
2
Learning material
Chapters 9-11 Confidence Interval Estimation Chapters 12-14 Testing hypotheses
3
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
4
Ideas and evidence
Hypotheses (Proposed answers)
Case reports
Biology
Epidemiology Clinical
observation
Imagination
Reasoning
Observational studies
Experimental studies
Tests of hypothesis
EVIDENCE-BASED INFORMATION
IDEAS
5
Examples Mechanisms of disease at the molecular level Drugs against antibiotic-resistant bacteria are developed through
knowledge of the mechanism of resistance
Case reports-Clinical observation Tamoxifen developed for contraception was found to prevent
breast cancer in high-risk women
Beliefs about herbal remedies Aspirin is a naturally occuring substance that has become
established as orthodox medicine after rigorous testing
Epidemiologic studies of populations Observations of low prevalence of colonic diseases (irritable
bowel syndrome appendicitis colorectal cancer) in Africa (where diet is high in fiber) led to efforts to prevent bowel disease with high-fiber diets Comparisons across regions have suggested the value of fluoride to prevent dental caries
6
Learning Objectives
bull Outline sources of ideashypotheses
bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
7
When to apply Statistical Hypothesis Testing - To answer a research question
Example
Is new antibiotic X a more effective drug for treating
infections than standard treatment Y
To test the folowing hypothesis proportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Y
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
2
Learning material
Chapters 9-11 Confidence Interval Estimation Chapters 12-14 Testing hypotheses
3
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
4
Ideas and evidence
Hypotheses (Proposed answers)
Case reports
Biology
Epidemiology Clinical
observation
Imagination
Reasoning
Observational studies
Experimental studies
Tests of hypothesis
EVIDENCE-BASED INFORMATION
IDEAS
5
Examples Mechanisms of disease at the molecular level Drugs against antibiotic-resistant bacteria are developed through
knowledge of the mechanism of resistance
Case reports-Clinical observation Tamoxifen developed for contraception was found to prevent
breast cancer in high-risk women
Beliefs about herbal remedies Aspirin is a naturally occuring substance that has become
established as orthodox medicine after rigorous testing
Epidemiologic studies of populations Observations of low prevalence of colonic diseases (irritable
bowel syndrome appendicitis colorectal cancer) in Africa (where diet is high in fiber) led to efforts to prevent bowel disease with high-fiber diets Comparisons across regions have suggested the value of fluoride to prevent dental caries
6
Learning Objectives
bull Outline sources of ideashypotheses
bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
7
When to apply Statistical Hypothesis Testing - To answer a research question
Example
Is new antibiotic X a more effective drug for treating
infections than standard treatment Y
To test the folowing hypothesis proportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Y
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
3
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
4
Ideas and evidence
Hypotheses (Proposed answers)
Case reports
Biology
Epidemiology Clinical
observation
Imagination
Reasoning
Observational studies
Experimental studies
Tests of hypothesis
EVIDENCE-BASED INFORMATION
IDEAS
5
Examples Mechanisms of disease at the molecular level Drugs against antibiotic-resistant bacteria are developed through
knowledge of the mechanism of resistance
Case reports-Clinical observation Tamoxifen developed for contraception was found to prevent
breast cancer in high-risk women
Beliefs about herbal remedies Aspirin is a naturally occuring substance that has become
established as orthodox medicine after rigorous testing
Epidemiologic studies of populations Observations of low prevalence of colonic diseases (irritable
bowel syndrome appendicitis colorectal cancer) in Africa (where diet is high in fiber) led to efforts to prevent bowel disease with high-fiber diets Comparisons across regions have suggested the value of fluoride to prevent dental caries
6
Learning Objectives
bull Outline sources of ideashypotheses
bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
7
When to apply Statistical Hypothesis Testing - To answer a research question
Example
Is new antibiotic X a more effective drug for treating
infections than standard treatment Y
To test the folowing hypothesis proportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Y
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
4
Ideas and evidence
Hypotheses (Proposed answers)
Case reports
Biology
Epidemiology Clinical
observation
Imagination
Reasoning
Observational studies
Experimental studies
Tests of hypothesis
EVIDENCE-BASED INFORMATION
IDEAS
5
Examples Mechanisms of disease at the molecular level Drugs against antibiotic-resistant bacteria are developed through
knowledge of the mechanism of resistance
Case reports-Clinical observation Tamoxifen developed for contraception was found to prevent
breast cancer in high-risk women
Beliefs about herbal remedies Aspirin is a naturally occuring substance that has become
established as orthodox medicine after rigorous testing
Epidemiologic studies of populations Observations of low prevalence of colonic diseases (irritable
bowel syndrome appendicitis colorectal cancer) in Africa (where diet is high in fiber) led to efforts to prevent bowel disease with high-fiber diets Comparisons across regions have suggested the value of fluoride to prevent dental caries
6
Learning Objectives
bull Outline sources of ideashypotheses
bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
7
When to apply Statistical Hypothesis Testing - To answer a research question
Example
Is new antibiotic X a more effective drug for treating
infections than standard treatment Y
To test the folowing hypothesis proportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Y
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
5
Examples Mechanisms of disease at the molecular level Drugs against antibiotic-resistant bacteria are developed through
knowledge of the mechanism of resistance
Case reports-Clinical observation Tamoxifen developed for contraception was found to prevent
breast cancer in high-risk women
Beliefs about herbal remedies Aspirin is a naturally occuring substance that has become
established as orthodox medicine after rigorous testing
Epidemiologic studies of populations Observations of low prevalence of colonic diseases (irritable
bowel syndrome appendicitis colorectal cancer) in Africa (where diet is high in fiber) led to efforts to prevent bowel disease with high-fiber diets Comparisons across regions have suggested the value of fluoride to prevent dental caries
6
Learning Objectives
bull Outline sources of ideashypotheses
bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
7
When to apply Statistical Hypothesis Testing - To answer a research question
Example
Is new antibiotic X a more effective drug for treating
infections than standard treatment Y
To test the folowing hypothesis proportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Y
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
6
Learning Objectives
bull Outline sources of ideashypotheses
bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
7
When to apply Statistical Hypothesis Testing - To answer a research question
Example
Is new antibiotic X a more effective drug for treating
infections than standard treatment Y
To test the folowing hypothesis proportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Y
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
7
When to apply Statistical Hypothesis Testing - To answer a research question
Example
Is new antibiotic X a more effective drug for treating
infections than standard treatment Y
To test the folowing hypothesis proportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Y
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
8
Important terms in Hypothesis Testing
bull Null and Alternative Hypotheses bull P-value bull Type I and Type II Errors bull Significance level bull Confidence level bull Power of a test bull Test statistic bull One(two)-tailed test bull Statistical tests
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
9
Null and Alternative Hypotheses The null hypothesis (H0) is usually of the form there is NO difference between the two groups The alternative hypothesis (Ha) would be there is a difference
Examples of H0 ldquoproportion of survivors in population of patients treated by X= =proportion of survivors in population of patients treated by Yrdquo
ldquoH0 πX= πYrdquo
ldquomean weight in population of patients in your clinic=mean weight in
general populationrdquo ldquoH0 μ=μ0rdquo
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
10
The p-value Example H0 The coin is fair (ie will produce as many heads as tails) =gt population proportion π=05
Outcome 42 heads out of 100 times tossing =gt sample proportion p=042 Is the difference between 05 and 042 statistically significant or due to chance How do we decide what proportion of heads we might expect to get if the coin is fair Matter of interest P(heads le 42 | coin is fair)=0067 gt 005
=gt the coin is most likely fair P(heads le 41 | coin is fair) = 0044 lt 005 =gt the coin is most likely not fair p-value
p-value
if outcome 41 heads
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
11
Definition The p-value is defined as the probability of obtaining the result or a more extreme result if the null hypothesis is true Interpretation of p-value
We usually say if p le 005 then the results are
statistically significant (or unlikely due to chance) and there is strong enough evidence against the null hypothesis
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
12
Example
lt005
For Ceftazidim the difference in Odds Ratios for Denmark (OR=153) and Israel (OR=34) is statistically significant (plt005) For Ceftriaxone there is no evidence to conclude that the difference (between OR=80 and OR=37) is statistically significant (pgt005)
gt005
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in hospital-acquired versus community-acquired infections
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
13
Type I and Type II Errors
Type I error (false positive) Rejecting H0 when it is true α (alpha) the probability of Type I error Significance level (the probability of Type I error that we are willing to accept) usually α = 5 Confidence level 1- α usually 95 Type II error (false negative) Accepting H0 when it is false β the probability of Type II error
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
14
Power
The probability of finding a specified difference or larger when a true difference exists (the probability of correctly rejecting the null hypothesis) Power = [1 - (probability of a Type II Error)] =1- β
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
15
To define Power
bull Power depends on 1048707 significance level (α) 1048707 sample size 1048707 minimum size of the effect that would be clinically useful bull Fix α (= 5) and then try to minimize β (maximize 1 - β) bull Keeping other variables constant the best way to increase power is to increase sample size (Studies with small sample sizes tend to have low power) bull Typical power is 80 or greater
bull You can compute the power for a study that you are about to run (good idea) or you can compute post-hoc power after an experiment is done
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
16
RCT of homeopathic arnica for post fracture healing
Example
Conclusion
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
17
gt 005 (= α) probability of observing 5 difference or more when the null hypothesis is true pgt5 =gt do not reject null hypotesis
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
18
=gt do more research with a larger sample
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
19
Test statistic
bull A function of the sample data on which the decision is to be based
bull Follows the general format
0Observed Value - Expected Value (H )
Standard Error
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
20
0
xt
s n
Test statistic Example
variability
difference in means
one sample t-test statistic
statistical difference
difference in means
variability
micro0
H0 μ= μ0
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
Rejection area
0
xt
s n
Sampling distribution of t under H0
The rejection region is the set of all values of the test statistic that
cause us to reject the null hypothesis
The t-distribution contains all possible values of t computed for random sample means selected from the population described by H0
one sample t-test statistic
critical value
H0 μ= μ0
t t
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
22
One(two)-tailed statistical test
One-tailed Ha μgtμ0
Two-tailed Ha μneμ0
α=05
α=025 α=025
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
23
The hypothesis testing process bull Use your research question to define H0 and Ha
bull Collect samples data and determine sample statistics (eg sample mean
sample proportionhellip) bull Choose the appropriate statistical test
bull Check assumptions for this test
bull Express H0 and Ha in mathematical terms
bull Decide on a level of significance (usually 5) bull Calculate test statistic
bull Refer test statistic to known distribution it would follow with H0
bull Calculate p-value (a probability of a test statistic arising as or more extreme than observed if H0=true)
bull If p-value lt significance level then reject H0 otherwise do not reject H0
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
24
There are many different statistical tests The choice of which test to use depends on several factors The type of data (continuous nominal etc) The distribution of the data (normally distributed or not) The type of sample statistics (mean median proportion ratio etc)
Statistical test
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
25
One Sample t test Purpose to compare the mean score of a sample to a known value Assumptions bull Random sample bull Metric sample data bull Normally distributed sample data (although this assumption is less critical when the sample size ge 30)
0
xt
s n
0observed value - expected value (H )test statistic=
standard error
H0 μ= μ0
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
One sample t test - example
bull Research question Are patients at your clinic have higher level of blood creatinine than the national average bull H0 creatinine level in population of men in your clinic = creatinine level in general male population bull For healthy men creatinine levels are normally distributed
the average creatinine level in male population is μ0=09 mgdL
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
bull Sample
_
x 12
s = 0352
se= 0088
mg dL
mg dL
mg dL
checking normality
metric data
random sample
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
28
bull Test one-sample t-test
bull a=5 bull H0 μ=09 Ha μne09
bull 2-tailed test bull Test statistics t = (12-09) 0088 = 34 (=gt the results are 34 standard error units higher the expected value)
bull Use a statistic table to look up the t-distribution and find critical value t
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
29
df
α
t distribution depends on degrees of freedom df = n-1
t=213 (depends on df=n-1=15)
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
30
t=34
P-value is the area in the tails greater than |t|=34
bull Calculate p-value
t=-34 Here p lt a=005
bull P-value lt a =gt reject the null hypothesis
We conclude that the result we saw was unlikely to have occurred by chance alone and that difference in mean creatinine levels in malersquos from the clinic and in a general male population is statistically significant (005 significance level)
t
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
31
One sample t test ndash in SPSS
plt5 =gt Reject Ho Difference is statistically significant
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
32
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
Alternatively Estimation
Mean is
unknown
Population Random Sample I am 95
confident that is between
101 amp 138
Mean
X = 12
Sample
CI = an interval of values that contains the true value of the parameter with specified confidence
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
34
95 CI for a population mean
(If is known)
bull Assumptions
ndash Population standard deviation () is known (this is hardly
ever true)
ndash Population is normally distributed or sample is large
n
σ961Xμ 95 Confidence Interval Estimate
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
35
95 CI for a population mean
( If is unknown)
bull Assumptions
ndash Population standard deviation ( ) is unknown =gt use
sample standard deviation (s)
ndash Population is normally distributed or sample is large
95 Confidence Interval Estimate n
stXμ
Use a statistic table to look up the t-distribution and find critical value t
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
36
CI of the Mean in SPSS (rsquocreatininersquo example)
The 95 confidence interval does not include the comparison value (09) This is equivalent to rejecting the null hypothesis
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
37
Graphical presentation of a CI
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
38
CI of the Mean Difference does not include 0 lt=gt p-valuelt005 =gt reject H0
CI for a Mean Difference
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
39
In Denmark the CI of the OR contains 1 (08-18)
=gt despite a sample OR of nearly 4 there is no evidence to conclude
that hospital acquisition of a coagulase-negative staphylococci in Denmark is a statistically significant rsquoriskrsquo for resistance to penicillin
In Israel the CI of the OR does not contain 1 (13-38) =gt hospital acquisition of a coagulase-negative staphylococci in Israel is a statistically significant rsquoriskrsquo for resistance to penicillin
13th ICID Abstract 66004
Odds Ratios of antimicrobial resistance in nosocomial versus non-nosocomial infections
CI for an Odds Ratio
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
40
CI of the OR in SPSS (rsquoApgar scorersquo example)
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
41
Learning Objectives bull Outline sources of ideashypotheses bull Understand the process of hypothesis testing
bull Understand the purpose and interpretation of confidence intervals
42
42