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PHE5IST-Biostatistics

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1: Alcohol and nicotine consumption during pregnancy may harm children. Because drinking and smoking behaviours may be related, it is important to understand the nature of this relationship when assessing the possible effects on children. One study classified 452 mothers according to their alcohol intake prior to pregnancy recognition and their nicotine intake during pregnancy. The data are summarized in the following table (from Ann P. Streissguth et al., “Intrauterine alcohol and nicotine exposure: attention and reaction time in 4?year?old children,” Developmental Psychology, 20 (1984), pp. 533?541):
 
Carry out a complete analysis of the association between alcohol and nicotine consumption. That is, describe the nature and strength of this association and assess its statistical significance. You may include figures, if required, to display the associations.
 
2. Human immunodeficiency virus (HIV) counselling and testing is recognized as the gateway to HIV prevention and access to antiretroviral treatment (ART), care and support. In Sub-Saharan African countries, including South Africa, uptake of HIV testing among men remains a major challenge. The factors implicated in reduced likelihood of HIV testing in research studies include age, racial group, employment status, being single, place of residence, and sexual behaviours. A researcher presents you with the following data from a cross sectional survey of 112 men in a South African village that she has just completed. The data she collected included HIV testing in the last 12 months, together with socioeconomic and demographic information. She is particularly interested in HIV testing and the impact of unemployment, but also has other questions of interest.
 
a. The researcher wishes to know if undergoing HIV testing is associated with employment status.
 
i. What proportion of the population sampled underwent HIV testing?
 
ii. What proportion of those unemployed underwent HIV testing?
 
iii. What proportion of those employed underwent HIV testing?
 
iv. Based on i., ii. and iii., state whether you believe undergoing HIV testing is associated with employment status and give your reasons in a short answer.
 
v. Is undergoing HIV testing associated with employment status? Present a complete analysis – state your hypothesis, compute test statistic, p value and 95% CI and interpretation.
 
b. Using the fact that the odds ratio (OR) for the association between HIV testing and being employed is 2.15 with 95% CI (1.01, 4.62), report to the researcher your conclusion to her questions about HIV testing and the impact of employment status.
 
c. Before the researcher presents these results publicly, what should she be thinking of doing to strengthen them or make them more reliable? (Think about any weaknesses in the analysis so far.)
 
3.The therapeutic efficacy and tolerability of calcipotriol ointment and betamethasone ointment in psoriasis were compared in a multicentre, prospective, randomised, double-blind, right/left trial. 345 patients with psoriasis vulgaris were treated twice daily for 6 weeks with calcipotriol ointment and betamethasone ointment randomly assigned to opposite sides of the body. The severity of the condition was assessed by selfreport as “cleared”, “pronounced improvement”, “slight improvement”, “no change”, or “worse” and by the psoriasis area and severity index (PASI), scored by the investigator.
 
The reduction in PASI score was significantly lower (p < 0.001) for the calcipotriol side (mean reduction 68.8%) than the betamethasone side (mean reduction 61.4%). Patients were more likely to report “cleared” or “pronounced improvement” on the calcipotriol side (Kragballe et al., 1991).
 
a. Suggest 2 methods that could be used to carry out the significance test on the PASI score.
 
b. The self-assessment was recoded into two categories, “cleared or pronounced improvement” or “little or no improvement”. What method could be used to carry out the significance test for the recoded data?

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