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Chapter 10: Problem 12

Antibiotic or Placebo A large number of surgery patients get infections after surgery, which can sometimes be quite serious. Researchers randomly assigned some surgery patients to receive a simple antibiotic ointment after surgery, others to receive a placebo, and others to receive just cleansing with soap. If we wanted to test the association between treatment and whether or not patients get an infection after surgery, would this be a test of homogeneity of of independence? Explain. (Source: Hospitals could stop infections by tackling bacteria patients bring in, studies find. New York Times, January \(6,2010 .)\)

Short Answer

Expert verified
This test is a test of independence, as it seeks to evaluate the relationship or association between the type of treatment given and infection occurrence in the same population of surgery patients.

Step by step solution

01

Reviewing the Problem

The study described is about surgery patients and the treatment they received post-surgery. The three types of treatments given were antibiotic ointment, placebo, and cleansing with soap, and the response variable is whether or not an infection occurred post-surgery. We need to decide if this would be a test of homogeneity or of independence in order to test the association between treatment and infection occurrence.
02

Defining the Tests

A test of homogeneity is when we look at the distribution of a single categorical variable across different populations. On the other hand, a test of independence is when two categorical variables are considered in the same population to see if they are independent. Here, our two categories are 'treatment given' and 'whether or not infection occurred'.
03

Applying the Concepts to the Problem

Since the study is effectively looking for any association between the treatment and whether an infection occurs in the same population of surgery patients, this can be viewed as a test of independence. A test of homogeneity would be more appropriate if we were comparing the distribution of infections across different populations.

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Key Concepts

These are the key concepts you need to understand to accurately answer the question.

Surgical Infections
Surgical infections are a common concern for patients undergoing surgery. These infections occur at the site of the surgery and can lead to complications in the patient's recovery process. There are different factors contributing to surgical infections, including the type of surgery, the environment, and the patient's own health condition.
Managing surgical infections is critical. It requires an understanding of the causes and appropriate preventative measures.
It's essential to mitigate risks by maintaining sterile environments during surgery and providing appropriate aftercare. Education on post-operative care is also vital to prevent infection and ensure fast recovery.
Understanding how treatments like antibiotics, placebos, or even simple washing with soap play a role in preventing infections can help in creating better healthcare practices. By having a well-structured prevention plan, the risk of these infections can be significantly reduced.
Antibiotic Treatment
Antibiotic treatments are one of the primary defenses against bacterial infections. They work by killing bacteria or preventing their growth, which helps in overcoming infections more efficiently.
When it comes to surgery patients, antibiotics are used post-operatively to reduce the risk of infection at the surgical site. The effectiveness of antibiotic treatments varies depending on the type of bacteria and the patient's health condition.
However, the use of antibiotics also needs to be judicious. Overuse or misuse can lead to antibiotic resistance, where bacteria evolve to resist the effects of medication, making infections harder to treat.
It's crucial to adhere to prescribed doses and treatment durations, tailored to the patient鈥檚 specific needs. Patients should follow medical guidance strictly to prevent complications and avoid resistance issues.
Researchers regularly study the balance between effectiveness and risks to ensure antibiotics remain effective tools in healthcare.
Placebo Effect
The placebo effect is a fascinating psychological phenomenon where patients experience real changes in their health after receiving a treatment that has no therapeutic effect, like a sugar pill or a fake cream.
It's based on the power of belief and expectation. Patients receiving a placebo often report improvements simply because they believe they are being treated.
This effect plays a significant role in medical research, helping to test the actual effectiveness of new treatments compared to placebo.
When studying surgical infections, comparing the results of those treated with an antibiotic, a placebo, or just soap washing can help determine how much of the outcome might be attributed to belief rather than the treatment itself.
Understanding the placebo effect is crucial for designing clinical trials and interpreting their results correctly, ensuring that the treatments being tested are truly effective apart from any psychological influences.

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Most popular questions from this chapter

Funds and Returns In May 2016, the Economic Times reported that "Growth- oriented funds tend to exhibit strong returns within a short span of time." Is this conclusion likely to be the result of an observational study or a controlled experiment? Is it saying that growth-oriented funds lower the risk of low returns?

Party and Right Direction (Example 3) Suppose a polling organization asks a random sample of people if they are Democrat, Republican, or Other and also asks them if they think the country is headed in the right direction or the wrong direction. If we wanted to test whether party affiliation and answer to the question were associated, would this be a test of homogeneity or a test of independence? Explain.

Effect of Confederates on Compliance (Example 7) A study was done to see whether participants would ignore a sign that read, "Elevator may stick between floors. Use the stairs." The people who used the stairs were classified as compliant, those who used the elevator as noncompliant. The study was done in a university dorm on the ground floor of a building that had three floors. There were three different situations, two of which involved a person who was secretly working with the experimenter. (This person is called a confederate.) In the first situation, there was no other person using the stairs or elevator - that is, no confederate. In the second, there was a compliant confederate (one who used the stairs). In the third, there was a noncompliant confederate (one who used the elevator). Suppose that the participants (people who arrived to use the elevator at the time the experiment was going on) were randomly assigned to the three groups. There were significant differences between groups. a. Can we generalize widely to a large group? Why or why not? b. Can we infer causality? Why or why not?

Tight Control of Blood Sugar "Tight glycemic control" means that the blood sugar is kept within a narrow range. Read the abstract below, and then answer the questions that follow it. "Methods: In this two-center, prospective, randomized trial, we enrolled 980 children, 0 to 36 months of age, undergoing surgery with cardiopulmonary bypass. Patients were randomly assigned to either tight glycemic control ... targeting a blood glucose level of 80 to \(110 \mathrm{mg}\) per deciliter \(\ldots\) or standard care in the cardiac intensive care unit. Results: A total of 444 of the 490 children assigned to tight glycemic control ( \(91 \%\) ) received insulin versus 9 of 490 children assigned to standard care \((2 \%) \ldots\) [T]ight glycemic control was not associated with a significantly decreased rate of health careassociated infections \((8.6\) vs. \(9.9\) per 1000 patient-days, \(\mathrm{P}=0.67\) ). Conclusions: Tight glycemic control can be achieved with a low hypoglycemia rate after cardiac surgery in children, but it does not significantly change the infection rate \(\ldots .\) as compared with standard care." a. Identify the treatment variable and the response variable. b. Was this a controlled experiment or an observational study? Explain. c. What does the p-value show? d. Can you conclude that the use of tight glycemic control affects the rate of infections? Why or why not?

Treatment of Diarrhea A research group compared probiotics with antibiotics to know the best way to treat diarrhea. It showed that consumption of probiotics was a better way to cure diarrhea than antibiotics. a. What do you need to know to decide whether this was an observational study or a controlled cxperiment? b. Why do controlled experiments with randomization allow us to draw conclusions implying cause and effect?
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