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Chapter 14: Problem 49

Refer to a landmark study conducted in 1896 in Denmark by Dr. Johannes Fibiger, who went on to receive the Nobel Prize in Medicine in \(1926 .\) The purpose of the study was to determine the effectiveness of a new serum for treating diphtheria, a common and often deadly respiratory disease in those days. Fibiger conducted his study over a one-year period (May 1896-April 1897) in one particular Copenhagen hospital. New diphtheria patients admitted to the hospital received different treatments based on the day of admission. In one set of days (call them "even" days for convenience), the patients were treated with the new serum daily and received the standard treatment. Patients admitted on alternate days (the "odd" days) received just the standard treatment. Over the one-year period of the study, eight of the 239 patients admitted on the "even" days and treated with the serum died, whereas 30 of the 245 patients admitted on the "odd" days died. (a) Describe as specifically as you can the target population for Fibiger's study. (b) Describe the sampling frame for the study.

Short Answer

Expert verified
The target population for Fibiger's study is all individuals who were sick with diphtheria. The sampling frame refers to the diphtheria patients who got admitted to the specific Copenhagen hospital from May 1896 to April 1897 and underwent treatment. The study results indicate a lower mortality rate for patients treated with the new serum compared to those receiving the standard treatment alone.

Step by step solution

01

Identifying the Target Population

The target population in a study is the entire group that you are interested in drawing conclusions about. For Fibiger's study, the target population would be all individuals who were ill with diphtheria.
02

Defining the Sampling Frame

The sampling frame is a list of items or people forming a population from which a sample is taken. In this case, the sampling frame for the study can be considered as the patients who were admitted to the Copenhagen hospital with diphtheria from May 1896 to April 1897 and were treated either with the standard treatment or with the new serum depending on the day of admission.
03

Interpreting the Study Results

The study results are interpreted based on the comparison of the outcomes from the two sets of patients: those admitted on even days (and treated with the new serum) versus those admitted on odd days (receiving only the standard treatment). By comparing the mortality rates of the two groups (8 out of 239 for the even days and 30 out of 245 for the odd days), it can be inferred that patients treated with the new serum had a lower mortality rate than those who received just the standard treatment.

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Key Concepts

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

Target Population
Understanding the target population is essential when designing a study. The target population represents the entire group about which researchers want to draw conclusions. In Dr. Johannes Fibiger's diphtheria study, the target population comprised all individuals suffering from diphtheria at the time. This focus is crucial because it sets the boundaries for who can be impacted by the findings of the study.

By clearly defining the target population, researchers like Fibiger aimed to ensure that the findings of their research would be relevant and applicable to the right group. This step of defining the target population helps guide the study's direction and ensures that the outcomes can contribute to better treatments and interventions for the disease being studied.
Sampling Frame
Constructing a sampling frame involves identifying and listing the members of the target population that will be studied. It's a crucial step because it serves as the source from which a sample is drawn. For Fibiger's study, the sampling frame was the group of patients admitted to the Copenhagen hospital with diphtheria from May 1896 to April 1897.

By establishing this sampling frame, Fibiger was able to focus specifically on a subset of the target population that was accessible and practical to study within the timeframe. It's important to ensure that the sampling frame is as inclusive and representative as possible to minimize biases. By doing so, the study results are more likely to reflect the true characteristics of the broader target population.
Clinical Trial
A clinical trial is an essential component of experimental design, especially in medical research. It is a systematic investigation aimed at evaluating the effectiveness of new treatments or interventions in humans. In Dr. Fibiger鈥檚 study, the clinical trial helped assess the new serum's ability to treat diphtheria by observing and recording the health outcomes of patients.

These trials are key because they provide data on safety and efficacy. For instance, Fibiger assessed mortality rates under different treatments to infer the serum's benefits. Clinical trials involve rigorous protocols to ensure the dependability of their findings, which can then lay the groundwork for broader applications in public health.
Comparative Study
The principle of a comparative study involves evaluating two or more groups to determine differences and similarities. Fibiger's experiment was a classic comparative study, where patients were divided based on an objective criterion: their day of admission. This stratification allowed for a clear comparison between those who received the new serum and those who did not.

Comparative studies help in establishing cause-and-effect relationships. By comparing outcomes鈥攕uch as the differing mortality rates in Fibiger's patients鈥攔esearchers can draw conclusions about the efficacy of a treatment. In this study, such comparison indicated the new serum鈥檚 potential benefits, providing evidence to support its use in broader medical practice.

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Most popular questions from this chapter

Refer to a study on the effectiveness of an HPV (human papilloma virus) vaccine conducted between October 1998 and November \(1999 .\) HPV is the most common sexually transmitted infection-more than 20 million Americans are infected with HPV-but most HPV infections are benign, and in most cases infected individuals are not even aware they are infected. (On the other hand, some HPV infections can lead to cervical cancer in women.) The researchers recruited 2392 women from 16 different centers across the United States to participate in the study through advertisements on college campuses and in the surrounding communities. To be eligible to participate in the study, the subjects had to meet the following criteria: (1) be a female between 16 and 23 years of age, (2) not be pregnant, (3) have no prior abnormal Pap smears, and (4) report to have had sexual relations with no more than five men. At each center, half of the participants were randomly selected to receive the HPV vaccine, and the other half received a placebo injection. After 17.4 months, the incidence of HPV infection was 3.8 per 100 woman-years at risk in the placebo group and 0 per 100 woman-years at risk in the vaccine group. In addition, all nine cases of HPV-related cervical precancerous growths occurred among the placebo recipients. (a) Describe the sample for the study. (b) Was the sample chosen using random sampling? Explain.

Refer to the following story (see also Exercise 32): The Dean of Students at Tasmania State University wants to determine how many undergraduates at TSU are familiar with a new financial aid program offered by the university. There are 15,000 undergraduates at \(T S U,\) so it is too expensive to conduct a census. The following sampling method, known as systematic sampling, is used to choose a representative sample of undergraduates to poll. Start with the registrar's alphabetical listing containing the names of all undergraduates. Randomly pick a number between 1 and \(100,\) and count that far down the list. Take that name and every 100 th name after it. For example, if the random number chosen is \(73,\) then pick the \(73 \mathrm{rd}, 173 \mathrm{rd}, 273 \mathrm{rd},\) and so forth, names on the list. (a) Compare and contrast the sampling frame and the target population for this survey. (b) Give the exact \(N\) -value of the population.

Refer to the following story: The 1250 students at Eureka High School are having an election for Homecoming King. The candidates are Tomlinson (captain of the football team), Garcia (class president), and Marsalis (member of the marching band). At the football game a week before the election, a pre- election poll was taken of students as they entered the stadium gates. Of the students who attended the game, 203 planned to vote for Tomlinson, 42 planned to vote for Garcia, and 105 planned to vote for Marsalis. (a) Give the sample statistics estimating the percentage of the vote going to each candidate. (b) A week after this survey, Garcia was elected Homecoming King with \(51 \%\) of the vote, Marsalis got \(30 \%\) of the vote, and Tomlinson came in last with \(19 \%\) of the vote. Find the sampling errors in the survey expressed as percentages.

Refer to the following story (see also Exercise 32): The Dean of Students at Tasmania State University wants to determine how many undergraduates at TSU are familiar with a new financial aid program offered by the university. There are 15,000 undergraduates at \(T S U,\) so it is too expensive to conduct a census. The following sampling method, known as systematic sampling, is used to choose a representative sample of undergraduates to poll. Start with the registrar's alphabetical listing containing the names of all undergraduates. Randomly pick a number between 1 and \(100,\) and count that far down the list. Take that name and every 100 th name after it. For example, if the random number chosen is \(73,\) then pick the \(73 \mathrm{rd}, 173 \mathrm{rd}, 273 \mathrm{rd},\) and so forth, names on the list. (a) Explain why the method used for choosing the sample is not simple random sampling. (b) If \(100 \%\) of those responding claimed that they were not familiar with the new financial aid program offered by the university, is this result more likely due to sampling variability or to sample bias? Explain.

Refer to a clinical trial named APPROVe designed to determine whether Vioxx, a medication used for \(a r\) thritis and acute pain, was effective in preventing the recurrence of colorectal polyps in patients with a history of colorectal adenomas. APPROVe was conducted between 2002 and 2003 and involved 2586 participants, all of whom had a history of colorectal adenomas. The participants were randomly divided into two groups: 1287 were given 25 milligrams of Vioxx daily for the duration of the clinical trial (originally intended to last three years), and 1299 patients were given a placebo. Neither the participants nor the doctors involved in the clinical trial knew who was in which group. During the trial, 72 of the participants had cardiovascular events (mostly heart attacks or strokes). Later it was found that 46 of these people were from the group taking the Vioxx and only 26 were from the group taking the placebo. Based on these results, the clinical trial was stopped in 2003 and Vioxx was taken off the market in 2004. Describe the sample for APPROVe.
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