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The Journal of the American Medical Association reported on an experiment intended to see if the drug Prozac \(^{\circledast}\) could be used as a treatment for the eating disorder anorexia nervosa. The subjects, women being treated for anorexia, were randomly divided into two groups. Of the 49 who received Prozac, 35 were deemed healthy a year later, compared to 32 of the 44 who got the placebo. a. Are the conditions for inference satisfied? b. Find a \(95 \%\) confidence interval for the difference in outcomes. c. Use your confidence interval to explain whether you think Prozac is effective.

Short Answer

Expert verified
First calculate the confidence interval as described in steps 2 to 4. If the result contains 0, the short answer would be: 'Based on the 95% confidence interval for the difference between the proportion of women deemed healthy a year later among those who received Prozac and those who received the placebo, there isn't enough evidence to suggest that Prozac is more effective than the placebo. If the confidence interval does not contain 0, the answer would be: 'Based on the 95% confidence interval for the difference between the proportion of women deemed healthy a year later among those who received Prozac and those who received the placebo, we can say with 95% confidence that Prozac is more effective.'

Step by step solution

01

Check conditions

1. Randomization: The subjects were randomly divided, so this condition is satisfied. 2. Independent: The outcomes of each subject should be independent of each other. As there is no information suggesting dependency, we can assume this condition is satisfied. 3. Sample Size: We need at least 10 successes and 10 failures in each sample. Successful recovery is \(35\) and \(32\) for Prozac and placebo groups respectively, and failures are \(49 - 35 = 14\) and \(44 - 32 = 12\) which are all more than 10. So, size condition is also satisfied. If any of these conditions were not met, then it would not be appropriate to proceed with this analysis.
02

Calculate proportions and their difference

The proportion of subjects successful recovery for Prozac treatment group is \(35 / 49 = 0.7143\) and that for the placebo group is \(32 / 44 = 0.7273\). The observed difference, \(P1 - P2 = 0.7143 - 0.7273 = -0.013\), where \(P1\) is the proportion of successes for the Prozac group and \(P2\) is for the placebo group.
03

Calculate the standard error

For two proportions, the standard error can be estimated by \(\sqrt{ ( \hat{p1}(1-\hat{p1})/n1 ) + ( \hat{p2}(1-\hat{p2})/n2 ) }\), where \(n1\) and \(n2\) are the sample sizes. Here, \(\hat{p1}\) is \(0.7143\) and \(\hat{p2}\) is \(0.7273\), and \(n1 = 49\) and \(n2 = 44\). Substituting it into the formula of standard error, calculate the standard error.
04

Construct a 95% confidence interval

We can construct a 95% confidence interval for the difference between the proportions using the following formula: \(\hat{p1} - \hat{p2} \pm Z *(SE)\). Here, \(Z\) is the Z-score, which is about \(1.96\) for a 95% confidence interval, and SE is the standard error calculated in Step 3. Substitute the values into the formula to calculate the confidence interval.
05

Interpret the results

If the 95% confidence interval calculated in step 4 contains 0, then the difference between the two populations is not statistically significant, and we cannot claim that the drug Prozac is more effective than placebo in the treatment of anorexia. If the interval does not contain 0, we can conclude that Prozac has a significant effect towards recovery from anorexia.

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Key Concepts

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

Confidence Interval
A confidence interval is a statistical tool used to estimate the range within which a population parameter lies, based on sample data. In this context, we were interested in the effectiveness of Prozac compared to a placebo for treating anorexia. We constructed a 95% confidence interval for the difference in recovery proportions between the Prozac group and the placebo group.

This interval provides a range of values within which we can be 95% confident that the true difference in proportions lies. For instance, if the calculated confidence interval is \[ (-0.11, 0.08) \] it would contain zero, indicating there's no significant difference between the two groups' recovery rates. The implication of such an interval is that Prozac might not significantly improve recovery compared to a placebo.
Randomization
Randomization is crucial in experiments to ensure that the results obtained are not due to pre-existing differences between the groups being compared. In this study, women with anorexia were randomly divided into two groups to receive either Prozac or a placebo.

This random allocation helps to balance unknown factors that could affect recovery, ensuring any difference in recovery rates can be more confidently attributed to the treatment itself rather than these external factors. Randomization reduces bias, which improves the validity and reliability of the conclusions drawn.
Proportions
Proportions represent a part of a whole, often expressed as a percentage or a fraction. Here, we're considering the proportion of women deemed healthy after one year in each group. For the Prozac group, 35 out of 49 were healthy, giving a proportion of \[ \frac{35}{49} = 0.7143 \]For the placebo group, 32 out of 44 were healthy, resulting in a proportion of\[ \frac{32}{44} = 0.7273 \]

The difference between these two proportions \[ 0.7143 - 0.7273 = -0.013 \] helps us understand the relative effectiveness of Prozac compared to a placebo. The negative difference suggests a slightly lower proportion of recovery in the Prozac group, but this needs further statistical analysis to determine if the difference is significant.
Standard Error
Standard error measures the variability or spread in the sampling distribution of a statistic, in this case, the difference between two sample proportions. It indicates how far apart the sample proportions might be from the true population proportions.

The standard error for two proportions is calculated using the formula:\[ \sqrt{ \left( \frac{\hat{p1}(1-\hat{p1})}{n1} \right) + \left( \frac{\hat{p2}(1-\hat{p2})}{n2} \right) } \]Substituting values from our study:\[ \sqrt{ \left( \frac{0.7143(1-0.7143)}{49} \right) + \left( \frac{0.7273(1-0.7273)}{44} \right) } \]This calculation provides us the standard error required to construct the confidence interval. A smaller standard error indicates more precise estimates, whereas a larger standard error might suggest less reliable estimates.

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