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Doctors and nurses Nurse-practitioners are nurses with advanced qualifications who often act much like primary-care physicians. Are they as effective as doctors at treating patients with chronic conditions? An experiment was conducted with 1316patients who had been diagnosed with asthma, diabetes, or high blood pressure. Within each condition, patients were randomly assigned to either a doctor or a nurse-practitioner. The response variables included measures of the patients' health and of their satisfaction with their medical care after 6months.50

a. Which are the blocks in this experiment: the different diagnoses (asthma, diabetes, or high blood pressure) or the type of care (nurse or doctor)? Why?

b. Explain why a randomized block design is preferable to a completely randomized design in this context.

c. Suppose the experiment used only diabetes patients, but there were still 1316subjects willing to participate. What advantage would this offer? What disadvantage?

Short Answer

Expert verified

(a) The blocks in this experiment are different diagnoses.

(b) The randomized block design is preferred due to lesser variability in blocks.

(c) The advantage is that result does not differ by the diagnosis of patient and disadvantage is that it only applicable for diabetes patient.

Step by step solution

01

Part (a) Step 1: Given information

We need to find whether the blocks in this experiment are different diagnoses or type of care.

02

Part (a) Step 2: Explanation

We know that

  • The patients had asthma, diabetes, or high blood pressure, and they were assigned to a nurse or doctor at random (type of care).
  • The treatments are being treated by a doctor and being treated by a nurse since the patients were randomly assigned to a doctor or a nurse (thus the types of care are the treatments).

The blocks cannot be therapies; instead, they must be patient features, and so the diagnoses must be separate blocks.

03

Part (b) Step 1: Given information

We need to find the reason for preference of randomized block design.

04

Part (b) Step 2: Explanation

We know that

The patients had asthma, diabetes, or high blood pressure, and they were assigned to a nurse or doctor at random (type of care). The diagnosis are represented by the blocks.

Comparing the outcomes inside a completely randomized experiment would be far more challenging, because a person's health and happiness with their diagnoses could be closely associated (some diagnoses require more specialized care than other diagnoses).

05

Part (c) Step 1: Given information

We need to find the advantages and disadvantages.

06

Part (c) Step 2: Explanation

The advantage of employing only diabetic patients is that the effects of the therapies are unaffected by the patients' diagnoses (because we excluded those without a diabetes diagnosis), making our results more credible for diabetes patients.

The disadvantage is that the findings will only apply to diabetic patients and not to the broader public (as we only included diabetes patients in the study).

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