Side effects of Avandia. Rosiglitazone is the active ingredient in the controversial type 2 diabetes medicine Avandia and has been linked to an increased risk of serious cardiovascular problems such as stroke, heart failure, and death. A common alternative treatment is pioglitazone, the active ingredient in a diabetes medicine called Actos. In a nationwide retrospective observational study of 227,571 Medicare beneficiaries aged 65 years or older, it was found that 2,593 of the 67,593 patients using rosiglitazone and 5,386 of the 159,978 using pioglitazone had serious cardiovascular problems. These data are summarized in the contingency table below.
Cardiovascular problems Yes No Total
Treatment Rosiglitazone 2,593 65,000 67,593 Pioglitazone 5,386 154,592 159,978 Total 7,979 219,592 227,571
(a) Determine if each of the following statements is true or false. If false, explain why. Be careful: The reasoning may be wrong even if the statement’s conclusion is correct. In such cases, the statement should be considered false.
i. Since more patients on pioglitazone had cardiovascular problems (5,386 vs. 2,593), we can conclude that the rate of cardiovascular problems for those on a pioglitazone treatment is higher.
ii. The data suggest that diabetic patients who are taking rosiglitazone are more likely to have cardio- vascular problems since the rate of incidence was (2,593 / 67,593 = 0.038) 3.8% for patients on this treatment, while it was only (5,386 / 159,978 = 0.034) 3.4% for patients on pioglitazone.
iii. The fact that the rate of incidence is higher for the rosiglitazone group proves that rosiglitazone causes serious cardiovascular problems.
iv. Based on the information provided so far, we cannot tell if the difference between the rates of incidences is due to a relationship between the two variables or due to chance.
(b) What proportion of all patients had cardiovascular problems?
(c) If the type of treatment and having cardiovascular problems were independent, about how many patients in the rosiglitazone group would we expect to have had cardiovascular problems?
(d) We can investigate the relationship between outcome and treatment in this study using a randomization technique. While in reality we would carry out the simulations required for randomization using statisti- cal software, suppose we actually simulate using index cards. In order to simulate from the independence model, which states that the outcomes were independent of the treatment, we write whether or not each patient had a cardiovascular problem on cards, shuffled all the cards together, then deal them into two groups of size 67,593 and 159,978. We repeat this simulation 1,000 times and each time record the num- ber of people in the rosiglitazone group who had cardiovascular problems. Use the relative frequency histogram of these counts to answer (i)-(iii).
i. What are the claims being tested?
ii. Compared to the number calculated in part (b), which would provide more support for the alterna- tive hypothesis, more or fewer patients with car- diovascular problems in the rosiglitazone group?
iii. What do the simulation results suggest about the relationship between taking rosiglitazone and hav- ing cardiovascular problems in diabetic patients?
Simulated rosiglitazone cardiovascular events 2250 2350 2450
Why Work with Us
Top Quality and Well-Researched Papers
Our writers have been trained on how to handle papers placed by our clients. The writer must read and understand before embarking on writing the papers. In case of any issue that needs clarification, writers are encouraged to ask the client or support.
Professional and Experienced Academic Writers
Our team comprises of the best writers and editors. We do thorough vetting during recruitment to make sure that our writers have the knowledge and experience we aspire in the team.
Free Unlimited Revisions
Our aim is to give the client the best outcome. If for some reason you are not satisfied with the wok done, you can ask the paper to be revised or rewritten. This will be done to your satisfaction with no extra charges.
Prompt Delivery and 100% Money-Back-Guarantee
We have writers who work round the clock. This helps in making sure that all our clients’ papers are delivered on time. If we have issues with the deadline, we will ask for extension. If its not possible, the money is fully refunded.
Original & Confidential
Our clients’ confidentiality is highly respected. We can never disclose our clients’ details to third parties. In the same regard, we strive to give our clients 100% original papers. We do not tolerate plagiarism from our writers.
24/7 Customer Support
Clients can reach us any time of the day, and any day of the week. There is a live chat, email or phone numbers to help in ease of communication.
Try it now!
How it works?
Follow these simple steps to get your paper done
Place your order
Fill in the order form and provide all details of your assignment.
Proceed with the payment
Choose the payment system that suits you most.
Receive the final file
Once your paper is ready, we will email it to you.
You should never be worried about your papers even in the middle of the night. Our team will work round the clock to deliver.
We have an able team that can deliver your work in the shortest time possible. The academic level or the type of work should never be a hindrance. Our highly competent support team is always around (24/7) to give you any assistance you may need.
Admission Essays & Business Writing Help
Do you need to be admitted in your dream institution but find it challenging to write an admission essay? Our team is in a position to write the best letter that will guarantee you an admission. We do as well write the best business proposals and reports.
Writing can be fun and enjoyable when everything has been done right. Writing is not just enough without proper editing and proofreading. We have a team of editors that ensure everything falls in place, whether its issues to do with grammar or referencing styles.
Once the paper has been done and submitted, that is not the end of it. You can always ask for amendment or improvement if you feel something has not been done right. Our team of writers and editors will gladly assist you to your satisfaction. Revision is free of charge.