EXHIBIT 2 Catching a Breath_ ninpi2lest Stopping Sleep Apnea Statistical versus Clinical Significance: They Are Not the Same Title: The Skeptical Scalpel Author: Skeptical Scalpel, August 8, 2011, http://skepticalscalpel.blogspot.com/2011/08/ Source: statistical-vs-clinical-significance.html In reference to an article that appeared on MedPage Today, August 5th, 2011 ("Compression Stocking Help Sleep Apnea," by Michael Smith), the Skeptical Scalpel writes: MedPage Today featured an article about the beneficial effects of daytime wearing of compression stockings on obstructive sleep apnea. The premise was that increased edema in the neck could be caused by fluid coming from the legs when patients were in the supine position at night. Twelve patients who served as their own controls wore compression stockings for a week and then no stockings for a week alternating. The stockings lowered the amount of fluid in the neck by 60%. a statistically significant difference. So far, so good. This resulted in another highly statistically significant finding, which was a 36% reduction in episodes of apnea [cessation of breathing] and hypopnea [inadequate breathing]. Sounds good, right? The problem is that the average number of episodes of apnea/hypopnea decreased from 48 per hour to 31 per hour. Patients experiencing more than 30 episodes of apnea/hypopnea per hour are classified as having severe obstructive sleep apnea. This means that the treatment only put the patients in the low range of severe obstructive sleep apnea. They still would require maximum therapy. Is a reduction in apnea/hypopnea episodes that does not move the patient out of the severe category really clinically significant? It does not seem so to me. Questions 1. Clearly identify what the null (H,) and alternative (H,) hypotheses appear to be in the context of this article. Which one was chosen and why? 2. The Skeptical Scalpel is making a point about practical significance. What is that point? Do you agree?

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EXHIBIT 2
Catching a Breath_
ninpi2lest
Stopping Sleep Apnea
Statistical versus Clinical Significance: They Are Not the Same
Title:
The Skeptical Scalpel
Author:
Skeptical Scalpel, August 8, 2011, http://skepticalscalpel.blogspot.com/2011/08/
Source:
statistical-vs-clinical-significance.html
In reference to an article that appeared on MedPage Today, August 5th, 2011 ("Compression
Stocking Help Sleep Apnea," by Michael Smith), the Skeptical Scalpel writes:
MedPage Today featured an article about the beneficial effects of daytime wearing of compression
stockings on obstructive sleep apnea. The premise was that increased edema in the neck could be
caused by fluid coming from the legs when patients were in the supine position at night. Twelve
patients who served as their own controls wore compression stockings for a week and then no
stockings for a week alternating. The stockings lowered the amount of fluid in the neck by 60%.
a statistically significant difference. So far, so good.
This resulted in another highly statistically significant finding, which was a 36% reduction in
episodes of apnea [cessation of breathing] and hypopnea [inadequate breathing]. Sounds
good, right? The problem is that the average number of episodes of apnea/hypopnea
decreased from 48 per hour to 31 per hour. Patients experiencing more than 30
episodes of apnea/hypopnea per hour are classified as having severe obstructive
sleep apnea. This means that the treatment only put the patients in the low range
of severe obstructive sleep apnea. They still would require maximum therapy. Is
a reduction in apnea/hypopnea episodes that does not move the patient out
of the severe category really clinically significant? It does not seem so to me.
Questions
1. Clearly identify what the null (H,) and alternative (H,) hypotheses appear to be in the context of
this article. Which one was chosen and why?
2. The Skeptical Scalpel is making a point about practical significance. What is that point?
Do you agree?
Transcribed Image Text:EXHIBIT 2 Catching a Breath_ ninpi2lest Stopping Sleep Apnea Statistical versus Clinical Significance: They Are Not the Same Title: The Skeptical Scalpel Author: Skeptical Scalpel, August 8, 2011, http://skepticalscalpel.blogspot.com/2011/08/ Source: statistical-vs-clinical-significance.html In reference to an article that appeared on MedPage Today, August 5th, 2011 ("Compression Stocking Help Sleep Apnea," by Michael Smith), the Skeptical Scalpel writes: MedPage Today featured an article about the beneficial effects of daytime wearing of compression stockings on obstructive sleep apnea. The premise was that increased edema in the neck could be caused by fluid coming from the legs when patients were in the supine position at night. Twelve patients who served as their own controls wore compression stockings for a week and then no stockings for a week alternating. The stockings lowered the amount of fluid in the neck by 60%. a statistically significant difference. So far, so good. This resulted in another highly statistically significant finding, which was a 36% reduction in episodes of apnea [cessation of breathing] and hypopnea [inadequate breathing]. Sounds good, right? The problem is that the average number of episodes of apnea/hypopnea decreased from 48 per hour to 31 per hour. Patients experiencing more than 30 episodes of apnea/hypopnea per hour are classified as having severe obstructive sleep apnea. This means that the treatment only put the patients in the low range of severe obstructive sleep apnea. They still would require maximum therapy. Is a reduction in apnea/hypopnea episodes that does not move the patient out of the severe category really clinically significant? It does not seem so to me. Questions 1. Clearly identify what the null (H,) and alternative (H,) hypotheses appear to be in the context of this article. Which one was chosen and why? 2. The Skeptical Scalpel is making a point about practical significance. What is that point? Do you agree?
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