Rosiglitazone is the active ingredient in the controversial type 2 diabetes medicine Avandia and has been inked 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. Yes No Total Rosiglitazone 2,593 65,000 67,593 5,386 154,592 159,978 7,979 219,592 227,571 Pioglitazone Total a) What proportion of patients using Rosiglitazone had cardiovascular problems? b) What proportion of patients using Pioglitazone had cardiovascular problems? =) What is the point estimate for the difference of proportions of serious cardiovascular problems between patients using Rosiglitazone and Pioglitazone? (Take your answer from part A and subtract your answer from part B.)

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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.
Yes
No
Total
Rosiglitazone 2,593
65,000
67,593
5,386 154,592 159,978
7,979 219,592 227,571
Pioglitazone
Total
a) What proportion of patients using Rosiglitazone had cardiovascular problems?
b) What proportion of patients using Pioglitazone had cardiovascular problems?
c) What is the point estimate for the difference of proportions of serious cardiovascular problems between
patients using Rosiglitazone and Pioglitazone?
· (Take your answer from part A and subtract
your answer from part B.)
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 statistical
software, suppose we actually simulate using index cards. In order to simulate from the null hypothesis,
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 10,000 times and each time record the proportion of
people in the Rosiglitazone group who had cardiovascular problems. Below is a histogram of these
proportions.
Point estimate
-0.006 -0.004 -0.002
0.000
0.002
0.004
0.006
d) What are the claims being tested?
Ho:
Select an answer
HA:
Select an answer
e) Based on the simulations, what is the p-value?
O less than .01 (strong evidence of a difference)
O between .01 and .05 (moderate evidence of of a difference)
O between .05 and .10 (little evidence of a difference)
O more than .10 (no evidence of a difference)
f) What do the simulation results suggest about the difference in proportions between taking Rosiglitazone
and Pioglitazone?
O Patients in the Pioglitazone group were more likely to have serious cardiovascular problems.
O Any differences in the problem rates of Rosiglitazone and Pioglitazone patients in our sample was
likely just random chance.
O Patients in the Rosiglitazone group were more likely to have serious cardiovascular problems.
Frequency
0 500
00s
Transcribed Image Text: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. Yes No Total Rosiglitazone 2,593 65,000 67,593 5,386 154,592 159,978 7,979 219,592 227,571 Pioglitazone Total a) What proportion of patients using Rosiglitazone had cardiovascular problems? b) What proportion of patients using Pioglitazone had cardiovascular problems? c) What is the point estimate for the difference of proportions of serious cardiovascular problems between patients using Rosiglitazone and Pioglitazone? · (Take your answer from part A and subtract your answer from part B.) 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 statistical software, suppose we actually simulate using index cards. In order to simulate from the null hypothesis, 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 10,000 times and each time record the proportion of people in the Rosiglitazone group who had cardiovascular problems. Below is a histogram of these proportions. Point estimate -0.006 -0.004 -0.002 0.000 0.002 0.004 0.006 d) What are the claims being tested? Ho: Select an answer HA: Select an answer e) Based on the simulations, what is the p-value? O less than .01 (strong evidence of a difference) O between .01 and .05 (moderate evidence of of a difference) O between .05 and .10 (little evidence of a difference) O more than .10 (no evidence of a difference) f) What do the simulation results suggest about the difference in proportions between taking Rosiglitazone and Pioglitazone? O Patients in the Pioglitazone group were more likely to have serious cardiovascular problems. O Any differences in the problem rates of Rosiglitazone and Pioglitazone patients in our sample was likely just random chance. O Patients in the Rosiglitazone group were more likely to have serious cardiovascular problems. Frequency 0 500 00s
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