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1 Wheel for assessing spinal block study Xue Han, Matt Shotwell, Department of Biostatistics Vanderbilt University December 13, 2012 Contents 1 Preliminary Summary 2 2 Fix effect examination, Ho: miu(n) = miu(p) Nonparametric Hypothesis Test Regression Analysis Random Effect Examination, Ho: sigma(n-observer)=sigma(p-observer) 8 List of Tables List of Figures 1 Distribution of Block Position for Group N and P, respectively Distribution of Block Position Difference between Group N and P Position Difference between N and P across Time

2 1 PRELIMINARY SUMMARY 1 Preliminary Summary Figure 1: Distribution of Block Position for Group N and P, respectively 2

3 1 PRELIMINARY SUMMARY Figure 2: Distribution of Block Position Difference between Group N and P 3

4 1 PRELIMINARY SUMMARY Figure 3: Position Difference between N and P across Time *Red/blue dots represent median of block position for Group N/P, error bars represent corresponding 25th and 75th pecentile at that specific time. 4

5 2 FIX EFFECT EXAMINATION, HO: MIU(N) = MIU(P) 2 Fix effect examination, Ho: miu(n) = miu(p) 2.1 Nonparametric Hypothesis Test Table 1a, 1b: Non parametric test to test the mean difference of block position between group N and group P Wilcoxon rank sum t e s t with c o n t i n u i t y c o r r e c t i o n data : datlongnew$positioncon by datlongnew$np W = , p value = a l t e r n a t i v e h y p o t h e s i s : t r u e l o c a t i o n s h i f t i s not equal to 0 Kruskal W a l l i s rank sum t e s t data : datlongnew$positioncon by datlongnew$np Kruskal W a l l i s chi squared = , df = 1, p value =

6 2.2 Regression Analysis 2 FIX EFFECT EXAMINATION, HO: MIU(N) = MIU(P) 2.2 Regression Analysis Table 2a: Mixed effect model, include subject as random effect Formula : P o s i t i o n c o n NP + o b s e r v e r + Time + L e ftright + (1 S u b j e c t ) Groups Name Variance Std. Dev. S u b j e c t ( I n t e r c e p t ) Residual Number o f obs : 776, groups : Subject, 41 ( I n t e r c e p t ) NPP observerjwd observerjw Time10min Time15min Time20min TimeEnd LeftRightR ( I n t r ) NPP obsjwd obsrjw Tm10mn Tm15mn Tm20mn TimEnd NPP observerjwd observerjw Time10min Time15min Time20min TimeEnd LeftRightR Table 2b: Regression Analysis:Mixed effect model including subject as random effect, considering interaction between Tools (N/P) and observers Formula : P o s i t i o n c o n NP * o b s e r v e r + Time + LeftRight + (1 S u b j e c t ) Groups Name Variance Std. Dev. S u b j e c t ( I n t e r c e p t ) Residual Number o f obs : 776, groups : Subject, 41 ( I n t e r c e p t ) NPP observerjwd observerjw Time10min Time15min Time20min TimeEnd LeftRightR NPP: observerjwd NPP: observerjw ( I n t r ) NPP obsjwd obsrjw Tm10mn Tm15mn Tm20mn TimEnd LftRgR NPP observerjwd observerjw

7 2.2 Regression Analysis 2 FIX EFFECT EXAMINATION, HO: MIU(N) = MIU(P) Time10min Time15min Time20min TimeEnd LeftRightR NPP: bsrvjwd NPP: bsrvrjw NPP:JWD NPP observerjwd observerjw Time10min Time15min Time20min TimeEnd LeftRightR NPP: bsrvjwd NPP: bsrvrjw Table 2c: Anova test indicate no benefit for adding the interaction term, so we choose the first model Models : mod1 : P o s i t i o n c o n NP + o b s e r v e r + Time + L e ftright + (1 S u b j e c t ) mod1blah : P o s i t i o n c o n NP * o b s e r v e r + Time + LeftRight + (1 S u b j e c t ) Df AIC BIC l o g L i k Chisq Chi Df Pr(>Chisq ) mod mod1blah Table 2d: MCMC sampling calculate p value for both summary mod1 and anova mod1 $ f i x e d Estimate MCMCmean HPD95lower HPD95upper pmcmc Pr( > t ) ( I n t e r c e p t ) NPP observerjwd observerjw Time10min Time15min Time20min TimeEnd LeftRightR $random Groups Name Std. Dev. MCMCmedian MCMCmean HPD95lower HPD95upper 1 S u b j e c t ( I n t e r c e p t ) Residual Df Sum Sq Mean Sq F value upper. den. df upper. p. v a l lower. den. df NP o b s e r v e r Time L e ftright lower. p. v a l e x p l. dev.(%) NP o b s e r v e r Time L e ftright Table 3: Observer distribution of Group N and P, observer TC was not included for regression analysis since he/she only observed one subject t a b l e ( datlongnew$n ) CB JW JWD TC t a b l e ( datlongnew$p ) CB JW JWD

8 3 RANDOM EFFECT EXAMINATION, HO: SIGMA(N-OBSERVER)=SIGMA(P-OBSERVER) 3 Random Effect Examination, Ho: sigma(n-observer)=sigma(pobserver) Table 4a: Model3: Random intercept model, include both observers and subjects as independent random effect Formula : P o s i t i o n c o n NP + (1 o b s e r v e r ) + (1 S u b j e c t ) Groups Name Variance Std. Dev. S u b j e c t ( I n t e r c e p t ) o b s e r v e r ( I n t e r c e p t ) Residual Number o f obs : 776, groups : Subject, 4 1 ; observer, 3 ( I n t e r c e p t ) NPP ( I n t r ) NPP Table 4b: Model4: Random intercept for subjects, assuming random effect observer nested within NP Formula : P o s i t i o n c o n NP + (1 o b s e r v e r :NP) + Time + L e ftright + (1 S u b j e c t ) Groups Name Variance Std. Dev. S u b j e c t ( I n t e r c e p t ) o b s e r v e r :NP ( I n t e r c e p t ) Residual Number o f obs : 776, groups : Subject, 4 1 ; o b s e r v e r :NP, 6 ( I n t e r c e p t ) NPP Time10min Time15min Time20min TimeEnd LeftRightR ( I n t r ) NPP Tm10mn Tm15mn Tm20mn TimEnd NPP Time10min Time15min Time20min TimeEnd LeftRightR Table 4c: Model5, Random intercept for subjects, and consider observer as cross randome effect which is by observer adjustment to NP, allowing different variances between group N and group P Formula : P o s i t i o n c o n NP + (NP o b s e r v e r ) + Time + LeftRight + (1 S u b j e c t ) Groups Name Variance Std. Dev. Corr S u b j e c t ( I n t e r c e p t ) e e+00 8

9 3 RANDOM EFFECT EXAMINATION, HO: SIGMA(N-OBSERVER)=SIGMA(P-OBSERVER) o b s e r v e r ( I n t e r c e p t ) e e 05 NPP e e Residual e e+00 Number o f obs : 776, groups : Subject, 4 1 ; observer, 3 ( I n t e r c e p t ) NPP Time10min Time15min Time20min TimeEnd LeftRightR ( I n t r ) NPP Tm10mn Tm15mn Tm20mn TimEnd NPP Time10min Time15min Time20min TimeEnd LeftRightR Table 4d: ANOVA, likehood ratio test to examine the model fit Models : mod4 : P o s i t i o n c o n NP + (1 o b s e r v e r :NP) + Time + L e ftright + (1 mod4 : S u b j e c t ) mod5 : P o s i t i o n c o n NP + (NP o b s e r v e r ) + Time + L e ftright + (1 mod5 : S u b j e c t ) Df AIC BIC l o g L i k Chisq Chi Df Pr(>Chisq ) mod mod

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