Academic Integrity: tutoring, explanations, and feedback — we don’t complete graded work or submit on a student’s behalf.

Read the passage below, and then consider the following scenario. A physician is

ID: 3127658 • Letter: R

Question

Read the passage below, and then consider the following scenario. A physician is trying to decide whether to prescribe medication for cholesterol reduction in a 45-year-old female patient. The null hypothesis is that the patient’s cholesterol is less than the threshold of treatable hypercholesterolemia. However, a sample of readings over a 2-year time period shows considerable variation, usually below but sometimes above the threshold.

Define Type I and Type II error.

List the costs of each type of error (in general terms). Who bears the cost of each?

How might the patient’s point of view differ from the HMO’s or doctor’s?

In what sense is this a business problem? A societal problem? An individual problem?

"Hypercholesterolemia is a known risk factor for coronary artery disease. The risk of death from coronary artery disease has a continuous and graded relation to total serum cholesterol levels higher than 180 mg/dl. However, the ratio of total cholesterol to HDL cholesterol is a better predictor of coronary artery disease than the level of either fraction alone. …After menopause, plasma LDL cholesterol concentrations rise to equal, and then to exceed, those of men, at the same time HDL cholesterol concentrations fall slightly. …This puts women at equal or greater risk for cardiovascular disease. According to the results of medical trials, there is compelling evidence that a reduction in the level of cholesterol leads to a significant decrease in the rate of cardiovascular events. …Therefore, screening for high blood cholesterol is an important clinical intervention. The National Heart, Lung, and Blood Institute…recommends that all persons aged 20 and above have a cholesterol determination at least once every five years. …Timely identification of high-risk individuals allows consideration of various treatment alternatives. For patients who do not have coronary heart disease or peripheral vascular disease, emphasis should be placed on non-pharmacologic approaches, mainly changes in diet and exercise. Drug therapy should be reserved for those at highest risk of coronary heart disease: men above 35 years of age and postmenopausal women." (Source: www.dakotacare.com).

Explanation / Answer

Type I error refers to rejecting a true null hypothesis. Type II error refers to failure of rejecting a false null hypothesis.

In case of committing Type I error, the physician would report that patients cholesterol level is grater than or equal to threshold level of treatable hypercholesterolemia, when it is actually less than threshold level of treatable hypercholesterolemia. As aresult the patient would be refrained from drug therapy of reducing cholesterol. Type II error will occur when the physician will fail to report that patients cholesterol level is less than the threshold level of treatable hypercholesterolemia, when it is actually greater than or equal to threshold level of treatable hypercholesterolemia . In this case, patient would be treated with drug therapy, where it might prove fatal.

This is a societal probelm, where, statistics is used to measure the probability of committing Type I and Type II error, that is finally making a decsision through rejection of null hypothesis test. This result being statistically significant, further studies can be carried out based on it.