9. Was the sample size of this study adequate for conducting simple linear regre
ID: 3204174 • Letter: 9
Question
9. Was the sample size of this study adequate for conducting simple linear regression? Provide a rationale for your answer.
10. Describe one potential clinical advantage and one potential clinical problem with using the three novel formulas presented in Figures 1, 2, and 3 in a PICU setting.
Introduction Medications and other therapies often necessitate knowing a patient's weight. However a child may be admitted to a pediatric intensive care unit (PICU) without a known weight and instability and on-going resuscitation may prevent obtaining this needed weight Clinicians would benefit from a tool that could accurately estimate a patient's weight when such information is unavailable. Thus Flannigan et al. (2014) conducted a retro- spective observational study for the purpose of determining "if the revised APLS UK Advanced Paediatric Life Support United Kingdom) formulae for estimating weight are appropriate for use in the paediatric care population in the United Kingdom" (Flannigan et al., 2014, p. 927). The sample included 10,081 children (5,622 males and 4,459 females) who ranged from term-corrected age to 15 years of age, admitted to the PICU during a 5-year period. Because this was a retrospective study, no geographic location, race, and ethnicity data were collected for the sample. A paired samples t-test was used to compare mean sample weights with the APLS UK formula weight. The "APLS UK formula weight F (0.05 x age in months) 4' significantly overestimates the mean weight of children under 1 year admitted to PICU by between 10% and 25.4%" (Flannigan et al, 2014, p 928). Therefore, the researchers concluded that the APLS UK formulas were not appropri- ate for estimating the weight of children admitted to the PICU Relevant Study Results Simple linear regression was used to produce novel formulae for the prediction of the mean weight specifically for the PICU population" (Flannigan et al., 2014, p. 927). The three novel formulas are presented in Figures 1, 2, and 3, respectively. The new formulas calculations are more complex than the APLS UK formulas. "Although a good estimate of mean weight can be obtained by our newly derived formula, reliance on mean weight alone will still result in significant error as the weights of children admitted to PICU in each age and sex gender group have a large standard deviation...Therefore as soon as possible after admission a weight should be obtained, e.g., using a weight be (Flannigan et al., 2014, p. 929)Explanation / Answer
9. The sample size of 10081 was adequate to conduct simple linear regression. This is because 10081 is a very large sample and it is close to a normal distribution. The figures also show that the novel formula, although being a linear equation, calculates actual weight very accurately and there is very little variance between the two. This would not have occured if the sample size was not adequate.
10. One potential clinical advantage of using the three novel formulas is that a close approximation of children's weight can be obtained purely on the basis of their age in months. This can save the cost of buying and maintaining a weighing machine and the time spent in weighing each every kid in PICU.
One potential clinical problem of using the three novel formulas is that it may not provide the exact weight. Female and male children of the same age may vary a lot in their weight. This would be create issues if a medicine based on the weight of the child needs to be prescribed. Two kids of the same age but different weights may require different medication or prescription. Use of novel formula will not be able to identify this requirement leading to adverse consequences.
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