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Homework answers / question archive / The CEO of the diabetes clinic reviewed your recommendation on whether to continue with the disease management program based on your analysis of the pilot study that was the focus of Assignment 4

The CEO of the diabetes clinic reviewed your recommendation on whether to continue with the disease management program based on your analysis of the pilot study that was the focus of Assignment 4

Management

The CEO of the diabetes clinic reviewed your recommendation on whether to continue with the disease management program based on your analysis of the pilot study that was the focus of Assignment 4.1. She indicated an appreciation for your work and said she was still evaluating your recommendation but wanted some additional input to help her make a final decision. She was unclear as to the purpose and meaning of the p-value that was reported in the results. She also was interested in your opinion on a research article she read on a different diabetes disease management program. The research reported that the distance patients had to travel to participate in the program had a negative effect on the success of the program. The research reported that this finding was statistically significant. The CEO was having trouble understanding what travel distance had to do with disease management and wanted your opinion on the interpretation of this finding. She was interested in knowing whether patient travel time should be included in your analysis (Assignment 4.1) as a factor of success. Prepare a brief memo (in lay terms) to the CEO of the diabetes clinic (Dr. Wilhelmina Smith) answering her questions about your analysis and the research report she read. Specifically, your memo should include the following: 1. Discuss the p-value associated with the test statistic presented in the analysis in Assignment 4.1, explaining what the p-value means and how it should be interpreted in the context of evaluating the disease management program. 2. Additionally, explain the meaning of statistical significance in the context of the research report your CEO mentioned regarding the relationship between travel time and the success of a disease management program. Answer her question regarding whether you should add patient travel time to your analysis of the success of your disease management program. Activity 4.1 You are the director of a diabetes clinic that has recently completed a pilot for a new disease management program intended to reduce blood glucose levels in the participants. In developing the pilot study, you set out to demonstrate that the program will be effective in reducing average blood glucose levels for the program’s participants. You hope to demonstrate the value of the program to your CEO by presenting the findings from a hypothesis test based on the results from the pilot study. After extensive preparation, including a comprehensive review of the literature and discussions with subject matter experts, the specifics of the disease management program were devised. The program consisted of individual counseling and education regarding lifestyle changes and healthy eating choices. The program recruited 50 patients who were seen twice a month, at which time they received individual counseling, along with having their blood sugars checked and tracked. The pilot lasted six months and required a fairly large resource commitment on the part of the clinic. Prior to beginning the program, participants had their blood glucose level drawn. The expectation was that the average blood glucose level of the group at the end of the pilot period would be lower than the average blood glucose level at the beginning of the pilot. Over the course of the six-month pilot period, the program went well. The participants were engaged and seemed motivated, with very few missed appointments and no dropouts along the way. While the program ran smoothly the cost of the program compared to its value would continue to be a factor in whether the program would be renewed. The clinic expressed its commitment to continue the program if the program was found to be successful in reducing participants’ blood glucose levels. You are asked to prepare a report to the clinic’s CEO detailing the value of the disease management intervention. In collecting your data, you found that at the beginning of the pilot the group’s average blood glucose level was 257.5 milligrams per deciliter. At the end of the pilot period, the average blood glucose level for the group was 240 milligrams per deciliter. You have some knowledge of statistics and want to be pretty conservative in your analysis, so you set your desired alpha level at 0.01. You asked a statistician friend to run the numbers and she reported back with the following statistics: t-test value: -3.68 p-value:
 

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Subject: Statistical significance and the t-statistic

I am writing to discuss the statistical analysis results provided in assignment 4.1 and provide insights on the research article you read about the diabetes disease management program. Assignment 4.1 aimed to demonstrate that the new disease program will effectively reduce average blood glucose levels for the program’s participants. Therefore, it aimed to test the hypothesis that the average blood glucose level of the group at the end of the pilot period would be lower than the average blood glucose levels at the beginning of the pilot. The research results showed that this hypothesis is true since the average blood glucose level at the beginning of the period was 257.5 mg/dl while the average blood glucose level at the end of the period was 240 mg/dl, indicating a decrease over the two periods. In this case, the null hypothesis was that the blood glucose levels would be the same before and after the pilot period, while the alternative hypothesis was that the blood glucose levels would decline at the end of the pilot study. The desired alpha level was 0.01, which indicates that the confidence level was 99%. Therefore, the p-value was considered in comparison to the alpha. Since it was less than 0.01, the null hypothesis should be rejected, indicating that the blood glucose level did not remain constant. Instead, the study concluded that the blood sugar levels fell after the new disease program was implemented. Moreover, the p-value being less than 0.01 indicates that the analysis results are statistically significant since the null hypothesis should be rejected. Thus, there is a 99% chance that the new disease program adversely affected the bold glucose levels and a 1% that it did not. The t-test value for the study, on the other hand, was equivalent to -3.68. Any t-value that is greater than +2 or less than -2 is acceptable, and the higher the t-value, the higher the level of confidence there is in the predictor variable. Thus, the results indicated a negative and statistically significant relationship between the new disease program and blood glucose levels. Therefore, the t-test value indicates that individual counseling and educating people about lifestyle changes and healthy eating choices impact bold glucose levels. Based on the study, the clinic should continue with the new disease program.

The research article on a diabetes disease management program indicated that the distance that patients had to travel to participate in the program had a negative effect on the success of the program. These findings indicate that the longer the distance that the patients had to travel, the less likely the program was to succeed. The article also stated that the results were statistically significant, indicating that their analysis showed that the p-value was less than the alpha, meaning that the null hypothesis was rejected. Based on the findings of the article, travel distance has an effect on the results of the program and should thus be included as a factor in the analysis for the success of the program.

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