On Studybay you can order your academic assignment from one of our 45000 professional writers. Hire your writer directly, without overpaying for agencies and affiliates!
Check price for your assignment
For doctoral nursing biostatistics course. I need to write a 2 to 3 paragraph response statistically critiquing/analyzing the following attached article. The response is based on a discussion post that a fellow grad student in my program wrote. This is his discussion post based on his article (the one i attached). Write 2-3 paragraphs critiquing the statistical methods, studies etc that this article/study used.
Can implementation of systems of care within a large medical group improve treatment and control of dyslipidemia in high-risk group of Coronary Heart Disease (CHD) patients?
Research suggests that statins have a proven efficiency for the treatment of lipid disorders such as hyperlipidemia. However, for certain reasons these drugs are continually under utilized; reasons including inadequate physician titration of statins to reach adequate low-density-lipid cholesterol (LDL-C) and inadequate long-term patient adherence to prescribed drug therapy. In this study by O’Connor, Gray, Maciosek, Fillbrandt, Defor, Alexander, Weiss, & Teutsch (2005) the authors sought to determine if a “systems of care implemented with a large medical group are associated with improved treatment and control of dyslipidemia” (p. 2).
The study ran from January 1, 1995 through December 31, 1998 at the HealthPartners Medical Group (HPMG) in Minnesota. All participants had to be 19 years or older and have a CHD diagnosis based on the International Classification of Disease and Current Procedural Terminology. This formula of screening had a sensitivity of 0.85, a specificity of 0.99, and a positive predicate value of 0.89.
With this, there were a total of 2947 identified patients to define the population. From here, 1388 had two qualifying LDL-C levels that were recorded at least 365 days apart, to establish baseline and follow-up data. This, is the definition of group 1. Subsequently, group 2 had 1559 participants with LDL-C levels that were not collected within the 365 days period. The creation of group 3 was created to explore change in LDL-C and statin use. Group 3 comprised a total 1038 individuals with two LDL-C levels, (not 365 days apart) and pharmacy coverage, which was defined as coverage from the first LDL-C level to the second LDL-C level.
In analyzing the data the researchers found that in group 3 at baseline, only 24.3% of patients were receiving a statin therapy and only 12.5% had a LDL-C level of less than or equal to 100mg/dL, a level established by the National Cholesterol Education Program (NCEP). Subsequently, at the time of this study a program was implemented at HPMG that provided one-on-one sessions with nursing staff as well as discharging patients on statins post any acute cardiac event. Re-examination of the data at the follow-up point showed a significant increase in patients lowering their LDL-C to levels less than 100mg/dL, an increase from 12.5 to 39.8%.
Finally, the authors also provide that there are some limitations to their data. They suggest that there is the possibility that CHD was misclassified, the study was only applied to one medical group, and that requiring patients with two LDL-C could identify a population seeking more active management of their high cholesterol. Regardless, the authors conclude that increased statin use, utilizing clinical guidelines, optimizing high-risk registries, and prioritizing/monitoring patients caused the substantial improvement in LDL-C levels.
In this study, the researchers hypothesis that the implementation of systems care will improve LDL-C levels (Hypothesis 1) as to compared to LDL-C levels when systems care is not implemented (hypothesis 2). To determine which hypothesis the authors accepted, they analyzed the data meticulously. The authors compared differences in participants with and without two qualifying LDL-C levels utilizing a two-sample t-test. This approach, utilizing a standard deviation of 0.05, tells the researchers that the probability of their results falling within 3 standard deviations is likely, and that their data is not extraneous. This provides the authors with the ability to create meaningful associations regarding their results. Additionally, the mean LDL-C for patients with two measurements improved from 137.6mg/dL to 111.0mg/dL (p
For doctoral nursing biostatistics course. I need to write a 2 to 3 paragraph response statistically critiquing/analyzing the following attached article. The response is based on a discussion post that a fellow grad student in my program wrote. This is his discussion post based on his article (the one i attached).