The Chi-square test and t-test were used to determine the significance of
differences between categorical and numerical variables of two independent groups (the
intervention and the control group). Which variables would the Chi-square test have
been applied to, and which would the t-test have been applied to? [3 marks]
1.2 Which of these tests is the parametric statistical test and what are the main assumptions
about the data being subjected to that test? [4 marks]
1.3 Describe the results of the baseline comparisons in Table 1. [3 marks]
Part 2 (10 marks)
The following table shows some of results of multinomial logistic regession analyses of
predictor variables associated with 5650 healthy adults’ frequent or moderate ‘treatment and
release’ use of an Emergency Department. The predictor variables are bivariate (Yes/No or
Female/Male) except for the numerical variables ‘Age’ and ‘Number of outpatient visits’.
You are asked to focus just on the odds ratios and confidence intervals (OR and 95% CI).
2.1 Describe the results of this analysis for frequent and moderate ‘treatment and release
use’ of the ED. Report on the strength and direction of the statistically significant
associations. [5 marks]
2.2 Consider the situation where other studies have produced similar results for the main
factors predicting frequent and moderate ‘treatment and release use’ of the ED (NB –
you don’t need to try and find any other studies). What might be the implications of this
evidence for clinical practice when providing nursing services for such patients?
9058: Evidence Based Health Care
Semester 2, 2015 3
The following table shows results of a study that linked hospital facility data with staff nurse
survey data (N = 1024) and surgical patient discharge data (N = 76,036) from 14 teaching
hospitals with 700 or more beds. Logistic regression models that adjusted for a range of
patient and hospital factors were used to estimate the effects of three nursing characteristics
on risk-adjusted patient mortality within 30 days of admission.
The three nursing characteristics were nurse staffing (patients per nurse), nurse work
environment (better vs. mixed or poor) and nurse education (the percentage of nurses with a
Bachelor degree in nursing).
The fully adjusted logistic regression model controlled for patient age, gender, transfer status,
type of admission, major diagnostic category and co-morbidities, as well as hospital location
and number of beds.
3.1 Describe the results of this analysis, focussing on the statistically significant predictors
in the fully adjusted model. Report on the strength and direction of the associations. For
the purposes of this discussion, consider the fully adjusted result for nurse staffing
(patients per nurse) to be statistically significant.
3.2 Consider the situation where other studies have produced similar results for the main
nursing characteristics predicting patient mortality (NB – you don’t need to try and find
any other studies). What might be the implications of the evidence for the health system
in relation to the quality and safety of patient care?
9058: Evidence Based Health Care
Semester 2, 2015 4
You have been asked to work on a research project that has recently been submitted to a
Human Research Ethics Committee for approval. The project aims to investigate the use of
alcohol by underage adolescents (below age 18). Underage drinking, particularly binge
drinking, is an identified public health problem in Australia. The study will explore the
frequency and amount of alcohol use, sources of alcohol, types of alcoholic beverages, cooccuring
other substance use and the consequences of alcohol use. It is hoped that the study
can inform effective public health strategies to reduce underage drinking.
The data will be collected in 2 ways, as follows.
a. By self-reported, online survey – participants will be recruited via advertisements in
secondary schools, which will direct interested volunteers to a secure website.
b. By brief face-to-face interviews at selected events such as music festivals and major
concerts. Potential participants at the nominated events will be identified as:
i. Likely to be in the target age range
ii. Observed to be in possession of alcoholic beverages or appear to be under the
influence of alcohol.
The participants will be asked to answer a few questions, which will include confirming
inclusion criteria (screening for age and alcohol possession), and questions about the
source, type and amount of alcohol.
4.1 What do you believe to be the key risks associated with the research? Who bears those
4.2 What do you believe would be the potential benefits of the research? Who would
4.3 What additional ethical issues or concerns do you believe there may be?
4.4 Do you believe the Human Research Ethics Committee should approve this research
proposal, either in part or in full? Why or why not?
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