Effect of Parathyroid Hormone (1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with Osteoporosis - PowerPoint PPT Presentation

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Effect of Parathyroid Hormone (1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with Osteoporosis

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Effect of Parathyroid Hormone (1-34) on ... Elise Miller. Variables of Interest. Since we are dealing with Chi-square, there are 2 categorical variables. ... – PowerPoint PPT presentation

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Title: Effect of Parathyroid Hormone (1-34) on Fractures and Bone Mineral Density in Postmenopausal Women with Osteoporosis


1
Effect of Parathyroid Hormone (1-34) on Fractures
and Bone Mineral Density in Postmenopausal Women
with Osteoporosis
Elise Miller
2
Variables of Interest
  • Since we are dealing with Chi-square, there are 2
    categorical variables.
  • Women were placed into 3 groups
  • 1.)Placebo
  • N544
  • 2.)PTH 20-µg
  • N541
  • 3.)PTH 40-µg
  • N552

3
Variables of Interest cont.
  • The second variable was whether or not new
    nonvertebral fractures had developed since the
    baseline examinations.
  • Or whether or not new fragility fractures
    developed.

4
From Table 3
5
To Compare the P-Values
  • Placebo and Treatment were taken as the
    explanatory variables.
  • Whether there were new fractures was used as the
    response variable.

6
Minitab Procedure
  • For example
  • Placebo N544
  • Fracture 53
  • No Fracture 491
  • PTH 20 N541
  • Fracture34
  • No Fracture 507

These numbers get inputted into MiniTab to find
the P-value.
7
MiniTab Output
  • C1 C2 Total
  • 1 53 491 544
  • 43.62 500.38
  • 2.017 0.176
  • 2 34 507 541
  • 43.38 497.62
  • 2.028 0.177
  • Total 87 998 1085
  • Chi-Sq 4.398, DF 1, P-Value 0.036

8
Procedure cont.
  • The same procedure was done comparing each dose
    for total fracture and fragility fracture.

9
P-Values
  • Placebo vs. 20µg (Fracture)
  • By hand p.036
  • Given p.04
  • Placebo vs. 40µg (Fracture)
  • By hand p.015
  • Given p.02
  • Placebo vs. 20µg (Fragility)
  • By hand p.015
  • Given p.02
  • Placebo vs. 40µg (Fragility)
  • By hand p.012
  • Given p.01

10
Consequences of Error
  • Type 1
  • Researchers would give out a drug that doesnt
    have any benefit to eliminating fracture.
  • Type 2
  • The PTH would be considered ineffective and would
    not make it to the market.

11
Adverse Effects
  • No significant differences among the three groups
    regarding death.
  • Because the null states that both treatment and
    placebo have the same risk factors.. Would the
    null be accepted or rejected?
  • Regarding death, the null would be accepted
    because there was not significant difference
    between treatment and placebo.

12
What if researchers were wrong?
  • What type of error would be committed?
  • Type I
  • This error would mean that treatment actually has
    risk of death.

13
Potential Bias
  • Like most medical research, bias is considered
    and ultimately eliminated.
  • People had to meet certain criteria in order to
    participate.

14
Research Conclusions
  • Treatment of postmenopausal osteoporosis with
    parathyroid hormone (1-34) decreases the risk of
    fracture.
  • Increases total-body bone mineral density.
  • In order to have minimal side effects, with
    higher bone density results and minimal fracture,
    the 20µg dose is the most beneficial.
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