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Transcript
Shana Schwarz

Type I (i.e. false positive)
◦ Occurs by rejecting the null hypothesis even when it
is true.
◦ In other words, this is the error of accepting an
alternative hypothesis (the hypothesis of interest)
when the results can be attributed to chance.
 occurs when we are observing a difference when in
truth there is none.

Type II (i.e. false negative)
◦ Occurs by accepting the null hypothesis even when
it is wrong.
◦ In other words, this is the error of failing to observe
a difference when in truth there is one.

Type I
◦ Error that occurs when one drug is thought to be
more effective then another but is later discovered
that there is no difference.

Type II
◦ Error that occurs when two or more drugs are
thought to be equivalent in effectiveness and it is
later discovered that there is a superior drug.

Type I
◦ Error that occurs when a drug is thought to have
side effects but is later discovered that is does not.

Type II
◦ Error that occur when a drug is thought to have no
side effects but is later discovered that it does.
 What
is this article taking about?
 “Expensive new antipsychotic
drugs that are among the most
widely prescribed pills in medicine
are no more effective and no safer
than a older, cheaper drug that
has been largely discontinued”.

Null Hypothesis: H0
◦ There is no difference in effectiveness between the
older, cheaper drugs and the newer more expensive
ones.

Alternative Hypothesis: Ha
◦ The newer, more expensive drugs are more
effective then the older cheaper ones.



Indicates in the article that this study is the
longest, most comprehensive study ever
conducted
Government sponsored study costing over
$44 million dollars.
Do you see any reason/ source of error?
◦ I think not because the source interested in the
findings is not a privately owned drug company,
rather the government and the New England Journal
of Medicine.


Technically, the study didn’t measure drug
effectiveness rather it measured the amount
time a patient stayed on them.
What do you think about this?
◦ I would say this is a poor study design because the
drugs’ effectiveness is subjective to the clinician
and patients idea of whether or not the benefits
outweighed the undesirable effects.

Focus on the idea that originally drug
companies thought these newer, more
expensive drugs were more effective then the
older, less expensive ones.

Now it is believed after further studies that
there are no additional benefits from these
newer drugs.

Type I Error
◦ Error that occurs when one drug is thought to be
more effective then another but is later discovered
that there is no difference.


Patients are spending as much as 5.5 times
more money on these newer drugs then they
were on the older ones.
Texas Medication Algorithm Project (TMAP)
guidelines recommend these drugs as the
first line treatment therefore patients
incapable of paying for high priced drugs
may not be getting any treatment.

Actually, the study’s most shocking discovery
is how poorly current anti-psychotic drugs
work at all.
◦ Nearly ¾ of people treated stop taking the
medication within 18 months because of side
effects and/or poor control of symptoms.

What would the hypothesis’ be?
◦ H0 : No difference in the amount/ severity of side
effects among the two generations of drugs.
◦ Ha : The newer generation of drugs has less side
effects

It was aggressively marketed that the new
drugs “caused fewer side effects”.
◦ In fact, this was a false statement, therefore once
again there is type I error.
Despite Research, FDA Says Marijuana Has No
Benefit

Type I
◦ Error that occurs when one drug is thought to be
more effective then another but is later discovered
that there is no difference.

Type II
◦ Error that occur when two or more drugs are
thought to be equivalent in effectiveness and it is
later discovered that there is a superior drug.

Type I
◦ Error that occurs when a drug is thought to have
side effects but is later discovered that is does not.

Type II
◦ Error that occur when a drug is thought to have no
side effects but is later discover that it does.


What is this article talking about?
The FDA is denying the idea that medicinal
marijuana use is beneficial. However, many
researchers were left puzzled because they
believe that for many patients, medicinal
marijuana was extremely helpful. They, the
researchers, want additional research to be
carried out because they believe that this
rejection of its usefulness is politically driven.

Null Hypothesis: H0
◦ There are no positive benefits/side-effects to using
medicinal marijuana.

Alternative Hypothesis: Ha
◦ Medicinal Marijuana has many positive
benefits/side-effects.

I don’t think that there is convincing evidence
that should now cause the rejection of
medicinal marijuana use.
◦ FDA spokesperson on this issue is not commenting
◦ Donald Abrams, MD, says that this is a typical
report that the government comes out with about
every 10 years.
◦ Research on medicinal marijuana is very regulated
by the government and therefore, it is difficult to
obtain clear results.
◦ It would also be difficult to do a randomized
placebo-controlled study because the differences
between the substances are obvious.



“We have found sufficient evidence that
smoking marijuana has benefits for some
patients”.
It is believed that the FDA decision was based
on political pressure from Congress rather
then scientific merit.
Positive side-effects/benefits include helping
with nausea in chemotherapy patients,
increasing appetite and relieving pain in AIDS
patients, decreasing depression and making
people in the late stages of cancer happier.


Focus on the positive side effects/ benefits to
patients who use medicinal marijuana.
The FDA claims that medicinal marijuana is
useless, while researchers adamantly believe
that their research shows positive benefits
and that more research would continue to
confirm the idea.

Type II Error
◦ Error that occur when a drug is thought to have no
positive side-effects/benefits but is later discover
that it does.


Many chemo and AIDS patients are not
receiving the benefits of decreased nausea
and pain, increased appetite, and an overall
better mood.
Due to the FDAs position, only eleven states
have legalized medicinal use and therefore
patients who are prescribed medicinal
marijuana can be arrested in any of the other
39 states.




In 2000, Trovan, a drug being prescribed at a
rate of 300,000 patients per month was
determined to have unforeseen negative side
effects one year after is approval by the FDA.
Initial studies approved this drug to safely be
used for 14 different uses and no harmful side
effects were detected.
Hundreds of people suffered from liver disease
and the drug had to immediately be recalled.
Effects of this type of error included many
deaths, billions lost by the company who made
the drug and numerous lawsuits.
 Have
fun in the snow 