Abstract P822: In-Hospital Stroke Treated With IV tPA at a Comprehensive Stroke Center Compared to Primary Stroke Centers Pre and Post Telestroke Implementation

Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Manya Khrlobyan ◽  
Jiaxiao M Shi ◽  
Zahra Ajani ◽  
Duy Le ◽  
Pamela Cheng ◽  
...  
Keyword(s):  
Functional Outcomes ◽  
Small Sample Size ◽  
Small Sample ◽  
Complication Rates ◽  
Recognition Time ◽  
Chi Square ◽  
Wilcoxon Rank Sum Test ◽  
Delayed Recognition ◽  
Comprehensive Stroke Center ◽  
Stroke Center

Introduction: In-hospital strokes (IHS) often have delayed recognition time and a delay in physician assessment, playing a role in unfavorable outcomes. Telestroke (TS) participation is linked to lower odds of hospital mortality and is safe and effective in treating acute ischemic stroke. We implemented a TS program for IHS patients at primary stroke centers (PSC) and assessed tPA time metrics, complications and 90-day functional outcomes as compared to a robust in hospital stroke system of care at a comprehensive stroke center (CSC). Methods: Using a network database, data for all in-hospital code strokes were retrospectively abstracted between 2010-2020 at a CSC and 11 PSC’s. The CSC was compared to PSC’s pre and post implementation of a TS program. Data were analyzed using Wilcoxon rank-sum test, chi-square and exact tests. Results: We identified 193 patients, 77 at the CSC, 71 at pre-tele PSC’s, and 45 at post-tele PSC’s. Symptom-recognition-time (SRT) to neurology evaluation (median 15min {IQR 10-27} vs 75min {IQR 45-126, p=<0.0001) and SRT to IV t-PA (median 65min {IQR 46-91} vs 94min {IQR 73-112}, p=<0.001) were all faster at the CSC vs pre-tele PSC’s. There was no difference in rate of complications (p=0.05). When stroke mimics were excluded, CSC patients had a favorable 90-day mRS of 0-1 (24 patients, 35% vs 11 patients, 19%, p=0.04). After implementation of TS at PSC’s, there was no difference in tPA time metrics, except SRT to neurology evaluation remained faster at CSC (median 15min {IQR 10-27} vs 31min {IQR 18.5-52.5}, p=0.0002). There was no difference in rate of complications (p=0.21) and mRS at 90 days (p=0.82). Conclusions: Implementation of a TS program for IHS at PSC’s may improve tPA time metrics and 90 functional outcomes to the standards of CSC’s without increasing complication rates. Our study was limited by retrospective design and small sample size.

Abstract WP105: A Practical Wake up Tpa Protocol at a United States Based Comprehensive Stroke Center Hub and Its Telestroke Spokes

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Navdeep S Sangha ◽  
Duy Le ◽  
Raeesa Dhanji ◽  
Denise Gaffney ◽  
David McCartney ◽  
...  
Keyword(s):  
United States ◽  
Small Sample Size ◽  
Statistical Significance ◽  
The United States ◽  
Small Sample ◽  
The Difference ◽  
Waking Up ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Main Barrier

Background: IV tPA is established as an effective treatment for acute ischemic stroke. Currently it is endorsed up to 4.5 hours of last known well time by major guidelines. A randomized trial, WAKE-UP, displayed its safety and efficacy in patients who presented within 4.5 hours of waking up with their symptoms. Objective: To establish a practical tPA protocol for patients who wake up or are found with stroke symptoms at a large Comprehensive Stroke Center (CSC) and its 13 telestroke spokes (TS) based on the WAKE-UP trial. Methods: A wake up tPA protocol was created and given to all teleneurologists. Door to needle times (DTN) and reasons for no tPA were collected for 12 months post implementation and evaluated for differences between wake up (WU) and non-wake up (NW) patients. Results: 93 WU patients were identified; 23 at CSC and 70 at TS. 11 (47.8%) vs. 4 (5.7%) patients received tPA at CSC and TS, respectively. Median DTN was not significantly different for WU patients at CSC vs. TS (64 vs. 89 mins, p=0.54). Median DTN at CSC was shorter for NW vs. WU (37 vs. 64 mins; p=0.003). Similarly, median DTN at TS trended toward being shorter for NW vs. WU (44 vs. 89 mins; p=0.062). The reasons for no tPA at CSC were no mismatch found in 6 (50%), and MRI unavailability in 6 (50%); at TS were no mismatch found in 11 (16.6%), MRI unavailability in 54 (81,1%) and MRI was contraindicated in 1 (1.5%). Conclusion: Treating WU patients using a CSC Hub and TS model is feasible. DTN are longer for WU vs. NW. In the United States, MRI availability is the main barrier to WU tPA at both CSC and community hospitals. The difference between median DTN for WU between CSC and TS did not reach statistical significance, likely due to the small sample size.

Abstract WP124: Ataste 2: Assessment of Anti-Hypertensive Treatment and Acute Stroke Treatment Efficiency 2

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Brian Sorace ◽  
Brett Meyer ◽  
Dawn Meyer ◽  
Kunal Agrawal
Keyword(s):  
Small Sample Size ◽  
Small Sample ◽  
Stroke Treatment ◽  
Significant Difference ◽  
Blood Pressures ◽  
Pre Treatment ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Cerebral Reperfusion ◽  
Iv Tpa

Introduction: Treatment of acute ischemic stroke (AIS) with tPA must be rapid for timely cerebral reperfusion. Anti-hypertensive (AHT) medication may be required to lower blood pressures prior to tPA. Optimal AHT use and its impact on tPA times is unclear. We examined treatment with IV bolus only (IVB), IV continuous infusion only (IVCI), or both bolus and infusion (BBI) AHTs on door-to-needle time (DTN) in AIS patients eligible for IV tPA. We hypothesized that 1) DTN would be significantly longer in patients requiring IV AHT before treatment and 2) DTN would be significantly lower in patients treated with IVCI compared to IVB or BBI. Methods: We analyzed all stroke codes who received IV tPA at our comprehensive stroke center from July 1, 2008 to June 30, 2019. Subjects were grouped by those that required IV AHT prior to IV tPA (med+tPA) and those that did not (no-med+tPA). The three medication groups were IVB, IVCI, or BBI. Variables examined were initial and immediate pre-treatment blood pressures, NIHSS, mRS, and initial blood glucose. The primary outcome was DTN between groups. Results: Overall, 288 patients were included in the analysis. Approximately 12% (n=35) of patients required IV AHTs before tPA. There was a significant difference between the med+tPA and no-med+tPA groups in 1) median NIHSS (12.5, 10; p=0.040) and initial mean glucose (142, 122.5; p&lt;0.001), respectively. DTN was significantly longer in med+tPA vs no-med+tPA mean (77.5 min, 56.4 min; p=0.036). Systolic blood pressures (SBP) were significantly higher in patients requiring AHT treatment (initial SBP: med+tPA 175.5 mmHg, no-med-tPA 144.1 mmHg, p=0.001). There was no difference in DTN between IVB, IVCI, or BBI groups when compared to the no-med+tPA group (p=0.351, 1.000, & 0.997). There was no difference in the 90-day mRS between IVB, IVCI, or BBI compared to control (p=0.236, 0.339, & 0.326). Conclusions: Fewer patients required AHT than expected suggesting lower rates of baseline hypertension in our region. Type of AHT agent used did not significantly impact DTN. This may be due to the small sample size of patients receiving blood pressure medication prior to tPA in this study. Further prospective studies are needed to examine the optimal AHT treatment modality on DTN.

scholarly journals A Pilot Placebo Controlled Randomized Trial of Dexamethasone for Chronic Subdural Hematoma

2016 ◽  
Vol 43 (2) ◽  
pp. 284-290 ◽  
Author(s):  
Michel Prud’homme ◽  
François Mathieu ◽  
Nicolas Marcotte ◽  
Sylvine Cottin
Keyword(s):  
Conservative Treatment ◽  
Adverse Events ◽  
Small Sample Size ◽  
Chronic Subdural Hematoma ◽  
Symptomatic Patient ◽  
Placebo Treatment ◽  
Small Sample ◽  
Chi Square ◽  
Serious Adverse Events ◽  
Before And After

AbstractBackground: Current opinions regarding the use of dexamethasone in the treatment of chronic subdural hematomas (CSDH) are only based on observational studies. Moreover, the use of corticosteroids in asymptomatic or minimally symptomatic patient with this condition remains controversial. Here, we present data from a prospective randomized pilot study of CSDH patients treated with dexamethasone or placebo. Methods: Twenty patients with imaging-confirmed CSDH were recruited from a single center and randomized to receive dexamethasone (12 mg/day for 3 weeks followed by tapering) or placebo as a conservative treatment. Patients were followed for 6 months and the rate of success of conservative treatment with dexamethasone versus placebo was measured. Parameters such as hematoma thickness and clinical changes were also compared before and after treatment with chi-square tests. Adverse events and complications were documented. Results: During the 6-month follow-up, one of ten patients treated with corticosteroids had to undergo surgical drainage and three of ten patients were treated surgically after placebo treatment. At the end of the study, all remaining patients had complete radiological resolution. No significant differences were observed in terms of hematoma thickness profile and impression of change; however, patients experienced more severe side effects when treated with steroids as compared with placebo. Dexamethasone contributed to many serious adverse events. Conclusions: Given the small sample size, these preliminary results have not shown a clear beneficial effect of dexamethasone against placebo in our patients. However, the number of secondary effects reported was much greater for corticosteroids, and dexamethasone treatment was responsible for significant complications.

Abstract WP65: Clinical and Radiographic Characterization of Cerebral Hyperdensities on Post-thrombectomy Conventional Non-contrast Ct Brain: Differentiating Between Contrast Staining and Post-thrombectomy Hemorrhage

Stroke ◽  
2020 ◽  
Vol 51 (Suppl_1) ◽  
Author(s):  
Hyung K Kang ◽  
Raffi Ourfalian ◽  
Emilie T Nguyen ◽  
Fernando A Torres ◽  
Lei T Feng ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Anterior Circulation ◽  
Chi Square ◽  
Imaging Characteristics ◽  
Increase Risk ◽  
Patient’S Outcome ◽  
Ct Brain ◽  
Comprehensive Stroke Center ◽  
Stroke Center ◽  
Contrast Ct

Background: Post-interventional cerebral hyperdensities (PCHD) are present 31.2 to 87.5% of the time on post-thrombectomy (PT) CT. It can be difficult for radiologists to differentiate if PCHD represents intracerebral hemorrhage (ICH) or contrast staining using conventional CT. The ability to accurately determine the etiology of PCHD may be important for a patient’s outcome. Methods: We retrospectively investigated clinical risk factors, imaging findings, and interventional technique of patients who had a thrombectomy from 2011-2017 (n=238) at a Comprehensive Stroke Center. 112 patients with anterior circulation infarcts and immediate PT CTs as well as either a PT MRI or follow-up CT within 48 hours were included. Two experienced neuroradiologists interpreted all imaging. Baseline demographics and imaging characteristics were collected. The presence of ICH was determined by dephasing on gradient echo or by its persistence > 2 days on repeat CT. Chi-square and Fisher’s exact tests were used for statistical significance, and logistic regression to determine risk estimates. Results: 84% of patients had PCHD, of which 56% had ICH. Patients had similar demographics (ICH: median age 69, 47.5% female; non-ICH: median age 71, 42.5% female). Higher pre-thrombectomy ASPECTS score (OR 0.62, p < 0.05) decreased the risk of ICH, and higher Hounsfield units (HU) of PCHD both on immediate (OR 1.04, p < 0.05) and intermediate (OR 1.1, p < 0.0005) PT CT increased the risk of ICH. PCHDs in the deep grey matter (OR 2.84, p < 0.05) and demonstrating a confluent pattern (OR 3.9 p < 0.05) increased the likelihood of ICH. 10% increase risk of ICH was seen for every HU increase in density on PT CT at 24 or 48 hours. A 50% decrease in ICH was observed for each unit increase of the pre-thrombectomy ASPECTS score. ROC revealed the optimal cut-off for predicted probability as 0.64, sensitivity 70.2% and specificity 69.2%. The AUC for the predicted model was 0.84 (95%CI= (0.75- 0.92, p <0.0001). Conclusion: Several imaging characteristics of PCHDs and ASPECTS score can help differentiate between the PT ICH and contrast staining. Application of these variables to patients in the immediate PT period may change clinical management.

Lower rates of mortality, readmission and reoperation in patients receiving acupuncture after hip fracture: a population-based analysis

2020 ◽  
Vol 38 (5) ◽  
pp. 352-360
Author(s):  
Jeff Chien-Fu Lin ◽  
Tzu-Chieh Lin ◽  
Chi-Fung Cheng ◽  
Ying-Ju Lin ◽  
Sophia Liang ◽  
...  
Keyword(s):  
Hip Fracture ◽  
Lower Risk ◽  
Small Sample Size ◽  
Population Based ◽  
Small Sample ◽  
Acupuncture Group ◽  
Research Database ◽  
Complication Rates ◽  
Using Data ◽  
Reoperation Rates

Background: Studies on the effects of acupuncture on mortality and complication rates in hip fracture patients are limited by small sample size and short follow-up time. We aimed to assess the associations of acupuncture use with mortality, readmission and reoperation rates in hip fracture patients using a longitudinal population-based database. Methods: A retrospective matched cohort study was conducted using data for the years 1996–2012 from Taiwan’s National Health Insurance Research Database. Hip fracture patients were divided into an acupuncture group consisting of 292 subjects who received at least 6 acupuncture treatments within 183 days of hip fracture, and a propensity score matched “no acupuncture” group of 876 subjects who did not receive any acupuncture treatment and who functioned as controls. The two groups were compared using survival analysis and competing risk analysis. Results: Compared to non-treated subjects, subjects treated with acupuncture had a lower risk of overall death (hazard ratio (HR): 0.41, 95% confidence interval (CI): 0.24–0.73, p = 0.002), a lower risk of readmission due to medical complications (subdistribution HR (sHR): 0.64, 95% CI: 0.44–0.93, p = 0.019) and a lower risk of reoperation due to surgical complications (sHR: 0.62, 95% CI: 0.40–0.96, p = 0.034). Conclusion: This is the first study to suggest that postoperative acupuncture in hip fracture patients is associated with significantly lower mortality, readmission and reoperation rates compared with those of matched controls.

A Study of Adherence to Restrictive RBC Transfusion and 30 Day Patient Outcomes

Blood ◽  
2016 ◽  
Vol 128 (22) ◽  
pp. 5037-5037
Author(s):  
Zhen Wang ◽  
Elaine Zhai ◽  
Aleksic Sandra ◽  
Kibola Adam ◽  
Richard May ◽  
...  
Keyword(s):  
Cardiovascular Events ◽  
Small Sample Size ◽  
Small Sample ◽  
University Hospital ◽  
Red Blood Cell Transfusion ◽  
Current Guideline ◽  
Chi Square ◽  
Exact Test ◽  
Medicine Service ◽  
Rbc Transfusion

Abstract Background: The American Association of Blood Banks (AABB) 2012 Guidelines recommend a restrictive transfusion strategy of 7 g/dL to 8 g/dL in asymptomatic, hemodynamically stable patients (pts) and for Hgb less than 8 g/dL in pts with preexisting cardiovascular disease. [1] Additional recommendations based on expert opinion include transfusion at threshold Hgb of 7 g/dL for hemodynamically stable ICU pts and Hgb less than 10 g/dL in pts with symptomatic anemia. We examined adherence to these guidelines and for differences in outcomes between restrictive and non-restrictive approaches at an academic hospital. Methods: We performed an IRB-approved retrospective review of all pts admitted to the Internal Medicine Service at University Hospital in Newark, New Jersey from July 1st to November 30th 2015 who received RBC transfusions. Charts were abstracted for demographic information, past medical history, indication for transfusion, presence of signs or symptoms of anemia (chest pain, orthostatic hypotension or tachycardia unresponsive to fluid resuscitation, or congestive heart failure), pre-transfusion Hgb, number of units transfused, and post-transfusion hgb. Outcomes were defined as requirement for additional transfusions, infections, cardiovascular events, adverse transfusion reactions, and death within 30 days of transfusion. Each transfusion was categorized as either adherent or non-adherent to the guidelines. Difference in outcomes between groups (adherent vs non-adherent) was tested using chi-square and Fisher's exact test with SAS studio version 3.4 (Cary, NC). Results: We reviewed 318 RBC transfusion records for 210 pts (median age: 55±17 years) with 157 (49%) transfusions in male and 161 (51%) in female pts. Site was ICU for 86 and the ward for 232 transfusions. The leading indication was acute bleeding (121 or 38%; pre-transfusion Hgb 6.9±1.3g/dL), followed by asymptomatic anemia (107 or 33%; pre-transfusion Hgb 6.8±0.8g/dL), and symptomatic anemia (91 or 29%; pre-transfusion Hgb 6.6±0.8g/dL). Of the 107 pts with asymptomatic anemia, 37 had pre-existing heart disease. Within this group, 35 were transfused at Hgb < 8g/dL (adherence of 95%). Seventy of the 107 transfusions were performed in pts without pre-existing cardiac disease. Fifty-nine were transfused at hgb < 7g/dL with an adherence of 84%. In the ICU, 21 of the 27 transfusions occurred for hgb < 7 g/dL in hemodynamically stable pts with an adherence of 78%. There were 91 transfusions for symptomatic anemia and all were adherent (100%). Regarding 30 day post-transfusion outcomes, there were 140 (44%) with subsequent transfusions; 54 (14%) infections; 7 (2.2%) cardiovascular events; 8 (2.5%) transfusion adverse reactions; 27(8%) deaths. No difference was detected for 30 day outcomes between the adherent group and the non-adherent group. (Table 1) Transfusion of at least 2unitsRBC in asymptomatic, symptomatic, and active bleeding pts were 25% (27/107), 44% (40/91), 57% (69/120) respectively. No difference in outcomes was found for the group receiving only 1 unit RBC (restrictive) compared to the group receiving 2 or more units RBC (non-restrictive). (Table 1) Conclusion: The majority of transfusions (92%) performed adhered to current guideline. While the restrictive approach was not associated with more complications or mortality, this study is limited by the small sample size and further work is being done. Acknowledgment: The authors are grateful to Dr. Koshy, Director of Blood Bank at University Hospital, for assistance. Reference: 1. Carson, J. L. et al. Red blood cell transfusion: a clinical practice guideline from the AABB. Ann Intern Med 157, 49-58 (2012). Disclosures Chang: Johnson and Johnson: Other: Stock; Amgen: Other: Research; Boehringer Ingelheim: Other: Research.

scholarly journals The perceived health effects of e-cigarette use among adult smokers

2020 ◽  
Author(s):  
Joey Cheng ◽  
BCIT School of Health Sciences, Environmental Health ◽  
Dale Chen
Keyword(s):  
Health Effects ◽  
Smoking Status ◽  
Small Sample Size ◽  
Health Benefits ◽  
Target Population ◽  
Small Sample ◽  
Multiple Choice Questions ◽  
Chi Square ◽  
Objective Health ◽  
The Government

Background: Vaping and e-cigarettes have been an epidemic among youths in recent years. In addition, as of April 2020, there has been hundreds of vaping related illnesses causing fatalities. As such there has been increased coverage by media and the government in regard to reporting vaping-related dangers and implementing regulatory changes such as bans. These actions could deter the target population from engaging in vaping – tobacco users. Research has shown that e-cigarettes are significantly less toxic relative to tobacco and that it could be more effective as a cessation treatment relative to nicotine gums or patches. This study surveyed current perceptions of Canadians with regards to vaping in order to determine if certain groups (i.e. varying ages, smoking status) hold different opinions in terms of harm, health benefits, and support for stricter e-cigarette regulations. Methods: Self-administered online surveys created on Survey Monkey were distributed to Canadians via online platforms Reddit and Facebook. The survey assessed opinions and perceptions of Canadians through multiple choice questions and were collected over a three week period. Results: This study received 157 respondents the majority of which were under 35 (73.08%) and from British Columbia (65.38%). Thirteen chi-square tests were performed comparing group variables (age, smoking status, and awareness of vaping related news) to perception variables (perceived harm, health benefits, safety). There was no association found between age and the tested perception variables. Several associations were found where e-cigarette users viewed e-cigarettes more favourably relative to tobacco users and non-users based on chi-square results. Chi-square associations between media awareness and harm perceptions could not be established due to a small sample size (n< 30). Conclusion: The results indicated that there are associations with e-cigarette perceptions and a person’s smoking status. This may be an indication that there is possible misinformation between groups when it comes to evaluating objective health effects of e-cigarettes. Non-users and a percentage of tobacco users seem to overstate

scholarly journals Seroprevalence of torch infections among complicated pregnancies in Atbara river Nile state - Sudan

2021 ◽  
Vol 10 (1) ◽  
pp. 18-20
Author(s):  
Mohammed Ahmed Ibrahim Ahmed ◽  
Hanaa Elzain Musaad ◽  
Nahla Ahmed Mohammed Abdurrahman ◽  
Wadei Mohammed Yasin ◽  
Mosab Nouraldein Mohammed Hamad ◽  
...  
Keyword(s):  
Pregnant Women ◽  
Small Sample Size ◽  
Education Level ◽  
Small Sample ◽  
P Value ◽  
River Nile ◽  
Serological Evidence ◽  
Chi Square ◽  
Cross Sectional ◽  
Torch Infection

Objective: The aim of this study was to find the seroprevalence of TORCH infection among volunteered pregnant women and to find out the correlation between TORCH infection and age, complicated pregnancies and education level. Methods: A descriptive cross-sectional laboratory-based study carried out between March to June 2012 at Atbara River Nile State northern Sudan. The statistical descriptive determined in means of percentages. Chi-square used for trend analysis and calculates p-values. Results: A total of (75) voluntary pregnant women, Age between 15-55 years. The most common age group was 26-35 years (37/75) 49%.Serological evidence of Toxoplasmosis were positive for (22/75) 29 %. All volunteered pregnant women were negative for other components of TORCH complex. Study showed non-significant correlation between age, education level and complicated pregnancies, P-value 0.13, 0.43 and 0.51 respectively. Conclusion: Low prevalence of Toxoplasmosis and absent of serological evidence of other TORCH complex among volunteered pregnant women in Atbara has been documented. Insignificant correlation between toxoplasmosis and age, education level as well as number of complicated pregnancies reported. This attributed, in part, to the small sample size and using screening tool as diagnostic modalities.

Neoadjuvant bevacizumab: Surgical complications of mastectomy with and without reconstruction.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. 1100-1100
Author(s):  
Kari Joanne Kansal ◽  
Laura Stewart Dominici ◽  
Sara M. Tolaney ◽  
Steven J. Isakoff ◽  
Ian E. Krop ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Therapy ◽  
Surgical Complications ◽  
Small Sample Size ◽  
Small Sample ◽  
P Value ◽  
Data Sets ◽  
Complication Rates ◽  
Similar Time ◽  
Time Period

1100 Background: Neoadjuvant therapy is commonly used in operable breast cancer. We prospectively evaluated the surgical complications in a cohort of patients who underwent mastectomy following neoadjuvant doxorubucin hydrochloride/cyclophosphamide/paclitaxel (AC/T) plus bevacizumab and compared the rate of complications to a matched cohort of neoadjuvant AC/T without bevacizumab. Methods: One hundred patients with HER2-negative breast cancer enrolled in a single-arm trial of neoadjuvant AC/T plus bevacizumab (cohort 1), 60 of these patients underwent mastectomy and were matched with 59 patients who received standard neoadjuvant AC/T (cohort 2) over a similar time period in the same healthcare system. All patients underwent mastectomy with or without reconstruction. Fisher’s exact tests were used to compare complication rates, with a p<0.05 was considered significant. Results: Patients were matched well in terms of demographics. The overall complication rate was 33% in cohort 1 and 31% in cohort 2 (P-value=0.84; Table). In cohort 1, 7 of 23 (30%) patients who underwent immediate expander/implant reconstruction had complications, including 2 patients who had explantation of their reconstructions. In cohort 2, 0 of 8 (0%) had complications (p value=0.15). Conclusions: Nearly a third of patients undergoing neoadjuvant therapy with AC/T with or without bevacizumab developed a postoperative complication after mastectomy. The use of bevacizumab was not associated with a significant increase in surgical complications, although this is a non-randomized data with a small sample size. As larger data sets become available with the use of neoadjuvant bevacizumab with mastectomy, further refinement may be necessary. [Table: see text]

Transformasi Terhadap Min bagi Menguji Taburan Terpencong

2012 ◽  
Author(s):  
Nor Haniza Sarmin ◽  
Md Hanafiah Md Zin ◽  
Rasidah Hussin
Keyword(s):  
Key Words ◽  
Simulation Study ◽  
Bias Correction ◽  
Type I Error ◽  
Small Sample Size ◽  
Small Sample ◽  
Skewed Distribution ◽  
Type I ◽  
Skewed Distributions ◽  
Chi Square

Suatu transformasi terhadap min dilakukan menggunakan penganggar pembetulan kepincangan bagi mendapatkan statistik untuk menguji min hipotesis taburan terpencong. Penghasilan statistik ini melibatkan pengubahsuaian pemboleh ubah . Kajian simulasi yang dijalankan terhadap taburan yang terpencong iaitu taburan eksponen, kuasa dua khi dan Weibull ke atas Kebarangkalian Ralat Jenis I menunjukkan bahawa statistik t3 sesuai untuk ujian satu hujung sebelah kiri dan saiz sampel yang kecil (n=5). Kata kunci: Min; statistik; taburan terpencong; penganggar pembetulan kepincangan; kebarangkalian Ralat Jenis I A transformation of mean has been done using a bias correction estimator to produce a statistic for mean hypothesis of skewed distributions. The statistic found involves a modification of the variable . A simulation study that has been done on some skewed distributions i.e. esponential, chi-square and Weibull on the Type I Error shows that t3 is suitable for the left-tailed test and a small sample size (n=5). Key words: Mean; statistic; skewed distribution; bias correction estimator; Type I Error

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