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Development and evaluation of a one-month research track in emergency medicine for medical students
CONCEPTS, COMPONENTS & CONFIGURATIONS education, undergraduate, research
Development and Evaluation of a One-Month Research Track in E m e r g e n c y Medicine for Medical Students We present our experience with the development and evaluation of a onemonth research track in emergency medicine for medical students. The curriculum includes reading and problem-solving in research methods, biostatistics, and design (80 hours); data collection in one or more of the ongoing studies in the department (usually chart review - - 40 to 60 hours); one major literature search using Index Medicus and Science Citation Index (20 to 40 hours); and participation in all research-related meetings in the Division, as well as the hospital's Institutional Review Board. Evaluation of the student is done by a pretest and final exam covering the topics of the readings. ])re- and post-testing demonstrated increased understanding of basic research concepts and the use of statistics./Gold IW, Jayne HA: Development and evaluation of a one-month research track in emergency medicine for medical students. Ann Emerg Med June 1987;16:686-688.]
INTRODUCTION To our knowledge, despite a great deal written on undergraduate education in emergency medicine, us no one has yet approached the problem of providing an experience in research in emergency medicine for undergraduate medical students. Thus we present an outline of a one-month research elective.
ira W Gold, MD, MSPH Harold A Jayne, MD, FACEP Chicago, tllinois From the CoNege of Medicine, University of Illinois, Chicago, Illinois. Received for publication December 22, 1986. Accepted for publication February 16, 1987. Presented at the Annual Mee'dng of the University Association for Emergency Medicine in Portland, Oregon, May 1986. Address for reprints: Ira W Gold, MD, JFK Medical Center, 5645 West Addison, Chicago, Illinois 60634.
THE PROGRAM The main objective of the research elective program is to provide a meaningful experience to undergraduate students. Although we had students engaged full-time in the planning or data collection of a project, we wanted to design a program that would introduce them to basic principles of research design and statistical analysis as well as firsthand experience with data collection and a literature search. The activities were designed to meet these objectives (Figure 1). Independent reading formed the center of activity of the month. Articles 6 zs on research design included several devoted to each of the major study designs, such as retrospective studies and controlled clinical trials. Emphasis was placed on the understanding of such basic statistical concepts as beta and P values. Statistics texts were available to the participants, who were expected to learn to perform the t test and chi square by hand on sets of raw data. Eighty hours were allowed for this phase. For the data collection phase, the participant was assigned to one of the department's ongoing research projects. Activities involved abstracting of medical records and review of the emergency department log books after an initial training period. Forty to 50 hours were assigned to this effort. A manual literature search was required to ensure that the participant would be familiar with the reference resources of a medical library, specffi• cally Index Medicus and Science Citation Index. The concepts of key words and fields were clarified when the student also was allowed to do a computerized search with the medical librarian. Ten to 20 hours were allocated during the month. Meetings included biweekly residency didactic conferences as well as a weekly meeting with the faculty member in charge of the rotation. During these tutorial style meetings, the student could clarify problems with the readings while the faculty member could perform interim evaluation of the student's activities and comprehension. Furthermore, the student was int6:6 June 1987
Annals of Emergency Medicine
686/127
EMERGENCY MEDICINE RESEARCH TRACK Gold & Jayne
v i t e d to t h e m o n t h l y m e e t i n g of t h e h o s p i t a l ' s I n s t i t u t i o n a l R e v i e w Board. The month's meeting time totalled a p p r o x i m a t e l y 25 to 30 h o u r s . As o r i e n t a t i o n , o n or before t h e first day of t h e r o t a t i o n , t h e s t u d e n t m e t with the faculty advisor and a clear o u t l i n e of t h e m o n t h ' s o b j e c t i v e s a n d activities was presente d . In addition, t h e n e c e s s i t y for i n d e p e n d e n t s t u d y was e m p h a s i z e d , as w e l l as t h e p o t e n t i a l for t h e s t u d e n t ' s e x p e r i m e n t i n g w i t h h i s o w n s t y l e of l e a r n i n g . Although each student was encouraged to s t r u c t u r e a n d s c h e d u l e h i s act i v i t i e s to b e s t fit h i s o w n personality, a r e c o r d of h o u r s s p e n t o n e a c h act i v i t y was required. T h i s w a s d o n e i n a m o d i f i e d d i a r y style, j u s t as is req u i r e d of t h e d e p a r t m e n t ' s f a c u l t y m e m b e r s . A w e e k l y r e v i e w of t h i s diary i n t h e t u t o r i a l m e e t i n g s a l l o w e d f o r a f i n e - t u n i n g of t h e s t u d e n t ' s efforts. Finally, a " p r e t e s t " (in fact, t h e f i n a l exam with a different heading) was g i v e n to e a c h s t u d e n t o n t h e first day. T h i s p r o v i d e d a n i n d i c a t i o n of t h e level of c o m p e t e n c e t h a t h e w a s expected to obtain.
PROBLEMS We c o n s i d e r o u r s e l v e s l u c k y to h a v e designed an elective that self-selects only highly motivated students. Their problems were limited to the unders t a n d i n g of c e r t a i n r e s o u r c e s a n d texts, p a r t i c u l a r l y t h o s e d e a l i n g w i t h s t a t i s t i c s . O c c a s i o n a l l y a n o t h e r facu l t y m e m b e r or r e s i d e n t w o u l d v i e w t h e s t u d e n t as a s o u r c e of free l a b o r a n d a t t e m p t to e n l i s t h i m i n a n addit i o n a l r e s e a r c h project. T h i s w a s disc o u r a g e d b e c a u s e it t e n d e d to c a u s e a drop i n t h e a m o u n t of t i m e d e v o t e d to reading.
EVALUATION A f i n a l e v a l u a t i o n of t h e s t u d e n t was d r a w n f r o m several sources. T h e most objective was the final exam (Figure 2). T h e s t u d e n t ' s p a r t i c i p a t i o n i n t h e t u t o r i a l d i s c u s s i o n a n d h i s ability to discuss t h e r e a d i n g s also w e r e m a j o r c o n s i d e r a t i o n s . Finally, t h e perf o r m a n c e Of a s s i g n e d tasks, b o t h data collection and literature searches, were evaluated by the faculty in charge of t h o s e projects. T h e s t u d e n t was a s k e d to e v a l u a t e
128/687
FIGURE
1. V o c a b u l a r y search elective.
l i s t f o r re-
F I G U R E 2. R e s e a r c h e l e c t i v e f i n a l (2 hours).
h i s e x p e r i e n c e i n w r i t t e n or v e r b a l form a t . T h e r e s p o n s e was u n i f o r m l y ent h u s i a s t i c . We b e l i e v e t h e s u c c e s s of t h e p r o g r a m lies w i t h t h e r e l a t i v e ind e p e n d e n c e g i v e n to t h e p a r t i c i p a n t s , c o u p l e d w i t h a c l e a r i n d i c a t i o n of o u r e x p e c t a t i o n s of t h e m . W i t h w e e k l y f e e d b a c k to b o t h s t u d e n t a n d m e n t o r from the other, adjustments can be m a d e t o e n s u r e a s u c c e s s f u l a n d rew a r d i n g m o n t h for all p a r t i c i p a n t s . CONCLUSION We b e l i e v e t h a t a s u c c e s s f u l i n t r o duction to research in emergency medicine can be attained in a month of i n v o l v e m e n t w i t h a n i n v e s t i g a t o r , a c t i v e p a r t i c i p a t i o n i n a r e s e a r c h project, a n d i n d e p e n d e n t reading.
Hypothesis Null hypothesis Normal curve Baye's theorem Data Data collection Descriptive statistics Inductive statistics Controlled, double-blinded Randomization Single-blinded Cohort study Trohoc (retrospective study) c~ (alpha) Type II error L3 (beta) Sensitivity Specificity Positive predictive value Negative predictive value Informed consent Validity Reliability
REFERENCES 1. Sanders AB, Criss E, Witzke D, et ah Survey of undergraduate emergency medical education in the United States. Ann Emerg Med 1986;15: 1-5. 2. Sanders AB, Criss E, Witzke D: Core content survey of undergraduate education in emergency medicine. Ann Emerg Med 1986;15:6-11. 3. Shesser R, Smith M, Kline P, et ah A costeffective emergency medicine clerkship. J Med Educatdon 1985;60:288-292. 4. 8hesser R, Smith M, Kline P, et ah A student emergency medicine clerkship that uses new information technologies. J Emerg Med I985;2: 455-461. 5. Society of Teachers of Emergency Medicine: Core content for undergraduate education in emergency medicine. A n n Emerg Med 1985; 14:474-476. 6. Ahman DG: Statistics and ethics in medical research. Br Med J 1980;28h1336-1338. 7. Cornfield J: Principles of research. A m J Mental Deficiency 1959;64:240-252. 8. DerSimonian R, Charette LJ, McPeek B, et ah Reporting on methods in clinical trials. N e w Engl J Med 1982;306:1332-1337. 9. Elenbaas RM, Klenbaas JK, Cuddy PG: Evaluating the medical literature, Part II: Statistical analysis. Arm Emerg Med 1983;12:610-620. 10. Fletcher RH, Fletcher SW: Clinical research in general medical journals. N e w Engl J Med 1979;301:I80-183. ll. Froom J, Culpepper L, Becket L, et ah Research design in family medicine. J Faro Pract 1978;7:75-90. 12. Gifford RH, Feinstein AR: A critique of methodology in studies of anticoagulant ther-
Annals of Emergency Medicine
apy for acute myocardial infarction. N Engl J Med 1959;280:351-357.
13. Glantz SA: Biostatistics: How to detect, correct and prevent errors in the medical literature. Circulation 1980;6i:1-7. 14, Gold I, Podolsky S, Kuhn M, et ah A review of research methodology in an emergency medicine journal Ann Emerg Meal 1983;12:769-773. 15, Hills M, Armitage P: The two-period crossover clinical trial. Br J Clin PharmacoI 1979; 8:7-20. 16. Tricyclic antidepressant poisoning in children. The Lancet Sept 8, 1979, p 511. 17. McMaster University Health Science Centre: How to read clinical journals, parts I-V. CMA Journal, March 1, 1981-May 1, 1981. 18. Owen R: Reader bias. JAMA 1982;247: 2533-2534. 19. Peto R: Clinical trial methodology. Bio~ medicine Special Issue 1978;28:24-36. 20. Phillips TJ: Research considerations for the family physician. J Farn Pract 1978;7:121-128. 2I. Sackett DL, Gent M: Controversy in counting and attributing events in clinical trialsl N Engl J Med 1979;301:1410-1412. 22. Sackett DL: Bias in analytic research. J Chronic Diseases 1979;32:51-63. 23. SartwelI Pt~: Retrospective studies: A review for the clinician. A n n Intern Med 1974; 8I:381-386. 24. Riegelman RK: Studying a Study and Testing a Test. Boston, Little, Brown and Col 1981. 25. Feinstein AR: Clinical Biostatistics. St Louis CV Mosby Co, 1977.
16:6 June 1987
1. Define the following terms:
6. These are the results of validating a blood test for herpes encephalitis against the autopsy findings:
Null h y p o t h e s i s -
Autopsy Findings + -
Randomization - (alpha) - Type II e r r o r -
Blood Test
÷ A - C
B D
Double blinded - -
a. Which are the false positives?
Informed c o n s e n t b. Which are the false negatives? 2. A patient reports that he smoked 20 pack years prior to developing emphysema. This type of data would be obtained from (circle one): a. clinical trial
d. Its sensitivity:
b. retrospective study c~ double blinded controlled study
e. Its positive predictive value:
3. A statistic that would be appropriate to use when n u m b e r s stand for c a t e g o r i e s (eg, m a l e = 0 ; female = 1) would be: a. t test b. chi square 4. If a patient's body temperature drops one degree for each ten degrees below 58.6, F ambient temperature, what is the correlation coefficient? a. b. c. d.
30 10 0.1 3
b. controlled uncontrolled decontrolled c. systematically assigned unrandomized randomly assigned haphazardly assigned d. chi square t test
16:6 June 1987
f. Its negative predictive value:
7. I am interested determining if marijuana use protects against the likelihood of myocardial infarction. List two advantages and two disadvantages of the trohoc (retrospective) study design as compared to a controlled clinical trial: 8. These are the results of a study:
Cigarette + 1,500 Smoking _ 200
300 1,000
a. Could these data have been obtained by a: (yes or no)
5. If you wanted to test a drug's effects on a patient's body temperature, what kind of study would one do? (choose one from each category): a. retrospective prospective cross sectional
Write the following formulas describing these results: c. The specificity of the test:
cohort study? retrospective study? clinical trial? double-blinded study? b. What kind of statistical test could be used to determine if these results are s i g n i f i c a n t ? _
c. Do you expect the results to be significant? (circle one) Yes No d. If correlation coefficient were determined from these data, what would be its sign?
Annals of Emergency Medicine
688/129
Development and Evaluation of a One-Month Research Track in E m e r g e n c y Medicine for Medical Students We present our experience with the development and evaluation of a onemonth research track in emergency medicine for medical students. The curriculum includes reading and problem-solving in research methods, biostatistics, and design (80 hours); data collection in one or more of the ongoing studies in the department (usually chart review - - 40 to 60 hours); one major literature search using Index Medicus and Science Citation Index (20 to 40 hours); and participation in all research-related meetings in the Division, as well as the hospital's Institutional Review Board. Evaluation of the student is done by a pretest and final exam covering the topics of the readings. ])re- and post-testing demonstrated increased understanding of basic research concepts and the use of statistics./Gold IW, Jayne HA: Development and evaluation of a one-month research track in emergency medicine for medical students. Ann Emerg Med June 1987;16:686-688.]
INTRODUCTION To our knowledge, despite a great deal written on undergraduate education in emergency medicine, us no one has yet approached the problem of providing an experience in research in emergency medicine for undergraduate medical students. Thus we present an outline of a one-month research elective.
ira W Gold, MD, MSPH Harold A Jayne, MD, FACEP Chicago, tllinois From the CoNege of Medicine, University of Illinois, Chicago, Illinois. Received for publication December 22, 1986. Accepted for publication February 16, 1987. Presented at the Annual Mee'dng of the University Association for Emergency Medicine in Portland, Oregon, May 1986. Address for reprints: Ira W Gold, MD, JFK Medical Center, 5645 West Addison, Chicago, Illinois 60634.
THE PROGRAM The main objective of the research elective program is to provide a meaningful experience to undergraduate students. Although we had students engaged full-time in the planning or data collection of a project, we wanted to design a program that would introduce them to basic principles of research design and statistical analysis as well as firsthand experience with data collection and a literature search. The activities were designed to meet these objectives (Figure 1). Independent reading formed the center of activity of the month. Articles 6 zs on research design included several devoted to each of the major study designs, such as retrospective studies and controlled clinical trials. Emphasis was placed on the understanding of such basic statistical concepts as beta and P values. Statistics texts were available to the participants, who were expected to learn to perform the t test and chi square by hand on sets of raw data. Eighty hours were allowed for this phase. For the data collection phase, the participant was assigned to one of the department's ongoing research projects. Activities involved abstracting of medical records and review of the emergency department log books after an initial training period. Forty to 50 hours were assigned to this effort. A manual literature search was required to ensure that the participant would be familiar with the reference resources of a medical library, specffi• cally Index Medicus and Science Citation Index. The concepts of key words and fields were clarified when the student also was allowed to do a computerized search with the medical librarian. Ten to 20 hours were allocated during the month. Meetings included biweekly residency didactic conferences as well as a weekly meeting with the faculty member in charge of the rotation. During these tutorial style meetings, the student could clarify problems with the readings while the faculty member could perform interim evaluation of the student's activities and comprehension. Furthermore, the student was int6:6 June 1987
Annals of Emergency Medicine
686/127
EMERGENCY MEDICINE RESEARCH TRACK Gold & Jayne
v i t e d to t h e m o n t h l y m e e t i n g of t h e h o s p i t a l ' s I n s t i t u t i o n a l R e v i e w Board. The month's meeting time totalled a p p r o x i m a t e l y 25 to 30 h o u r s . As o r i e n t a t i o n , o n or before t h e first day of t h e r o t a t i o n , t h e s t u d e n t m e t with the faculty advisor and a clear o u t l i n e of t h e m o n t h ' s o b j e c t i v e s a n d activities was presente d . In addition, t h e n e c e s s i t y for i n d e p e n d e n t s t u d y was e m p h a s i z e d , as w e l l as t h e p o t e n t i a l for t h e s t u d e n t ' s e x p e r i m e n t i n g w i t h h i s o w n s t y l e of l e a r n i n g . Although each student was encouraged to s t r u c t u r e a n d s c h e d u l e h i s act i v i t i e s to b e s t fit h i s o w n personality, a r e c o r d of h o u r s s p e n t o n e a c h act i v i t y was required. T h i s w a s d o n e i n a m o d i f i e d d i a r y style, j u s t as is req u i r e d of t h e d e p a r t m e n t ' s f a c u l t y m e m b e r s . A w e e k l y r e v i e w of t h i s diary i n t h e t u t o r i a l m e e t i n g s a l l o w e d f o r a f i n e - t u n i n g of t h e s t u d e n t ' s efforts. Finally, a " p r e t e s t " (in fact, t h e f i n a l exam with a different heading) was g i v e n to e a c h s t u d e n t o n t h e first day. T h i s p r o v i d e d a n i n d i c a t i o n of t h e level of c o m p e t e n c e t h a t h e w a s expected to obtain.
PROBLEMS We c o n s i d e r o u r s e l v e s l u c k y to h a v e designed an elective that self-selects only highly motivated students. Their problems were limited to the unders t a n d i n g of c e r t a i n r e s o u r c e s a n d texts, p a r t i c u l a r l y t h o s e d e a l i n g w i t h s t a t i s t i c s . O c c a s i o n a l l y a n o t h e r facu l t y m e m b e r or r e s i d e n t w o u l d v i e w t h e s t u d e n t as a s o u r c e of free l a b o r a n d a t t e m p t to e n l i s t h i m i n a n addit i o n a l r e s e a r c h project. T h i s w a s disc o u r a g e d b e c a u s e it t e n d e d to c a u s e a drop i n t h e a m o u n t of t i m e d e v o t e d to reading.
EVALUATION A f i n a l e v a l u a t i o n of t h e s t u d e n t was d r a w n f r o m several sources. T h e most objective was the final exam (Figure 2). T h e s t u d e n t ' s p a r t i c i p a t i o n i n t h e t u t o r i a l d i s c u s s i o n a n d h i s ability to discuss t h e r e a d i n g s also w e r e m a j o r c o n s i d e r a t i o n s . Finally, t h e perf o r m a n c e Of a s s i g n e d tasks, b o t h data collection and literature searches, were evaluated by the faculty in charge of t h o s e projects. T h e s t u d e n t was a s k e d to e v a l u a t e
128/687
FIGURE
1. V o c a b u l a r y search elective.
l i s t f o r re-
F I G U R E 2. R e s e a r c h e l e c t i v e f i n a l (2 hours).
h i s e x p e r i e n c e i n w r i t t e n or v e r b a l form a t . T h e r e s p o n s e was u n i f o r m l y ent h u s i a s t i c . We b e l i e v e t h e s u c c e s s of t h e p r o g r a m lies w i t h t h e r e l a t i v e ind e p e n d e n c e g i v e n to t h e p a r t i c i p a n t s , c o u p l e d w i t h a c l e a r i n d i c a t i o n of o u r e x p e c t a t i o n s of t h e m . W i t h w e e k l y f e e d b a c k to b o t h s t u d e n t a n d m e n t o r from the other, adjustments can be m a d e t o e n s u r e a s u c c e s s f u l a n d rew a r d i n g m o n t h for all p a r t i c i p a n t s . CONCLUSION We b e l i e v e t h a t a s u c c e s s f u l i n t r o duction to research in emergency medicine can be attained in a month of i n v o l v e m e n t w i t h a n i n v e s t i g a t o r , a c t i v e p a r t i c i p a t i o n i n a r e s e a r c h project, a n d i n d e p e n d e n t reading.
Hypothesis Null hypothesis Normal curve Baye's theorem Data Data collection Descriptive statistics Inductive statistics Controlled, double-blinded Randomization Single-blinded Cohort study Trohoc (retrospective study) c~ (alpha) Type II error L3 (beta) Sensitivity Specificity Positive predictive value Negative predictive value Informed consent Validity Reliability
REFERENCES 1. Sanders AB, Criss E, Witzke D, et ah Survey of undergraduate emergency medical education in the United States. Ann Emerg Med 1986;15: 1-5. 2. Sanders AB, Criss E, Witzke D: Core content survey of undergraduate education in emergency medicine. Ann Emerg Med 1986;15:6-11. 3. Shesser R, Smith M, Kline P, et ah A costeffective emergency medicine clerkship. J Med Educatdon 1985;60:288-292. 4. 8hesser R, Smith M, Kline P, et ah A student emergency medicine clerkship that uses new information technologies. J Emerg Med I985;2: 455-461. 5. Society of Teachers of Emergency Medicine: Core content for undergraduate education in emergency medicine. A n n Emerg Med 1985; 14:474-476. 6. Ahman DG: Statistics and ethics in medical research. Br Med J 1980;28h1336-1338. 7. Cornfield J: Principles of research. A m J Mental Deficiency 1959;64:240-252. 8. DerSimonian R, Charette LJ, McPeek B, et ah Reporting on methods in clinical trials. N e w Engl J Med 1982;306:1332-1337. 9. Elenbaas RM, Klenbaas JK, Cuddy PG: Evaluating the medical literature, Part II: Statistical analysis. Arm Emerg Med 1983;12:610-620. 10. Fletcher RH, Fletcher SW: Clinical research in general medical journals. N e w Engl J Med 1979;301:I80-183. ll. Froom J, Culpepper L, Becket L, et ah Research design in family medicine. J Faro Pract 1978;7:75-90. 12. Gifford RH, Feinstein AR: A critique of methodology in studies of anticoagulant ther-
Annals of Emergency Medicine
apy for acute myocardial infarction. N Engl J Med 1959;280:351-357.
13. Glantz SA: Biostatistics: How to detect, correct and prevent errors in the medical literature. Circulation 1980;6i:1-7. 14, Gold I, Podolsky S, Kuhn M, et ah A review of research methodology in an emergency medicine journal Ann Emerg Meal 1983;12:769-773. 15, Hills M, Armitage P: The two-period crossover clinical trial. Br J Clin PharmacoI 1979; 8:7-20. 16. Tricyclic antidepressant poisoning in children. The Lancet Sept 8, 1979, p 511. 17. McMaster University Health Science Centre: How to read clinical journals, parts I-V. CMA Journal, March 1, 1981-May 1, 1981. 18. Owen R: Reader bias. JAMA 1982;247: 2533-2534. 19. Peto R: Clinical trial methodology. Bio~ medicine Special Issue 1978;28:24-36. 20. Phillips TJ: Research considerations for the family physician. J Farn Pract 1978;7:121-128. 2I. Sackett DL, Gent M: Controversy in counting and attributing events in clinical trialsl N Engl J Med 1979;301:1410-1412. 22. Sackett DL: Bias in analytic research. J Chronic Diseases 1979;32:51-63. 23. SartwelI Pt~: Retrospective studies: A review for the clinician. A n n Intern Med 1974; 8I:381-386. 24. Riegelman RK: Studying a Study and Testing a Test. Boston, Little, Brown and Col 1981. 25. Feinstein AR: Clinical Biostatistics. St Louis CV Mosby Co, 1977.
16:6 June 1987
1. Define the following terms:
6. These are the results of validating a blood test for herpes encephalitis against the autopsy findings:
Null h y p o t h e s i s -
Autopsy Findings + -
Randomization - (alpha) - Type II e r r o r -
Blood Test
÷ A - C
B D
Double blinded - -
a. Which are the false positives?
Informed c o n s e n t b. Which are the false negatives? 2. A patient reports that he smoked 20 pack years prior to developing emphysema. This type of data would be obtained from (circle one): a. clinical trial
d. Its sensitivity:
b. retrospective study c~ double blinded controlled study
e. Its positive predictive value:
3. A statistic that would be appropriate to use when n u m b e r s stand for c a t e g o r i e s (eg, m a l e = 0 ; female = 1) would be: a. t test b. chi square 4. If a patient's body temperature drops one degree for each ten degrees below 58.6, F ambient temperature, what is the correlation coefficient? a. b. c. d.
30 10 0.1 3
b. controlled uncontrolled decontrolled c. systematically assigned unrandomized randomly assigned haphazardly assigned d. chi square t test
16:6 June 1987
f. Its negative predictive value:
7. I am interested determining if marijuana use protects against the likelihood of myocardial infarction. List two advantages and two disadvantages of the trohoc (retrospective) study design as compared to a controlled clinical trial: 8. These are the results of a study:
Cigarette + 1,500 Smoking _ 200
300 1,000
a. Could these data have been obtained by a: (yes or no)
5. If you wanted to test a drug's effects on a patient's body temperature, what kind of study would one do? (choose one from each category): a. retrospective prospective cross sectional
Write the following formulas describing these results: c. The specificity of the test:
cohort study? retrospective study? clinical trial? double-blinded study? b. What kind of statistical test could be used to determine if these results are s i g n i f i c a n t ? _
c. Do you expect the results to be significant? (circle one) Yes No d. If correlation coefficient were determined from these data, what would be its sign?
Annals of Emergency Medicine
688/129