Tutorial 5 – Supplementary Questions

Confidence interval for a mean and comparison of two means

1. Dengue Shock Syndrome. The following data were collected from a randomised double-blind
controlled trial comparing intravenous fluid regimens for initial resuscitation of Vietnamese
children with Dengue Shock Syndrome (Nhan et al. CID 2001: 32; 204-213).

Secondary outcome variable Intravenous fluid administered

Absolute decrease in haematocrit at 1 hour post Dextran 70 Normal saline
administration of intravenous fluid (% units)
Sample mean (sample standard deviation) 11.5 (3.3) 6.5 (2.9)
Number of patients 55 56

The 95% confidence interval for the population mean difference in ‘absolute decrease in
haematocrit at 1 hour post administration of intravenous fluid’ between children with Dengue
Shock Syndrome administered Dextran 70 intravenous fluid and Normal saline intravenous fluid
was 3.8 up to 6.2 (% units).

a. What is your interpretation of the 95% confidence interval for the above randomised
controlled trial comparing intravenous fluid regimens?
b. If we had calculated the 90% confidence interval for the above data would the interval
be wider or narrower than the above 95% confidence interval.

2. BreastScreen Victoria. The rising trend in diagnosis of ductal carcinoma in situ (DCIS) has
become a controversial area of breast cancer research with the advent of mammographic
screening. Although, the natural history of invasive breast cancer is well established the natural
history of DCIS is yet to be clarified. The size of DCIS tumours tends to be larger in women
attending mammographic screening for the first time than in women attending for a subsequent
breast screen. One possible factor in determining the size of the tumour in women presenting at
their first attendance is the presence of symptoms. In a sample of 15 women diagnosed with
DCIS at first attendance with no symptoms, the mean tumour size was 28.07mm with standard
error of the mean 12.55 mm. In a separate group of 16 women with the presence of symptoms
at diagnosis of DCIS, the mean tumour size was 20.44 mm with a standard error of 3.91 mm.

a. In light of the similar sample size in each of the two groups, comment on the size of the
standard error in each of the groups. What does this tell us about the relative size of the
(sample) standard deviation of the measurements in each group?
b. (Challenge question!) The sample standard deviations in each group can be calculated
explicitly by multiplying the standard error of the mean by the square root of the sample
size. Compare the size of the sample standard deviation to the sample mean in each
group – what does this tell us about the shape of distribution of tumour size
measurements in each group?