02 May Question: 12 Table 4.4 shows results from the study of diabetic patients discussed in Goldman and Smith (20…
12 Table 4.4 shows results from the study of diabetic patients discussed in Goldman and Smith (2002). Recall that three groups of patients separated by education level were treated with one of two therapies (conventional vs. intensive). Their average hemoglobin Alc levels (also known as glycosylated hemoglobin) before and after the experiment are reported. Note that, as in golf, lower scores are better on the hemoglobin Alc test, which measures how well the patient has kept blood glucose lev els in control. Most treatment regimens for diabetes are designed to keep hemoglobir Alc levels low Table 4.4. Improvement in hemoglobin measurement for diabetics by treatment regime and age. Glycosylated hemoglobin Group Postgraduate College grad/ some college HS degree/some seconda egree Conventional therapy only (n 495) 8.42 8.88 0.46 8.96 9.59 0.63 Baseline 8.76 9.08 0.32 End-to-study Difference Intensive treatment only (n 490) Baseline 8.04 7.18 -0.85 1.31 8.86 7.30 1.56 1.88 8.93 7.43 1.51 End-of-study Difference Treatment effect Treatment effect is the improvement in glycemic control among the intensive treatment group relative to conventional therapy. Average follow-up period was 72 months. Significance levels are for a test of equivalence with the postgraduate category and control for duration in study, gender, marital status, and age. Intensive treatment was more efficacious for the less educated. P 0.10 P 0.05 Source: Goldman and Smith (2002).Copyright (2002) National Academy of Sciences, USA. Reproduced with
As the figure indicates, average hemoglobin Alc levels deteriorated for patients in the control group, but improved for patients in the treatment group a In all three groups of conventional-therapy patients, glucose levels got worse Which of the conventional therapy groups glycosylated hemoglobin levels? Which intensive-treatment group had the biggest improvement in average glyco- sylated hemoglobin levels? For which group of patients did the intensive-treatment intervention seem to have the biggest effect compared with the conventional therapy? The smallest effect? Explain how this evidence is consistent with the efficient producer hypothesis. had the biggest deterioration in average b c d
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