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David Rangel

Sample Presentation Math 146

The Vitamin D-Lemma*


Testing a hypothesis about sun exposure

*Maxmen,

A. (2011). Nature, 475(7354), 23-25.

Vitamin-D deficiency
Mean serum 25(OH)D levels decreasing in all categories of US Population* ! Vitamin D: essential for bone health ! Insufficiency possibly** associated with: ! Cardiovascular disease ! Prostate cancer ! Infection

!
25-hydroxyvitamin D (25-hydroxycholecalciferol)

Why are levels decreasing in the US Population?


*(1) National Health & Nutritional Examination Survey (19881994, 20012003, (2) Ginde et al. (2009) Arch. Intern. Med., 169(6):626632. **(1) Lio, Peter (2010) National Eczema Ass., (2) Chung, Mei, et al. (2009) Rockville, MD: Agency for Healthcare Research and Quality, Evidence Report/Technology Assessment 183 (3) Ross, A. Catharine, et al., Journal of Clinical Endocrinology & Metabolism 96.1 (2011): 53-58.

In defense of the sun


UVB exposure influences vitamin-D levels*

Unfettered sunshine is good for you!

Does our lack of sun put your health in danger?


The Northwest's dreary winters are infamous for inducing depression. But a growing body of evidence suggests it can raise your risk of cancer and increase susceptibility to other diseases, such as diabetes.

Michael F. Holick The Linus Pauling of vitamin-D (2005)

-Sandi Doughton (2008)


Grant, William (2009). Dermato-Endocrinology, 1(4): 207--214

Risks of UVB Exposure


Sensationalistic recommendations regarding unprotected sun exposure* promote unhealthy habits ! Solar exposure increases risk of melanoma

The D-Lemma: If sun is necessary, how do we assess risks of low vitamin-D levels with risks of UVB exposure and make recommendations?

Gilchrest, Barbara (2008). Am. J. Clin. Nutr., 88(suppl):570S-7S

Critical Thinking
Is sun exposure really correlated with healthy vitamin D levels? ! Perform an observational study of individuals with habitually high sun exposure

Where to find such a population???

! Target population ! Healthy individuals receiving high levels of UVB exposure ! Sample ! 93 surfers* ! 22.4 hours/week unprotected sun exposure ! Clinically tanned

Binkley, N., et al. Journal of clinical endocrinology & metabolism 92.6 (2007): 2130-2135.

The Statistical Question


Is the mean vitamin-D level of those receiving high sun exposure significantly greater than the general US population?

Hypothesis Testing will help answer the question!

Essentials of a Hypothesis Test


Statistical Hypothesis: A claim concerning a population parameter ! Null hypothesis (H0): The hypothesis to be tested (no effect) ! Alternative hypothesis (Ha): The alternative to the null hypothesis Hypothesis test: Use a probability model and sample data to decide whether the null should be rejected in favor of the alternative hypothesis ! Calculate the likelihood of obtaining the sample statistic by chance variation alone assuming the null is true

The hypothesis test: Hypotheses


0. Create null and alternate hypotheses ! What claim serves as the null? ! What is the alternative to this claim?

The hypothesis test: Hypotheses


0. Create null and alternate hypotheses ! H0: Mean [25(OH)D] = 30 ng/mL (US mean) ! Ha: Mean [25(OH)D] > 30 ng/mL

The hypothesis test: Model


1. Select a probability model: Use a probability model appropriate for statistic under investigation* assuming the null is true. ! What distribution describes sample means? Why? ! How is the distribution centered? Why? ! What is the relationship between this distributions variance and the parent population variance?

If the standard deviation of the target population is known, or assumed. Otherwise, use Students t-Distribution

The hypothesis test: Model


1. Select a probability model: Use a probability model appropriate for statistic under investigation*.
US Mean = 30 ng/mL
0.3 0.25 0.2 Probability 0.15 0.1 0.05 0 20

US SD = 15 ng/mL SD of the means = 15/!93

[25(OH)D] (ng/mL)

30

40

Assumes population standard deviation of 15, so that ! x = ! If using Students t-Distribution, use s = 3.4 ng/mL and sx =

n = 15

93 " 1.5

The hypothesis test: P-Value


2. Calculate the probability: Use the model to calculate the probability of obtaining sample data at least as inconsistent with the null hypothesis as the sample data actually obtained (P-Value) . ! What information do we need before calculating this probability? ! What does at least as inconsistent with the null imply? ! How do you calculate the P-Value?

The hypothesis test: P-Value


2. Calculate the probability: (a) Obtain mean from sample data* Mean [25(OH)D] = 31.6 ng/mL
0.3 0.2

Relative 0.2 Frequency


0.1 0.1 0.0 13 18 23 28 33 38 43 48 53 58 63

[25(OH)D] (ng/mL)
Binkley, N., et al. Journal of clinical endocrinology & metabolism 92.6 (2007): 2130-2135.

The hypothesis test: P-Value


2. Calculate the probability: (b) Calculate the P-Value = area to right of 31.6 ng/mL under normal distribution (cumulative probability*) P-Value = 0.15 (15%)
0.3 0.25 0.2 0.15 0.1 0.05 0 20 30

Probability

31.6

40

[25(OH)D] (ng/mL)
P-Value obtained using Applet found at: http://davidmlane.com/hyperstat/z_table.html

The hypothesis test: Decision


3. Make a decision: Decide whether the null hypothesis should be rejected in favor of the alternative hypothesis based on calculated probability (P-Value). ! At what P-Value do you consider the result too unlikely to have occurred by chance variation alone? If the P-Value is High, the Null will Fly If the P-Value is Low, the Null must Go ! How will you state your decision to address the original claim?

The hypothesis test: Decision


3. Make a decision: Decide whether the null hypothesis should be rejected in favor of the alternative hypothesis based on calculated probability. ! Test the Null: Assuming the null, there is a good chance that a mean vitamin-D level at least as great as the the sample mean could have occurred by chance alone (P = 0.15). !! Fail to reject the null ! Conclusion: The data do not support the claim that mean vitamin-D level of those receiving high sun exposure is significantly greater than the general US population. ! Implication: Continue to use UV protection and seek safe sources of vitamin-D

Thank you

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