Understanding Equivalence and Non Inferiority Testing

Question: Write an essay onUnderstanding Equivalence and Non Inferiority Testing. Answer: Introduction The research article deals with the effective standards developed in clinical settings that determines whether the current efficacies in use are similar or different from each other. The equivalence as well as non-inferiority with higher efficacies is either to find the difference between the two or to analyze the superiority than the tradition methods. However, the basic aim of the article states the concepts and the statistical methods implicated in testing the equivalence/ non-inferiority efficacies and the critical evaluation of the current usage of these efficacies. Procedure The simplest method that can be used to test equivalence is one-sided test known by TOST procedure which can be extended to testing equivalency in other parameters like odds ratios, means, etc. It is generally carry forward after checking its relevance at the (12) 100% confidence interval for the difference in efficacies because this method is identical to performing two one-sided tests. However, efficacy is measured by two ways firstly, through success rates, when higher is better and through, failure rates which when lower is better. However, after applying the TOST procedure of hypothesis testing using confidence intervals, the strength of evidence is carried out using p value. However, the test can be distinguished as: Traditional testing p-value is less than alpha such that hypothesis (equivalence) is established. Non inferiority p-value is readily available for the TOST. Equivalence Margin The equivalence margin is determined by such that a narrow difference in the value will cause difficulty in establishing equivalence. The value of the study helps in giving result as well as the credibility of the study through relevant evidence and sound clinical considerations. On the other hand, it is primarily designed to minimize the possibility of new theory that stands out to be non-superior to the sample. However, the margin of non-superiority can be evaluated through the previous studies. The displacement from the equivalence with a small fraction can be given by . Conversely, different like Kaul and Diamond, is governed by the maximum efficacy loss of the new theory. Before, the data is recorded, it is important to know the equivalence margin to maintain the Type 1 error at the anticipated level. On the other hand, if there is no difference it does not imply that there would be no equivalence. However, equivalence often lead to incorrect conclusions through wrong hypothesis, non-significant result and no considering of marginal equivalence. Nevertheless, the inconsistencies are measured through the graphs. In TOST and traditional testing, the difference lies between the confidence interval such that in the former, the null hypothesis is rejected and does not cover zero whereas in the latter, the confidence interval is included between the intervals (, ) (Walker and Nowacki 2011). Sample Size and Measure of Effect The sample size is the main dimension in determining number of observations through desired power such that the sample size depends on the equivalence margin. However, the sample size was collected between a new dug and an active control for testing the equivalence using the software PASS. The measure of effect is measured using the proportions in absolute or the relative way. The former explains the difference between the proportions called the absolute risk difference (ARD) whereas when the study is made on the ratios of proportions then the study measures relative risk (RR) as well as odds ratio (OR). The difference lies between the two is that absolute measures are independent of the baseline rate whereas relative measure is dependent to the denominator of equivalence margin (Walker and Nowacki 2011). Analysis of Data The analysis of data is made regarding the decision to be performed on per protocol (PP) or the intention to treat (ITT) analysis. In data analysis, in ITT, the patients either receive the treatment or follow the protocol whereas in PP, the patients receive the treatment, followed by the protocol. The difference in efficacies is smaller in ITT because it makes the equivalence/ non-inferiority hard to reject the null hypothesis and is based on the conservative approach. Therefore, discrepancies experienced in the results the possibility of exclusion bias and the reasons for the non-inclusion of patients in the PP analysis. Conclusion To conclude, the research article emphasizes on the increase in the equivalence due to the new therapies with the same effectiveness and better properties such as lower costs and convenience. Nevertheless, as depicted the confusion in the literature is regarding the equivalence/ non inferiority. The confusion is primarily due to the lack of transparency and uniformity. This applicable when the new methods are introduced with a state of affair that the guidelines for reporting equivalence/ non inferiority studies has improved. However, the use of equivalence/ non inferiority studies has increased if the clinician judges its value in the current times. Reference Walker, E. and Nowacki, A. (2011). Understanding Equivalence and Noninferiority Testing.J GEN INTERN MED, 26(2), pp.192-196.

Was Canadian conscription in World War I justified Essay Example

Was Canadian conscription in World War I justified Paper A. Plan of Investigation Was Canadian conscription in World War I justified? Many people have addressed the issue of Canadian conscription in World War I and debated back and forth as to the justification and necessity of it at the time. The purpose of this internal assessment is to determine whether instituting conscription was a valid decision through an investigation of the different groups affected and their points of views. To do this, I will use a variety of sources and my own knowledge to look at both sides of the argument and come up with a valid conclusion. In section B, I will examine different viewpoints and their reasons for and against conscription. We will write a custom essay sample on Was Canadian conscription in World War I justified specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Was Canadian conscription in World War I justified specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Was Canadian conscription in World War I justified specifically for you FOR ONLY $16.38 $13.9/page Hire Writer In section C, I will evaluate two sources that have very different views as to whether conscription was the right thing to do. In section D, I will analyse the effect of conscription on the population of Canada, how historians view the issue, and its significance in Canadian history. In section E, I will make a final statement and then give my reasons for it. It is my opinion that conscription was unjustified as it infringed on basic rights, and divided the country as it had never been divided before. B. Summary of Evidence Arguments for Conscription The arguments for conscription mainly concern the fact that Borden wanted Canada to appear as a strong united country that was capable of holding her own in battle.i As World War I dragged on, Canadas volunteer recruitment program was failing. Fewer people were volunteering, and Bordens promise of 500 000 men was beginning to look outrageous. Not wanting to appear weak, Borden decided his only option was conscription. To justify this, he said that Canada would finally be considered an autonomous state when the world saw the power of her army.ii Borden also justified it by stating that most European countries supported conscription including Britain.iii He simply did not understand that Canadians did not have the passion for war that the British or any other Europeans did for that matter, because they did not feel like the war affected them in any meaningful way. Arguments against Conscription The arguments against conscription are many, and most if not all are reasonable and justified. One of the main arguments against conscription was that people did not feel like the war affected them in any way, as it was so far away. People did not really care who won the war, because it could never cross the ocean and affect them, and therefore their participation in the war was pointless and stupid.iv Another argument against conscription was that it infringed on the basic rights of Canadians as human beings. In the constitution, it stated that no man should be forced to enlist in the army, unless a force threatened the territory of Canada itself.v With this argument, many Canadians saw it as illegal for the government to conscript men, as they believed the war did not affect Canada directly. The Quebecois were especially against conscription, as they felt they were being discriminated against within the armed forces. Once in the army, Quebeckers had to serve under English commanders who knew little to no French, and the Quebeckers were often harassed.vi They also felt no loyalty to Britain as their English counterparts did, and did not feel loyal to France either.vii Another group that was strongly against conscription was the farmers. They felt conscription was wrong because it took away able-bodied men that were desperately needed on the farm to harvest the crops. They argued that without the crops, there would not be enough supplies to feed the men overseas.viii Another strong argument against conscription, were the facts that came out after the war. Of the 400 000 men who were registered as being up for conscription, only 59 991 were ever ordered to duty. All the others were either granted exemptions, or declared unfit to serve.ix This clearly shows that conscription could not have had that much of an impact if only fifteen percent of men conscripted ever made it to service. Perhaps the biggest argument against conscription, was the loss of so many lives. No matter how hard Borden tried, not many people accepted the loss of so many innocent young men as simply the consequences of a war that half the country did not support. C. Evaluation of Sources Morton, Desmond. When Your Numbers Up: the Canadian Soldier in the First World War. Canada, Random House, 1993. This book, written by Desmond Morton in 1993, is a secondary source that talks about the experiences of Canadian soldiers in World War I. Its purpose is to give information about what it was like to be a soldier in the Canadian forces during World War I through historical research. Its main thesis about conscription is that it was necessary to keep a strong Canadian contingent fighting, not only to help the war effort, but also to show the world what a power Canada was. The main value of this book is that it is written by a well-known and well-respected historian and therefore the information within it is reliable. Its main limitation is that it is a secondary source written many years after the war by someone who did not experience it first hand, and therefore all the information is based on research conducted by him. Grubb, Edward. Memories of the No-Conscription Fellowship by the Treasurer. Canada: Richard Cobden-Sanderson, 1935. This source, written by the treasurer of the organization, Edward Grubb in 1935, is a primary source that recounts the No-Conscription Fellowship, an organization against conscription in Canada during World War I. Its purpose is to give information and detailed accounts of what the organization was and what it did to help in the fight against conscription. Its main thesis is that conscription was wrong because it infringed on basic human rights, and therefore it was their duty to oppose it and fight it any way they could. Its main value is that it is a primary source written by someone who lived during the war and fought conscription himself, and therefore the information is a first-hand account. Its limitations are that it only gives one side of the argument about conscription, and it was written around 17 years after the war, and therefore the information may be embellished or changed. D. Analysis The evidence against conscription far outweighs the evidence for it. This section will analyse what effect conscription had on the population of Canada, and then the opinions of historians on conscription. Finally, I will look at the importance of this issue in the history of Canada. When conscription was first proposed, there was an instant divide between English and French Canada. English Canada was generally for conscription as they felt they should support Britain as much as possible.x French Canada on the other hand, felt no loyalty towards Britain and therefore was strongly opposed. The issue of conscription threatened to divide Canada. Borden faced a tough decision, he had to decide whether to support Britain and gain international recognition, or save his country from internal destruction. When Border chose the former, there was instantly civil unrest throughout the country. In Quebec, there were riots protesting conscription and many refused to serve when they were conscripted. It was not only the men being conscripted who rebelled, police in Quebec who were supposed to get the conscripts mostly refused to do it, so Borden had to gather a special conscription force to go and collect the men. The country was divided as it had never been before, and Borden was very worried. French Canadians were extremely angry at the ignorance of Borden and his lack of sympathy for their cause, while English Canadians felt that the French were going against Canada by opposing conscription. Borden had no solution for this problem, and Canada would remain divided for many years to come. Most historians, when talking about the issue of conscription in Canada during World War I, agree that it was unjustified. One of these historians was Grant Dexter, who wrote an essay specifically on the conscription crisis of 1917. He believed that conscription was wrong because of three main reasons.xi The first, was that it divided the country between English and French and soured relations between the two for years to come. The second reason, was that it infringed on basic constitutional rights set out that said that no man should be forced to fight outside of Canada unless the territory of Canada is threatened directly. The third reason, dealt with obligation without representation, and stated that since Canada had no say in British foreign policy, then she should not be obligated to fight Britains war. This is not to say that all historians agreed that conscription was wrong, some still believed that it was the right thing to do. One of these historians, was Desmond Morton, who wrote When Your Numbers Up, a book that deals with the roles of the Canadian soldier in World War I. In this book, he gives the point of view that conscription was necessary for two main reasons.xii The first, was that more men were necessary to help the war effort in Europe and without it, the central powers might be victorious. The second reason, was that Canada needed to show that she could be a formidable power in international affairs and could hold her own against any other country in the world. Because of these two reasons, Morton felt conscription was the only solution. As is evident from this section, the debate about conscription is not completely one-sided, however the arguments against are far more convincing. The impact of this issue on Canadian history is very great indeed. This was the first time in Canadian history that men had been forced to go to war out of North America. The divisive consequences of conscription would be evident for many decades to come, as there would always be a certain grudge between English and French Canadians on the issue of loyalty to Britain. Over the years that passed after conscription, the issue would continue to be brought up whenever loyalty to Britain was in question or debate. Because of this, many people see it as both a negative and positive event. It is seen as negative because of the division that resulted from it, but it is also seen as positive because it is hard to question our loyalty to Britain when we were willing to go so far as to force young men to go to war and most likely death, simply to show our support for their cause. Conscription will always be remembered in Canada as an issue that separated Canada, but brought us closer to Britain . E. Conclusion In conclusion, conscription in Canada during World War I was unjustified and wrong. It infringed on the basic rights of Canadians set out in the constitution that stated that no man should be forced to fight outside Canada unless there was a direct threat to Canada itself. It also was never fully supported in Canada, simply by the English Canadians who outnumbered French Canadians and therefore made up the majority. It divided Canada between English and French Canadians in a separation that was never fully mended, as there was always a certain resentment between the two groups. The facts speak for themselves, less than fifteen percent of the men conscripted were sent to duty overseas, which shows how futile and useless conscription was. Finally, and most importantly, many innocent lives were lost as a result of conscription, lives that would never be recovered. It does not matter what benefits we gained from the war, nothing can justify the loss of so many lives.

The Definition of Atomic Volume and How to Calculate It

The Definition of Atomic Volume and How to Calculate It The atomic volume is the volume one mole of an element occupies at room temperature. Atomic volume is typically given in cubic centimeters per mole: cc/mol. The atomic volume is a calculated value using the atomic weight and the density using the formula: atomic volume atomic weight/density Alternatives Another way to calculate atomic volume is to use the atomic or ionic radius of an atom (depending on whether or not you are dealing with an ion). This calculation is based on the idea of an atom as a sphere, which isnt precisely accurate. However, its a decent approximation. In this case, the formula for the volume of a sphere is used, where r is the atomic radius: volume (4/3)(Ï€)(r3) Example For example, a hydrogen atom has an atomic radius of 53 picometers. The volume of a hydrogen atom would be: volume (4/3)(Ï€)(533) volume 623000 cubic picometers (approximately)

Analysis of Patrick Henry essays

Analysis of Patrick Henry essays In the speech, "The Virginia Convention," Patrick Henry set out to convince the Virginia delegates that the war with England was inevitable and the longer they waited the harder the war would be to win. Patrick Henry uses the art of persuasion to win over his audience. In the essay, The Crisis, No. 1, Thomas Paine set out to persuade the people of each colony should stand up and fight for their freedom. He set out to convince the colonists that the tyrant England had binded the colonies in her grasp and transformed the colonists into slaves. In the, Notes on the State of Virginia, Thomas Jefferson sets out to convince the State of Virginia that whites are the superior race and that all African Americans that have been emancipated should be exported to another country. All of the authors institute effective use of the range of appeals, logos, ethos, and pathos giving the speech a quality of concrete mental and physical wholeness. The logos contribution of Henry's address makes use of solid facts to convince the people of Virginia that fighting or slavery are the only possible outcomes of their meeting. He uses this as a fear factor to persuade the people that fighting is the only way to maintain their freedom. These logical facts are used mainly in the third and fourth paragraphs and he also ends his assertions with questions. "Are fleets and armies necessary to work a love and reconciliation?" asks Henry of his audience. This arrangement of writing, a question, serves not only to state the obvious motive that the "fleets and armies" are not on American soil to promote peace, but to suppress the colonies and this shows the Convention a justification in their actions to fight not flight. Another purpose is achieved in the second part of the question to appeal to ethos, "love and reconciliation". This shows that while America is working for love and reconciliation, England is sending fleets and armies. The c ...

How long can a inmate stay in the county jail Essay

How long can a inmate stay in the county jail - Essay Example A day over that time, he has to go to prison. The norm is, no one ever serves their full sentence in a county jail, they usually spend a third of their sentence. However, a person who defies a judge's order, and is charged with contempt of court, may stay in jail indefinitely; as long as he/she refuses to follow the judge's order. The Wall Street Journal, posted January 8, 2009, Ashley Jones reported that a man who defies the judge's order, and was charged with contempt of court has been in jail for over ten years. No one can stay in jail longer than the time specified by a judge, unless that person commits another crime while in jail and has another trial, and is sentence to more time in jail. If this sentence exceeds a year, he has to go to prison. A judge does not file motions, a lawyer files a motion on the client,s behalf. The website, FindLaw.com, states that a lawyer can shorten his client's jail time by filing a habeas corpus, a writ requesting a speedy hearing before a judge . This is the time that the trial date is set. People have always misunderstood the difference between jail and prison. Upon arrest, a detainees goes to jail, however, an arrest before the Miranda rights is read, or without the Miranda right being read, will null the charges in a court of law. Most federal detainee goes to federal jail, but they sometimes go to county jail. Reference â€Å"The Arrest Process.† FindLaw.com.

Immigration Essay Example | Topics and Well Written Essays - 2500 words

Immigration - Essay Example For others it will be shown how they feel that immigration has become a looming problem within the country and increases the risk of terrorist activity within America. Overall, my conclusion will demonstrate how the United States has hallmarked itself in the world with invitations to foreigners to enter into our country for better opportunities, and a chance for a higher quality of life, therefore we have only brought the current problems with immigration onto ourselves with no one to blame but our own government. Across the span of time, the outcome of war and conflict has been the vehicle of change for nations and its population. The outcome of regional hostilities directly affects the positive and negative outcomes of established civilizations. Immigration is an element of population change and is defined as the movement of people from one nation to another with the intention of attaining permanent residence during a certain period of time. Immigration is defined as the process of people permanently leaving a nation or region to settle in another for better opportunities, improved life, and to build on their dreams for the future. America has represented itself to other nationalities as a place of peace, hope, and a better life, leaving the invitation open to come and immigrate to this land (Heaney 1977, pg. 15). Therefore, the United States, in reality, has no one to blame but themselves for the escalating problems that are associated with immigration issues today. People immigrate to improve their economic situations, avoid political or religious persecution, or as a result of war displacement. According to the Department of Immigration and Naturalization Services personnel, "American immigration patterns indicate that approximately twenty percent of all immigrants to the United States relocated as a result of war displacement"(Artingstall 2003). In past times, there were three major groups of people that migrated to the United States between 1950 and 2000; the Jews after WWII, the Asians after the Korean Conflict and the Vietnamese after the Vietnam War. Although, recent immigration continues to occur and increase the population of America, the above three armed conflicts have brought new immigration policy changes and the largest amount of immigration movement since 1945. Even so, more recently the immigration problem has been with Hispanics crossing over illegally and also due to the conflict in the Middle East which has brought many Arabs migrating to the United States, enlarging the threat of terrorism in many people's minds. It would seem that every time a war or conflict takes place it has brought about vast changes for the United States. For example, World War II brought about a vast population of people migrating from Europe to the United States. Although, the United States was spared the physical land damages other countries had experienced during the war, many major changes were occurring in cities across our nation. The construction of new factories, military bases and housing created

Operational Plan Essay Example for Free

Operational Plan Essay Offices Assistant Operational Plan Goal Increase the sales in each store by 10% by June 2013 Objectives: a) include graphic design services b) Acquisition of additional printer, photocopier and delivery van. c) Reorganize of fixtures and fitting within the store to make space for the equipment d) Multi-skill current retail product staff to include service knowledge. e) Increase in human resource requirements. Strategy In order to increase the sales, the company will need to employee 10 more people with costumer service background, and provide the correct training of the products and services. Consultation Stakeholder Role in the Problem Consultation Method Senior Management Team Decision Maker feedback session email communications newsletters Store Manager Develop an operational plan Meetings group meetings interviews Employees Implementers of the plan Focus groups Brainstorming sessions Feedback sessions. Suppliers Supply equipment Email communication Newsletters Customers Email communication Newsletters Media Involved in the advertisement ex Email communication Newsletters Actions: In order to complete the organization goal and objectives the following are the action that should be taken: a) Include a graphic designer The Marketing department need to advertise the position of graphic designer. Responsible: Manager of the area Timeframe: 18 Oct 2013 to 18 of November 2013 Budget: 500 b) Acquisition of additional printer, photocopier and delivery van To increase the sales, The Company will need to provide additional equipment. Responsible: Store Manager Time frame: 20 Oct 2013 to 18 of November 2013 Budget: 2500 c) Make space for the new equipment Reorganize of fixtures and fitting within the store to make space for the equipment. Responsible: Store Manager Time frame: 15 Oct 2013 to 20 November 2013 Budget: 1000 d) Training Multi-skill current retail product staff to include service knowledge. Responsible: Store Manager and team members Time frame: 18November to 30 November 2013 Budget: 2000 e) Recruitment 10 more people have to be hired. Responsible: Store managers and Manager of specific Areas. Time frame: 20 Oct to 18 November 2013 Contingence plan If the strategy of increasing the sales 10% by next year doesn’t work after the high season(November to January). We will need to focus more in how to advertise more the products and services provided. Because we already have the trained people to continue to project. The Marketing department need to focus in a strategy to get more costumers to increase the sales. Outcome: To increase the sales by 10% by next year. The company need to invest in the project $6000. That include a graphic design services, acquisition and organization of new equipment. Recruitment and training. Approval Name Position Date Sing Carolina Prieto Senior Management Carolina Prieto David Garcia Store Manger David Garcia