Hypothesis Testing

What is Hypothesis testing

It is a method of finding out whether one particular treatment or test or physiological value is different from another.

Eg

A patient comes to a physiotherapist with the Shoulder pain. He has been suffering from this for the past 3 months. He is a manual laborer whose monthly income is 2000 rs/ . He has two kids and dependent father and mother. If he does not go to a job there are no other sources of income and they have to have food only once in a day.

What treatment will you give?

The Dilemma

There are more treatments which are suggested. However all those treatments may not be effective.

Which treatment can we give to improve him?

In this scenario we do a research to find which treatment is effective. The procedures we follow is called research method and the analysis of the result is done by the procedure of Hypothesis testing.

The Basic Question?

Why cant we take the difference between 2 groups eg SWD and no Treatment and see in which group the pain has reduced more and conclude?

While performing a study, we cannot perform on our patient. We rather perform the study on another patient. The result obtained from that study is applied on our patient. Hence we cannot directly apply . We will have to use a statistical procedure called Hypothesis testing to obtain the result.

How do we perform a hypothesis test?

In a hypothesis test we make a basic assumption about the result. This is usually a Null Hypothesis. Eg - There is no difference between the 2 treatments. Since we do not Know which treatment is likely to be beneficial, we cannot assume one treatment is better than the other.

Calculate the difference

We then calculate what is the difference in result between the two groups. Eg. One group has reduced in pain by 6 units and other group has reduced in pain by 4 units. The difference is -------?

Generalizing

Given that the difference in the groups is 2 units, can I say that the same amount of improvement I will get in my patient? Here we are trying to convert the result obtained on a small group of people to a large population. This result is then understood for every other person or group of persons.

Question

If we apply the same treatment to another group, will we get the same result? The result if bigger say 4 units of difference, then it is okay and I can apply this to my patient. Bur if is less say 1 unit of difference then it may mean the treatment may not be effective.

Why can this problem occur?

This can occur because

A. Population

If I do a study on all the people who suffer from Pain then I can be sure. Since I do on a small no of people, I have to have a bit of doubt. If my measurement method is not sensitive to pick this difference?

B. Measurement method

I add a bit of doubt

This is expressed as p value (The level of significance) I say, that I am sure that the treatment is effective since the difference is 3 units. But because of the factors cited above the treatment effect may smaller or larger. This if happens in 5% of people, I would still believe that the treatment is effective.

Apply on my patient.

How much will you set your significance level ?

A more sensitive measurement method? A smaller sample?

Further problems

I have a result from not one person but a group of people. There are differences in result among the people. If I have to include all people, I should also consider the variation. The measure of variation is SD. Since there are 2 groups I use SE

Measurement tool

Nominal Ordinal Interval Ratio

The Statistical test

Nominal and Ordinal values logically cannot be added or subtracted. Hence we will have to analyze them differently. The method is called as Non parametric test. For Interval and ratio, we can use parametric method.

How do we infer finally.

For any population or the whole group of people, The

This is not the best method

There are other methods