PubMed · 10786538
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N Crichton. 1999. Information point: confidence interval.. https://pubmed.ncbi.nlm.nih.gov/10786538/
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Patients who mismanage their funds may benefit from financial advice, case management or the involuntary assignment of a payee who restricts direct access to funds. Data from a survey of psychiatric inpatients at four VA hospitals (N = 236) was used to evaluate the relationship between substance abuse and clinician-rated need for money management assistance. Multivariate analytic techniques were used to control for sociodemographic factors and psychopathology. Alcohol and drug use severity both were modestly associated with need for assistance. The effect of substance use severity was greater in patients who were also diagnosed with a major mental illness. Clinicians indicated that 27 patients (11% of the sample) required an involuntary payee and 21 of the 27 (78%) had a Substance Abuse diagnosis. Only drug use severity was significantly associated with need for a payee. These data describe a substantial unmet need for money management assistance in psychiatric inpatients, particularly among those with substance abuse disorders. There is a need to examine the process by which the Social Security and Veterans Benefits Administrations assign payees to determine whether patients with co-morbid substance abuse are not being assigned a payee in spite of their discernible need for one.
Confusion in the teaching of statistical inference dates back to the conflict of Fisher's P-values and significance tests with the Neyman-Pearson hypothesis testing approach. To avoid the well-known pitfalls arising from over-reliance on significance tests and the division of results into 'significant' or 'not significant', many medical journals now insist that presentation of statistical analyses includes confidence intervals as well as or instead of P-values. The confusion over how to report statistical analyses which is evident in the recent medical literature is matched by divergent teaching of hypothesis tests between the 16 U.K. medical schools represented at the April 2000 Burwalls meeting. Suggested guidelines for the teaching of statistical inference to medical students are presented, and possible future developments are discussed.
In this paper we propose a quasi-exact alternative to the exact unconditional method by Chan and Zhang (1999) estimating confidence intervals for the difference of two independent binomial proportions in small sample cases. The quasi-exact method is an approximation to a modified version of Chan and Zhang's method, where the two-sided p-value of an observation is defined by adding to the one-sided p-value the sum of all probabilities of more "extreme" events in the unobserved tail. We show that distinctively less conservative interval estimates can be derived following the modified definition of the two-sided p-value. The approximations applied in the quasi-exact method help to simplify the computations greatly, while the resulting infringements to the nominal level are low. Compared with other approximate methods, including the mid-p quasi-exact methods and the Miettinen and Nurminen (M&N) asymptotic method, our quasi-exact method demonstrates much better reliability in small sample cases.