Measures of Central Tendency Mean Median and Mode Assignment Can be completed in a simple word document. All pages needed to complete assignment are includ

Measures of Central Tendency Mean Median and Mode Assignment Can be completed in a simple word document. All pages needed to complete assignment are included. 80
EXERCISE 8 Measures of Central Tendency: Mean, Median, and Mode
mean is most affected by these, so the median might be the measure of central
scores such as outliers. An outlier is a value in a sample data set that is unusually low or
unusually high in the context of the rest of the sample data. If a study has outliers, the
included in the research report (Plichta & Kelvin, 2013). The formula for the mean is.
tendency
Mean= X =
??
N
EX is the sum of the raw scores in a study
N is the sample size or number of scores in the study
Example: Raw scores = 8, 9, 9, 10, 11, 11 N=6
Mean= 58+6 = 9.666 = 9.67
RESEARCH ARTICLE
Source
Winkler, C., Funk, M., Schindler, D. M., Hemsey, J. Z., Lampert, R., & Drew, B.J. (2013).
Arrhythmias in patients with acute
coronary syndrome in the first 24 hours of hospital
ization. Heart Lung 42(6), 422-427.
Introduction
Winkler and colleagues (2013) conducted their study to describe the arrhythmias of a
population of patients with acute coronary syndrome (ACS) during their first 24 hours
of hospitalization and to explore the link between arrhythmias and patients’ outcomes.
The patients with ACS were admitted through the emergency department (ED), where a
Holter recorder was attached for continuous 12-lead electrocardiographic (ECG) moni-
toring The ECG data from the Holter recordings of 278 patients with ACS were analyzed.
The researchers found that “approximately 22% of patients had more than 50 premature
ventricular contractions (PVCs) per hour. Non-sustained ventricular tachycardia (VT)
occurred in 15% of the patients…. Only more than 50 PVCs/hour independently pre-
dicted an increased length of stay (p < 0.0001). No arrhythmias predicted mortality. Age greater than 65 years and a final diagnosis of acute myocardial infarction (AMI) indepen- dently predicted more than 50 PVCs per hour (p = 0.0004)" (Winkler et al., 2013, p. 422). Winkler and colleagues (2013, p. 426) concluded: “Life-threatening arrhythmias are rare in patients with ACS, but almost one quarter of the sample experienced isolated PVCs. There was a significant independent association between PVCs and a longer length of stay (LOS), but PVCs were not related to other adverse outcomes. Rapid treatment of arrhythmias we no longer treat." the underlying ACS should remain the focus, rather than extended monitoring for Relevant Study Results The demographic and clinical characteristics of the sample and the patient outcomes for this study are presented in this exercise. "The majority of the patients (n = 229; 83%) had a near complete Holter recording of at least 20 h and 171 (62%) had a full 24 h recorded. We included recordings of all patients in the analysis. The mean duration of continuous 12-lead Holter recording was 2136 (median 24) h. The mean patient age was 66 years and half of the patients identified White as their race (Table 1). There were more males than females and most patients (92%) expe- rienced chest pain as one of the presenting symptoms to the ED. Over half of the patients Copyright © 2017, Elsevier Inc. All rights reserved. 82 EXERCISE 8. Measures of Central Tendency: Mean, Median, and Mode experienced shortness of breath (68%) and jaw, neck, arm, or back pain (55%). Hyperten sion was the most frequently occurring cardiovascular risk factor (76%), followed by ity had a personal history of coronary artery disease (63%) and 19% had a history of major- more than one); 2) inpatient length of stay; 3) readmission to either the ED or the hospital hypercholesterolemia (63%) and family history of coronary artery disease (53%). A arrhythmias” (Winkler et al., 2013, pp. 423-424). Winkler et al. (2013, p. 424) also reported: “We categorized patient outcomes into four groups: 1) inpatient complications (of which some patients may have experienced within 30-days and 1-year of initial hospitalization; and 4) death during hospitalization, within 30-days, and 1-year after discharge (Table 2). These are outcomes that are reported in many contemporary studies of patients with ACS. Thirty-two patients (11.5%) were lost to 1-year follow-up, resulting in a sample size for the analysis of 1-year outcomes of 246 patients” (Winkler et al., 2013, p. 424). TABLE 2 OUTCOMES DURING INPATIENT STAY, AND WITHIN 30 DAYS AND 1 YEAR OF HOSPITALIZATION (N = 278) N 21 17 7 6 5 2 777652 8 6 3 2 Outcomes Inpatient complications (may have >1)
AMI post admission for patients admitted with UA
Transfer to intensive care unit
Cardiac arrest
AMI extension (detected by 2nd rise in CK-MB)
Cardiogenic shock
New severe heart failure/pulmonary edema
Readmission
30-day
To ED for a cardiovascular reason
To hospital for ACS
1-year (N = 246)
To ED for a cardiovascular reason
To hospital for ACS
All-cause mortality
Inpatient
42
13
108
24
10
Ens at wo
10
13
27
4
11
4
Range
1-93
30-day
1-year (N = 246)
Mean (SD)
Median
Length of stay (days)
5.37 (7.02)
AMI, acute myocardial infarction; UA, unstable angina; CK-MB, creatinine kinase-myocardial band, ED, emergency department;
ACS, acute coronary syndrome; SD, standard deviation.
* Readmission: 1-year data include 30-day data,
“All-cause mortality: 30-day data include inpatient data; 1-year data include both 30-day and inpatient data.
Winkler, C., Funk, M., Schindler, D. M., Hemsey, J. Z., Lampert, R., & Drew, B.). (2013). Arrhythmias in patients with acute
coronary syndrome in the first 24 hours of hospitalization. Heart Lung, 42(6), p. 424
Measures of Central Tendency: Mean, Median, and Mode
EXERCISE 8
81
57
43
51
22
18
8
92
68
55
42
35
TABLE 1
DEMOGRAPHIC AND CLINICAL CHARACTERISTICS OLIHE SAMEN 278
Characteristic
N
Gender
Male
158
Female
120
Race
White
143
Asian
60
Black
50
American Indian
23
Pacific Islander
2
Presenting Symptoms to the ED (May Have >1)
Chest pain
255
Shortness of breath
189
Jaw, neck, arm, or back pain
152
Diaphoresis
116
Nausea and vomiting
96
Syncope
11
Cardiovascular Risk Factors (May Have >1)
Hypertension
211
Hypercholesterolemia
175
Family history of CAD
148
Diabetes
81
Smoking (current)
56
Cardiovascular Medical History (May Have >1)
Personal history of CAD
176
History of unstable angina
124
Previous acute myocardial infarction
114
Previous percutaneous coronary intervention
85
Previous CABG surgery
54
History of arrhythmias
53
Final Diagnosis
Unstable angina
180
Non-ST elevation myocardial infarction
74
ST elevation myocardial infarction
24
Interventions during 24-h Holter Recording
PCI S 90 min of ED admission
PCI > 90 min of ED admission
Thrombolytic medication
Interventions Any Time during Hospitalization
PCI
76
Treated with anti-arrhythmic medication
16
22
76
63
53
29
63
45
31
19
19
65
27
9
5
?? ???
CABG surgery
27
6
8
Mean (SD)
Median
Range
66 (14)
66
Age (years)
30-102
21 (6)
24
ECG recording time (hours)
2-25
ED, emergency department; CAD, coronary artery disease; CABG, coronary artery bypass graft: PCI, percutaneous coronary
intervention, SD, standard deviation; ECG, electrocardiogram.
Winkler
, C, Funk, M. Schindler, D. M. Hemsey, J. Z. Lampert, R. & Drew, B.J. (2013). Arrhythmias in patients with acute
coronary syndrome in the first 24 hours of hospitalization. Heart Lung 42(6). p. 424.
Copyright © 2017, Elsevier Inc. All rights reserved
EXERCISE
Questions to Be Graded
8
Name:
Class:
Date:
Follow your instructor’s directions to submit your answers to the following questions for grading.
Your instructor may ask you to write your answers below and submit them as a hard copy for
grading. Alternatively, your instructor may ask you to use the space below for notes and submit your
answers online at http://evolve.elsevier.com/Grove/statistics/ under “Questions to Be Graded.”
1. The number of nursing students enrolled in a particular nursing program between the years of
2010 and 2016, respectively, were 563, 393, 606, 520, 563, 610, and 577. Determine the mean
(X), median (MD), and mode of the number of the nursing students enrolled in this program.
Show your calculations.
mean = 576
median: 577
mode= 563
520,563,543,577,593, tore, 610
2. What is the mode for the variable inpatient complications in Table 2 of the Winkler et al. (2014)
study? What percentage of the study participants had this complication?
3. Does the distribution of inpatient complications have a single mode, or is this distribution
bimodal or multimodal? Provide a rationale for your answer.
4. As reported in Table 1, what are the three most common cardiovascular medical history events
in this study, and why is it clinically important to know the frequency of these events?
Copyright © 2017, Elsevier Inc. All rights reserved.
87
88
EXERCISE 8. Measures of Central Tendency: Mean, Median, and Mode
5. What are the mean and median lengths of stay (LOS) for the study participants?
6. Are the mean and median for LOS similar or different? What might this indicate about the
distribution of the sample? Provide a rationale for your answer.
ST
7. Examine the study results and determine the mode for arrhythmias experienced by the partici-
pants. What was the second most common arrhythmia in this sample?
8. Was the most common arrhythmia in Question 7 related to LOS? Was this result statistically
significant? Provide a rationale for your answer.
9. What study variables were independently predictive of the 50 premature ventricular contractions
(PVCs) per hour in this study?
10. In Table 1, what race is the mode for this sample? Should these study findings be generalized to
American Indians with ACS? Provide a rationale for
your answer.
R
Copyright © 2017, Elsevier Inc. All rights reserved.

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