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Review Question - QID 217250

QID 217250 (Type "217250" in App Search)
A research team is studying the effect of endoscopic carpal tunnel surgery on complication rates following surgery, compared to the traditional open approach. Due to the potential morbidity associated with infections, the team is interested in comparing the incidence of surgical site infections (SSIs) after these types of carpal tunnel surgery. They are designing a retrospective cohort study and estimate that they will require 2,456 patients in each cohort to detect a 1 percentage-point increase in SSI incidence (baseline incidence: 1%) with at least 80% power. They set the threshold for statistical significance at p < 0.001. Which of the following is the best interpretation of the statistical values given?

The maximum acceptable false negative and positive rates cannot be determined from this information.

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The maximum acceptable false negative rate is 0.1%.

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The maximum acceptable false negative rate is 20%.

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The maximum acceptable false positive rate is 5%.

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The maximum acceptable false positive rate is 20%.

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Statistical power is given by 100% - false negative rate (FNR); thus, FNR = 100% - power = 100% - 80% = 20%. The threshold for statistical significance, often denoted as α, is the maximum acceptable false positive rate.

Statistical power is defined as the probability that a statistical test will detect an effect when there actually is an effect to be detected (i.e., the true positive rate). It is closely related to the probability that a statistical test will fail to detect an effect when there actually is an effect (i.e., a false negative). This relationship takes the following form: power = 100% - FNR. By adequately powering a study, investigators can impose an upper bound on the FNR. The threshold for statistical significance, α, is the probability that a statistical test will detect an effect when there actually is no effect (i.e., a false positive). By defining a statistical significance threshold (e.g., setting significance as p < 0.001), investigators directly impose an upper bound on the false positive rate (FPR).

Incorrect Answers:
Answer 1: The maximum acceptable FNR and FPR cannot be determined from this information is incorrect because these values can be obtained from the given power and statistical significance threshold.

Answer 2: The maximum acceptable FNR is 0.1% is incorrect because 0.1% is the maximum acceptable false positive rate. The maximum acceptable FNR = 100% - power = 100% - 80% = 20%.

Answers 4 & 5: The maximum acceptable FPR is 5% and the maximum acceptable FPR is 20% are incorrect because these would correspond to statistical significance thresholds of p < 0.05 and p < 0.20, respectively. In this study, the statistical significance threshold was p < 0.001, which denotes the maximum FPR (0.1%).

Bullet Summary:
Statistical power is the probability of detecting an effect when an effect actually exists, whereas statistical significance, which often takes the form of p < 0.05, is the probability of detecting an effect when an effect actually does not exist.

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