Understanding Equivalence Non Inferiority Testing

Question: Discuss about the Understanding 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. Figure: TOST with Equivalence Margin Source: (Walker and Nowacki 2011) 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.

International Borders Have Always Been Centers Of Conflict, And Essays

International borders have always been centers of conflict, and the U.S.-Mexican border is no exception. With the European colonizing the New World, it was a matter of time before the powers collided. The Spanish settled what is today Mexico, while the English settled what is to day the United States. When the two colonial powers did meet what is today the United States Southwest, it was not England and Spain. Rather the two powers were the United States and Mexico. Both Counties had broken off from their mother countries. The conflict that erupted between the two countries where a direct result of different nation policies. The United States had a policy of westward expansion, while Mexico had a policy of self protection. The Americans never had a written policy of expansion. What they had was the idea of "Manifest Destiny." Manifest Destiny was the belief that the United States had the right to expand westward to the Pacific ocean. On the other hand, Mexico was a new country wanting to protect itself from outside powers. Evidence of U.S. expansion is seen with the independence of Texas from Mexico. The strongest evidence of U.S. expansion goals is with the Mexican-American War. From the beginning, the war was conceived as an opportunity for land expansion. Mexico feared the United States expansion goals. During the 16th century, the Spanish began to settle the region. The Spanish had all ready conquered and settled Central Mexico. Now they wanted to expand their land holdings north. The first expedition into the region, that is today the United States Southwest, was with Corando. Corando reported a region rich in resources, soon after people started to settle the region. The driving force behind the settlement was silver in the region. The Spanish settled the region through three major corridors; central, western and eastern. The first settlements were mainly through the central corridor. The Spanish went thorough what is now the modern Mexican state of Chihuahua into the U.S. state of New Mexico. Eventually the Spanish established the city of Santa Fe in 1689. The eastern corridor was through modern day Texas and led to the establishment of San Antonio. The eastern expansion was caused by the French expansion into modern day Louisiana. The Spanish crown wanted a buffer between the French in Louisiana and central Mexico. The last corridor of expansion was in the west, through the sea, which led to the establishment of San Diego in 1769 and Los Angles in 1781. The Spanish were not the only European power to colonize the new world; French, English and the Dutch also settled North and South America. The Spanish and the French settled what is present day U.S.-Mexico border region. The French settled modern day U.S. midwest, while the Spanish settled present day Mexico and U.S. southwest. As time went on, European influence in the region diminished.. The French sold there claims to the United States, in 1803 with the Louisiana Purchase. Mexico gained independence from Spain in 1821. Once the United States bought the Louisiana Purchase, western expansion began. This set the stage for major conflict in the region. The United States gained independence from England in 1775. After 1775, the Americans started to expand west. By the time Mexico gained independence, the United States had reached the Mexican frontier. Mexico needed to protect its northern borders. To protect the border region, Mexico needed to populate the area. Mexico continued the policy started by Spain of allowing Americans to settle Texas. The Americans had to follow Mexican law, religion and customs. The settlement of Texas played into the United States expansion plans. Eventually Mexico City closed Texas from more Americans from entering. This angered the Americans wanting to enter and Americans already living in Texas. Texas revolted from Mexico in 1833. Mexicans did live in Texas, and fought for the independence of Texas. The majority of Texans were Americans and fought for their independence. After the war the Americans intentionally or non-intentionally forced most Mexicans out of Texas. The ones that stayed faced racial tensions that continue to today. After gaining independence from Mexico, Texas wanted to join the United States immediately. The U.S. Congress voted against Texas from joining the Union. Congress was worried that annexation of Texas would anger Mexico. Mexico had never officially recognized Texas as independent. Congress was concerned that annexation would start a war with Mexico. Mexicos repose to American annexation was not the only factor in deciding against annexation. If Texas was to become a state, it would be a slave state. At the time, the United States an even balance between slave and non-slave

Whitmans Poetry and American Identity Essay Example

Whitmans Poetry and American Identity Essay Born on 31st May, 1819, Walt Whitman is an iconic figure in the history of American literature. His lifetime’s work, especially his poetry, has come to define the sentiments, aspirations and experiences of American citizens in the nineteenth century. Although Whitman was not active politically, he expressed his political views through his poetry. Having lived through the turbulence of the Civil War, he developed passionate views on the nature and complexion of American polity. Whitman envisioned America to be a vibrant multicultural society. This vision he expressed in many of his poems. The poem Passage to India is a good example of this idealism, which perhaps waned a little during the excesses of the Gilded Age. (Pannapacker, 2004, p.45) Through the medium of this art form, Whitman synthesized his notion of the American identity, encompassing within it concepts such as national sovereignty, individual freedom and democratic polity. For example, â€Å"During this American Renaissance, as it came to be known, authors and philosophers such as Hawthorne, Melville, Thoreau, and Emerson assessed the nation’s brief history in their writings and summarily expressed a national identity. Of all of them, it was Whitman, who, with his barbaric yawp, was the most radical in avowing that American identity was inextricable from the nation’s central premise of self-governance and equality. In poems such as â€Å"Song of Myself,† he stressed to his readers how their individual lives constituted the very circumference of democracy. â€Å"[T] he genius of the United States,† he pronounced, â€Å"is †¦ in the common people.†Ã¢â‚¬  (Schramm, 2005, p.24) We will write a custom essay sample on Whitmans Poetry and American Identity specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Whitmans Poetry and American Identity specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Whitmans Poetry and American Identity specifically for you FOR ONLY $16.38 $13.9/page Hire Writer Whitman’s early years were chaotic, as circumstances forced him to seek employment at the tender age of 11. At first he worked as an office boy for a lawyer and later served as an apprentice and printer’s devil for the newspaper Patriot (published in Long Island). But these early experiences had a profound influence on Whitman’s formative mind, as he absorbed the essence of good journalism and good writing here. Looking back in retrospect, many of the issues raised by Whitman in his seminal work Leaves of Grass have their origins in these early experiences. Under Editor Samuel Clements’ mentorship, Whitman learned about the technical aspects of the printing press, which would help him later in his efforts to self-publish his poems. It was here that he developed his views on American identity. (Barrett, 2005, p.67) Consistent with the thought of Ralph Emerson, Whitman too believed that an American poet must be â€Å"indivisible from the people about whom he wrote†¦the proof of the poet is that his country absorbs him as affectionately as he absorbed it†. (Barrett, 2005, p.67) This symbolic unity of the poet and his compatriots is most evident in the very first poem of Leaves of Grass titled Song of Myself. Through the generous use of â€Å"I† â€Å"me,† and â€Å"you,† that the â€Å"myself† he was singing about comes to represent all Americans. Whitman’s also wrote poems covering sexuality and sexual freedom. In poems such as ‘A Woman Waits for Me’, he famously observed that â€Å"Sex contains all, bodies, souls.† (Barrett, 2005, p.67) Although Whitman’s references to homosexuality and overt sexuality was controversial during his time (which is the why his collections were self-published), his views on the subject only r eflected the emerging liberal tradition of nineteenth century United States. Since Whitman is a quintessential 19th century writer, his works reflected his preoccupation with the Civil War. In the 1860 edition of Leaves of Grass, the imagery employed by the author conveyed his hopes for peace and reconciliation. â€Å"At one level, Whitman’s turn to seemingly personal concerns in ‘Calamus’ might seem odd at this moment, on the very eve of actual warfare, but for Whitman the ‘Calamus’ poems explored both important personal relationships and addressed political issues. It was love that was to serve as the glue holding a democracy together.† (Schramm, 2005, p.25) Indeed, based on Whitman’s personal correspondence, it is fairly obvious that he wished to be remembered as a staunch patriot and a nationalist, comparable to the status of Pushkin as the Russian national poet. For example, â€Å"Whitman ruminated about the curious national arithmetic of e pluribus unum (â€Å"Out of many one†) in ways that gave concrete expression-and vivid imagery-to the abstractions at the very heart of our democracy. In Whitman’s best lines, he casts himself as the spokesperson for women as well as men, blacks as well as whites, the well-heeled and the downtrodden. Taken together, the kaleidoscopic parts of America add up to . . . well, America. Whitman’s conception of America was also pluralistic, one in which multitudes could smoothly be integrated into the â€Å"larger, often mystically imagined Union†.† (Pinsker, 1999, p.716) His most influential master work Leaves of Grass is full of allusions, commentary and idealization of American identity. Concepts such as democracy as well as principles such as individual freedom also find frequent mention. In many ways, Leaves of Grass is to the fledgling notion of American identity what Homer and Virgil were to the ancient Greek milieu. In this sense, Leaves of Grass can be said to encapsulate the history, politics and culture of the nascent American nation-state in the form of poetry. Whitman looked around at Americans of all stations for inspiration. And what he found was a nation of nations that augured its years of glory to follow. By thus listening to the messages of daily life, American citizens could learn much about their country’s history, culture and the tendencies in the future. Further, as per Whitman’s conception, the country is in itself a great work of poetry where the past, present and the future conjoin in intricate ways. This notion of treating the country’s exclusive merits is consistent with the broader literary currents of the time, where authors tried to overcome the remaining European influences by way of forming a separate American idiom and literature. (Pannapacker, 2004, p.45) Whitman’s contribution to the development of American identity is seen in overt as well as subtle portrayals in his poetry and poetics. For example, his strong dislike of the institution of slavery is learnt from these lines from his personal correspondence: â€Å"I am the poet of slaves and of the masters of slaves. . . I go with the slaves of the earth equally with the masters and I will stand between the masters and the slaves, entering into both so that both shall understand me alike.† (Pinsker, 1999, p.717) On the other hand, his love of the common American folk is expressed by capturing

Caligula essays

Caligula essays Caligula has been known to history as a colorful emperor. He is the youngest son of Germanicus Ceaser and the grandnephew of Tiberius. Caligula as a child was said to have been very ill with a high fever that probably affected his mind. That would explain all the strange things that he did throughout his life. Gaius was given the name Caligula (Latin for little boot) in the military camps where he spent some of his early life. He succeeded his granduncle Tiberius in the year 37. Caligula was very popular with the army at first since he had served himself. Unlike Tiberius, Caligula was not concerned with having a surplus in the Roman treasury. Soon after he came to power, he began to throw lavish festivals and gladiator games. The people of Rome knew that he was depleting the treasury, and quickly became unpopular. He soon answered them with acts of tyranny and began to have people executed at whim. He banished or murdered most of his own relatives. Caligula committed incest with two of his three sisters. His retreat is to Capri where he indulges himself in immoral acts In 37, Caligula becomes ill, and tells all that he is not really ill, but is metamorphasizing into a god. He then forces the Senate to deify himself and his three sisters. He also forces the Sensate to make his horse a Senator on the grounds that it is Alexander The Greats horse reincarnated. This all becomes too much for the people of Rome. The leader of the Praetorian Guard leads a revolt and Caligula is assassinated on January 24, 41. ...

Marketing Plan for Product Line Essay Example | Topics and Well Written Essays - 1250 words

Marketing Plan for Product Line - Essay Example 1. How the Selected Small Appliance Supports Company G’s Mission Statement The small appliance supports Company G’s mission statement in several ways. In the first place, the appliances are made using very few materials and little energy. This will boil down to decreased cost of production, and eventually, helping clients purchase them at affordable rates. Beside the aforementioned advantage which will have clients saving their money, the pleasing visual features of design are also likely to excite the passions and happiness of the clients. This happiness is in fact a central part of client’s lives. B. Marketing Objectives 1. The target market for the company’s product is very broad, given that it incorporates all the areas that have undergone electrification. The veracity behind this postulation is elucidated by the fact that the new product can be used in a domestic setting. Given that America is entirely electrified, the whole of it serves as target mar ket. The rest of the developed world, such as the UK and Europe, can also serve as part of the target market, since globalization has become responsible for many multinationals. Multinationals, in turn, have the entire globe, continent, or a regional block serving as target market. 2. Four Selected Marketing Objectives for Company G and an Objective for Each of the Four Marketing Strategies (Product, Distribution, Price, and Promotion) Marketing objectives refer to the goals that an enterprise may wish to accomplish through marketing efforts. For Company G, they are: reaching the desired profit potential for the newly innovated small appliance; helping the appliance fit into the market effectively (introducing the brand to the market successfully); ensuring continuance of use by the market (fostering the demand of the product in the market); and improving the living standard of the market (by making the appliance as helpful, efficient, affordable and physically appealing as possible ). The objectives that Company G is intent on using are also four. The company is aiming at making favorable amounts of profit by tinkering with scientific innovation to deflate the cost of production. Secondly, Company G intends to introduce the brand to the market by making it as unique (helpful, efficient, affordable and aesthetically appealing) as possible. Similarly, the company intends to foster the demand for the same product in the market by promoting it, as a way of making both potential and prospective clients aware of the availability of the product in the market. Finally, by strengthening the attributes of the appliance, especially its affordability and efficiency, the company will have improved the living standards in the market. C. Competitive Situation Analysis 1. Classifying Company G’s Products Using the Three-Way Consumer Product Classification System (a) Convenience goods: the product will always be presented in the market as a commodity from which the like ly benefit from establishing cost and quality evaluation is believed to be less significant in regard to the time and effort of the consumer. (b) Shopping goods: The quality of company G’s product will enable the company to present it in the market to rationally make comparisons of the price, fashion, and suitability. This will be achieved by highlighting these qualities in ads targeted at likely and repeat consumers. (c)

Case study on a restaurant operations management (Ks Biryani) Essay

Case study on a restaurant operations management (Ks Biryani) - Essay Example The restaurant currently has 35 working-individuals to meet the appetite of the customers with their delicious variety of food. With the help of these employees, the restaurant serves almost 250 individuals every day. The chain of restaurant comprises of 2 takeaways and a restaurant. Each takeaway counter interacts nearly with 50 individuals each day while the restaurant has the capacity to serve 120 people during its operational time. The company was established in 2006 with an aim to provide its customers with high quality food to satisfy their appetite. Even though the company started with just a takeaway store, it expanded in terms of location and size in its forthcoming years. The company was just in its introductory stage when it opened its second takeaway outlet in 2008 and its third outlet; a restaurant, in the following year. With promising growth and opportunity ahead, the company is planning to inaugurate its third takeaway store in Jeddah; the heart of Saudi Arabia, in the second quarter of 2013. To provide the customers with high quality and delicious food, the company has several expansion plans for the upcoming years. These plans include expansion and opening the company’s takeaway and restaurants at Jeddah Airport to attract as many customers as possible. Another plan of the company is to open their restaurant in the heart of Mecca and Medina; the two most holy places as it promise great business potential. The management of the company is based on hierarchical structure; the employees report to the manager, who then reports to the top management. The hierarchical structure could also be observed in the takeaway stores; two chefs, two cashiers, one cleaner and a delivery boy. The hierarchical structure eventually helps the company to earn 22,500 pounds on monthly basis. The company started its operation in June 2006 and during the next six months the company had to face lots of setbacks. The store was not even able to reach its break-even point due to which the com pany had to re-introduce its takeaway store with completely different marketing strategies. The re-launching decision was taken after critical analysis of the business with consistent feedback from the employees. After changing the marketing strategies, the company’s sales boosted rapidly due to which another location was added within a year. To eliminate any mistake from the senior management, the launching of second takeaway store was done under the guidance of external consultancy which was hired to set the basic operational policies and processes. The hiring of external consultancy was aimed to assure the senior management regarding the structured and transparent work culture in the company. With continuous improvement in terms of sales and stability, the company launched its first restaurant based on the management techniques; risk management, quality management, capacity planning etc. This report would provide extensive knowledge regarding the different operational mana gement concepts applied by the company and the challenges

Social Computing Essay Example | Topics and Well Written Essays - 3500 words - 2

Social Computing - Essay Example Directing the customers from these pages to the actual scholarly articles. This will increase the readership of the ‘Educated People Society’ website. It will help them gain various sponsors to run the website and fund actions related to environmental activities and scientific research. Checking the level of awareness created through the social media tools by conducting a questionnaire survey among them and involving in the qualifying youngsters in projects related to their interests. Creating an environmental awareness is the main objective. Be it a laptop the youngsters use or a leather jacket, they should be educated regarding the way it is created, the core technology and the various political and economical facts associated with it. This knowledge is important to make them valuable citizens in future. A youngster who changes his mobile once in year will stick to one smart phone for years if they realize how much e-waste they are creating. A person who knows how the plastic covers thrown around affects the environment will never use them again. Providing such information in an interesting format is the main objective of the social media tools used. The aim of the social media campaign is to advertise about the same by entering their territory. It is hard to make youngsters visit a science related site or lecture them about environment. But, taking the site to tools like Blogger and Twitter where they use will make them peek at it automatically. The blog and Twitter page explains about the animals and the photography site in Nat Geo. The technology blog related dwells with various subjects shown as documentaries in NatGeo, WWF and Green Peace websites. So youngsters with diverse interests will be directed towards these sites from their favourite pastime areas in the internet. The info presented will be mostly in the format of quizzes, puzzles and