Question

You are a nurse practitioner working in an ambulatory clinic in Illinois with a case load of 350 patients.

You notice that a large proportion (179 patients) have COPD, and you wonder if it is related to smoking.

You create the following 2 x 2 table to explore the relationship between smoking and COPD

:

	With COPD	Without COPD	total
Smokers	82	97	179
Non-Smokers	18	153	171
	100	250	350

1. What is the rate of COPD among your patients who smoke?

2. What is the relative risk of COPD among the smokers and nonsmokers?

3. What is the risk for COPD that can be attributed to smoking?

4. What are the odds of getting COPD if a patient is a smoker?

5. You learn that the rate of COPD among nonsmokers in the state of Illinois is 0.26. Why does that statistic cause you concern? What is your next step?

6. What other statistics would help you determine how big the problem is among your patients?

Please answer with steps

Answer 1

Solution

Part (1)

Rate of COPD among patients who smoke = 82/179 = 0.4581 Answer 1

Part (2)

Relative risk of COPD among the smokers = 82/179 = 0.4581 and nonsmokers = 18/171

= 0.1053 Answer 3

Part (3)

Risk for COPD that can be attributed to smoking = 0.4581 – 0.1053 = 0.3528 or 35.3%

Answer 4

Part (4)

Odds of getting COPD if a patient is a smoker = 82 : 97 Answer 5

Part (5)

Among the 350 patients the rate of COPD is only 0.1053 or 10.83%, which is much lower than the reported rate for the state. This is a matter of concern, since the data is not representative or not sufficient. Answer 6

So, the next step would be to test if it is possible to get a sample value of 10.83% from a population having a value of 26%. Answer 7

Part (6)

Test of hypothesis would be the appropriate statistical method to determine how big the problem is. Answer 8

DONE