Hello David: Thanks for the suggestion, but I'm pretty sure that I won't read the book.
Can you give me some idea of what "interesting conclusion that changed the way we treat". Ron ----- Original Message ----- From: Lehman, David <[EMAIL PROTECTED]> Sent: Friday, August 04, 2006 To: OTlist@OTnow.com <OTlist@OTnow.com> Subj: [OTlist] FW: Interesting Stats LD> No, Ron....I think there is applicability....that is the reason to form LD> logarithms to form decisions made by clinicians. LD> I suggest you reading some of the work of Susan D. Horn and clinical LD> Practice improvement research methods... She has done work with LD> multiple centers across the world, gathering every piece of data LD> possible and then came to some interesting conclusions that changed the LD> way we treat. LD> David A. Lehman, PhD, PT LD> Associate Professor LD> Tennessee State University LD> Department of Physical Therapy LD> 3500 John A. Merritt Blvd. LD> Nashville, TN 37209 LD> 615-963-5946 LD> [EMAIL PROTECTED] LD> -----Original Message----- LD> From: [EMAIL PROTECTED] LD> [mailto:[EMAIL PROTECTED] On LD> Behalf Of Ron Carson LD> Sent: Thursday, August 03, 2006 3:31 PM LD> To: Lehman, David LD> Subject: Re: [OTlist] FW: Interesting Stats LD> David, it seems like what you are saying is that statistically, it's LD> possible to identify ALL variables affecting patient outcomes but LD> piratically speaking, there's little applicability? Is this an LD> accurate assessment? LD> ----- Original Message ----- LD> From: Lehman, David <[EMAIL PROTECTED]> LD> Sent: Thursday, August 03, 2006 LD> To: OTlist@OTnow.com <OTlist@OTnow.com> LD> Subj: [OTlist] FW: Interesting Stats LD>> Ron! It would require me to draw pictures with LD>> explanations....just draw a bunch of circles that represent every LD>> person in a population and then make sure each circle crosses over LD>> another circle it has things common with but, the circle is free LD>> of those things not common with the original circle. Then, look LD>> at all the circles and how each crosses over with other circles - LD>> the parts of the circle that are not overlapping with another LD>> circle represents unique variables for each person in the LD>> population. Then calculate the space that each circle has free LD>> versus each part of the circle that overlaps with other circles. LD>> That is your multivariate picture of how much is similar and LD>> fifferent for each circle. The thing is that you choose all those LD>> variables you listed previously as well as any and all variables LD>> that people have. You would eventually see the unique portion of LD>> each circle minimize into something that probably is not LD>> significant in the outcome you wish to acheive with that LD>> particular individual. LD>> Get it? LD>> ________________________________ LD>> From: [EMAIL PROTECTED] on behalf of Ron Carson LD>> Sent: Thu 8/3/2006 2:46 PM LD>> To: Lehman, David LD>> Subject: Re: [OTlist] FW: Interesting Stats LD>> WAY, WAY, WAY, over my head. LD>> David, please decipher!!! LD>> Ron LD>> ----- Original Message ----- LD>> From: Lehman, David <[EMAIL PROTECTED]> LD>> Sent: Monday, July 31, 2006 LD>> To: OTlist@OTnow.com <OTlist@OTnow.com> LD>> Subj: [OTlist] FW: Interesting Stats LD>>> Ron...from our buddy Dan...have fun with this one. LD>>> ________________________________ LD>>> From: Lofald, Dan [mailto:[EMAIL PROTECTED] LD>>> Sent: Mon 7/31/2006 2:00 PM LD>>> To: Lehman, David; Ron Carson LD>>> Subject: RE: [OTlist] Interesting Stats LD>>> Howdy David, Howdy Ron LD>>> We might not be sitting at the lunch table but the good LD> conversation continues. LD>>> As the Irish saying goes, "Is this a private fight or can anyone LD> join" LD>>> It appears to be that there are about 6 different concepts in play. LD>>> David's comments about taking all of the variables en' mass LD>>> and seeing what regression would tell us. LD>>> Yep-folks do this all of the time. For example, I was LD>>> involved trying to find lead indicators of newborn deaths at Univ. LD>>> of Florida Hospital. There were 1400 independent variables and 1 LD>>> dependent variable (death/life). LD>>> We hunted around for months looking for best predictive sets LD>>> of predictors. The approach to this work was, "if it works, it LD>>> works." However, this is nothing more than mainframe level data LD>>> grubbing. It can never tell us anything scientifically definitive LD>>> because the alpha level is astronomical. However, it might give LD>>> insight on a place to look with tools that are more sophisticated. LD>>> Invariably, meaningful finds with first-order relationships LD>>> are rare events. The good stuff is going to emerge out of finding LD>>> important suppressor and mediator variables at work. In addition, LD>>> most of the variables will probably not be in a linear LD>>> relationship with each other (especially not with human beings). LD>>> With regression, you can check for suppressor and mediator LD>>> variables and you can test polynomial solutions --- however-to get LD>>> to the good stuff, we would probably have use multi-variate tools. LD>>> At the broader level - the two of you have an ontological & LD>>> mathematical conversation combined (I love it). LD>>> Let's look at the passage, "All humans are unique." What LD>>> does that statement mean? Every part of every human is unlike LD>>> every part of every other human? If that were the case, and we LD>>> used Set Theory, we would have 121 billion non-intersecting LD>>> circles. If that were the case, not only would science be LD>>> impossible, but so also preclude the possibility of language and LD>>> culture. LD>>> If by, "All humans are unique," we mean, that some part of my LD>>> circle does not overlap with your circle - we are now onto LD>>> something important. Now we can ask how much of our two Venn LD>>> circles overlap and do not overlap. This is expression we have LD>>> with a Pearson product-moment correlation of p = .80, which means LD>>> that 64% of the variance in one variable can be predicted by the LD>>> variance of the other circle. LD>>> But what happens when there are ten of us. How do our LD>>> circles overlap now (we are talking about the ephemeral LD>>> phenomological/psychological variables that you guys are talking LD>>> about). If we look at enough people can we find patterns among LD>>> what initially appeared discretely idiosyncratic? LD>>> [[Oh gee - I cannot finish this response this week but I LD>>> should would like to take it up with you guys another time. You LD>>> are drilling down to one of the most interesting and important LD>>> pieces of social science. LD>>> Dan LD>>> Daniel R. Lofald, PhD LD>>> Staff Development Coordinator LD>>> Chippewa Valley Technical College LD>>> 620 W. Clairemont Ave., Eau Claire, WI 54701-6162 LD>>> Phone 715-852-1328 Fax 715-833-6451 LD>>> ________________________________ LD>>> From: Lehman, David [mailto:[EMAIL PROTECTED] LD>>> Sent: Wednesday, July 26, 2006 8:54 PM LD>>> To: Lofald, Dan LD>>> Subject: FW: [OTlist] Interesting Stats LD>>> Ron remembers you.....well! LD>>> More thoughts? LD>>> ________________________________ LD>>> From: [EMAIL PROTECTED] on behalf of Ron Carson LD>>> Sent: Wed 7/26/2006 8:42 PM LD>>> To: Lehman, David LD>>> Subject: Re: [OTlist] Interesting Stats LD>>> Given that you have a PhD, and if I remember, you and Dan LD> L. LD>>> frequently talked about this stuff, I feel that I am LD> definitely LD>>> out-classed!! <lol>. But, being the brave, (uh, stupid) person LD> that I LD>>> am, I will continue wading in the deep end of the pool. LD>>> It seems that regression analysis looks at individual variables. LD> But LD>>> we know that people are not just collection of individual LD> variables. LD>>> We are after all, greater then the sum of our parts. LD>>> How does regression analysis look at the SUM of the variables? LD>>> Also, is it possible to quantify a subjective feeling? I know this LD> is LD>>> done with pain scales, but the subjective nature of such LD> scales LD>>> renders them almost useless for comparisons sake. In other words, LD> my LD>>> reported pain of 9 is total meaningless when COMPARED to your LD> reported LD>>> pain of 9. LD>>> Lastly, just because someone has a history of any of the variables, LD> in LD>>> and of itself, that history is meaningless. For example, just LD> because LD>>> someone has a history of total hip arthroplasty, that doesn't LD> mean LD>>> they will need adaptations to dress their lower body. LD>>> Ok, one more "lastly". You said: david>>>> The more variables, the more chances for your results occuring david>>>> because of poor internal validity LD>>> Are you saying that the greater the number of variables, the LD> less LD>>> likely you can predict the results? If so, they I maintain that LD> the LD>>> number of variable affecting patient outcomes is infinite and thus LD> you LD>>> can never truly predict the outcomes. Keep in mind that I refer LD> to LD>>> patients, not to procedures. LD>>> Ron LD>>> ----- Original Message ----- LD>>> From: Lehman, David <[EMAIL PROTECTED]> LD>>> Sent: Wednesday, July 26, 2006 LD>>> To: OTlist@OTnow.com <OTlist@OTnow.com> LD>>> Subj: [OTlist] Interesting Stats LD>>>> I am not surprised you disagree, Ron! Thats what makes us get LD> along so well! LD>>>> I think you walked right into what I wanted to get across: LD>>>> Each of the variables you listed below can be measured, LD>>>> right? If something (a dependent or attribute variable) can be LD>>>> measured, then it has a number which can then be used to determine LD>>>> if the unique variable is significant , and this is the important LD>>>> part, I think, that when using a regression analysis, it takes LD>>>> into account all the other unique and not unique variables thought LD>>>> to be a contributor to the healing (increased functional LD>>>> activities, increased occupation). LD>>>> So, if one individual, has a history of any or most of these, LD>>>> then how does that effect your treatment versus if she had 30% LD>>>> relevant, or 10% relevant, etc... The more variables, the more LD>>>> chances for your results occuring because of poor internal LD>>>> validity (poor job controlling all the other variablesvariables) - LD>>>> and you dont know if it were treatment approach a or b or c or d LD>>>> or e.....or placebo. LD>>>> OK...I am going statistical here and trying to explain LD>>>> it..,.....but, if you can quantify something, you can study its LD>>>> relationship with other variables and outcomes. LD>>>> This is fun. LD>>>> ________________________________ LD>>>> From: [EMAIL PROTECTED] on behalf of Ron Carson LD>>>> Sent: Wed 7/26/2006 7:31 PM LD>>>> To: Lehman, David LD>>>> Subject: Re: [OTlist] Interesting Stats LD>>>> Hello David: LD>>>> I hate to disagree but every person has unique variables. That's LD> what LD>>>> makes us unique. And perhaps the greatest and uniqueness LD> variable of LD>>>> all is the subjective feeling and experiences associated with LD> injury, LD>>>> disease and illness. It is in fact that subjective experience of LD> our LD>>>> patient's that makes being an OT so difficult. LD>>>> Regarding a list, here's a few: LD>>>> age, gender, marital status, employment history, race, LD> religion, LD>>>> medical history, current medications, spiritual beliefs, LD> family LD>>>> support, financial support, cognitive status, mental LD> status, LD>>>> education, prior experience with OT, expectations, diet, LD> sleep LD>>>> patterns, do they have regular bowel movements, etc. LD>>>> The list is truly endless!! LD>>>> This is a GREAT topic LD>>>> Ron LD>>>> ----- Original Message ----- LD>>>> From: Lehman, David <[EMAIL PROTECTED]> LD>>>> Sent: Wednesday, July 26, 2006 LD>>>> To: OTlist@OTnow.com <OTlist@OTnow.com> LD>>>> Subj: [OTlist] Interesting Stats LD>>>>> I mis-spoke, perhaps....meaning that there really are no LD>>>>> unique variables that ONLY exist to one person on earth. If LD>>>>> enough data is gathered on a population, the "unique" or should I LD>>>>> say less appearing variables we call unique, would be detectable LD>>>>> and the statistical model would show us what contribution that LD>>>>> particular "unique variable" makes and if it is significant in LD> the LD>>>>> outcome. LD>>>>> I guess my next question would be to ask the members to list LD>>>>> variables they consider unique to a person that have an impact on LD>>>>> the treatment they provide. LD>>>>> ________________________________ LD>>>>> From: [EMAIL PROTECTED] on behalf of Ron Carson LD>>>>> Sent: Wed 7/26/2006 4:04 PM LD>>>>> To: Lehman, David LD>>>>> Subject: Re: [OTlist] Interesting Stats LD>>>>> I don't know much, if anything, about regression theory, LD> but I'm LD>>>>> pretty confident that it is impossible to take into account LD> ALL the LD>>>>> UNIQUE variables that account for healing. Also, it seems LD> rather LD>>>>> counterintuitive to try include a "unique" variable into a LD> "general" LD>>>>> logarithm. LD>>>>> Ron LD>>>>> ----- Original Message ----- LD>>>>> From: Lehman, David <[EMAIL PROTECTED]> LD>>>>> Sent: Wednesday, July 26, 2006 LD>>>>> To: OTlist@OTnow.com <OTlist@OTnow.com> LD>>>>> Subj: [OTlist] Interesting Stats LD>>>>>> all of the unique variables of LD>>>>>> a client could one day be analysed in a regression model LD>>>>>> and thus determine how much these LD>>>>>> unique variables actually account for healing, then LD>>>>>> include them in the logaritm? LD>>>>> -- LD>>>>> Unsubscribe? LD>>>>> [EMAIL PROTECTED] LD>>>>> Change options? LD>>>>> www.otnow.com/mailman/options/otlist_otnow.com LD>>>>> Archive? LD>>>>> www.mail-archive.com/otlist@otnow.com LD>>>>> Help? LD>>>>> [EMAIL PROTECTED] LD>>>> -- LD>>>> Unsubscribe? LD>>>> [EMAIL PROTECTED] LD>>>> Change options? LD>>>> www.otnow.com/mailman/options/otlist_otnow.com LD>>>> Archive? LD>>>> www.mail-archive.com/otlist@otnow.com LD>>>> Help? LD>>>> [EMAIL PROTECTED] LD>>> -- LD>>> Unsubscribe? LD>>> [EMAIL PROTECTED] LD>>> Change options? LD>>> www.otnow.com/mailman/options/otlist_otnow.com LD>>> Archive? LD>>> www.mail-archive.com/otlist@otnow.com LD>>> Help? LD>>> [EMAIL PROTECTED] LD>> -- LD>> Unsubscribe? LD>> [EMAIL PROTECTED] LD>> Change options? LD>> www.otnow.com/mailman/options/otlist_otnow.com LD>> Archive? LD>> www.mail-archive.com/otlist@otnow.com LD>> Help? LD>> [EMAIL PROTECTED] LD> -- LD> Unsubscribe? LD> [EMAIL PROTECTED] LD> Change options? LD> www.otnow.com/mailman/options/otlist_otnow.com LD> Archive? LD> www.mail-archive.com/otlist@otnow.com LD> Help? LD> [EMAIL PROTECTED] -- Unsubscribe? [EMAIL PROTECTED] Change options? www.otnow.com/mailman/options/otlist_otnow.com Archive? www.mail-archive.com/otlist@otnow.com Help? [EMAIL PROTECTED]
