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The Mcnemar Change Test

Here are the steps to solve this problem: 1. Concordant pairs = 52 + 35 = 87 pairs 2. Discordant pairs = 4 + 9 = 13 pairs 3. Using the McNemar test, with a total of 13 pairs changing status and α = 0.05, the critical value for X2 is 3.84. The calculated value of X2 is 4.07. Since the calculated X2 is greater than the critical value, we can conclude that there is a significant difference in effectiveness between the two drugs among males at p < 0.05.

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Hery Purnawant
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839 views10 pages

The Mcnemar Change Test

Here are the steps to solve this problem: 1. Concordant pairs = 52 + 35 = 87 pairs 2. Discordant pairs = 4 + 9 = 13 pairs 3. Using the McNemar test, with a total of 13 pairs changing status and α = 0.05, the critical value for X2 is 3.84. The calculated value of X2 is 4.07. Since the calculated X2 is greater than the critical value, we can conclude that there is a significant difference in effectiveness between the two drugs among males at p < 0.05.

Uploaded by

Hery Purnawant
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Download as PPT, PDF, TXT or read online on Scribd
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TWO MEASURES or PAIRED REPLICATES

The McNemar Change Test


The Wilcoxon Signed Ranks Test
The Sign Test

by Nimal Baroya
The McNemar Change Test
FUNCTION
For The significance of change is particularly
to before and after designs in which each
subject is used as its own control
The measurement are made on either
nominal or ordinal scale
It might be used to test the effectiveness of
particular treatment, ex : injection drug,
training, separation for family etc.
The McNemar Change Test
Rationale and Method
A fourfold table of
after
frequencies is used
to represent the first - +
and second sets of + A B
responses from the before
same individual
- C D
A denotes number of individuals Rationale and
whose responses were (+) on the
first measure and (-) on the Method
second measure
D is the number individuals who
changed from (-) to (+) after
B is the frequency of individual - +
who responded the same (+)
C is the number of individuals + A B

before
who responded the same (-) both
before and after
- C D
A+D is the total number of people
whose responses changed
Rationale and Method
The null hypothesis is that the number of
change in each direction is equally like
Ho is true, the expected frequency in each of
the two cells is (A+D)/2
The significances of changes follow the
sampling distribution X2 with df = 1
The McNemar Test for the Significances of Changes

With the correction continuity by Yates (1934)

2
X = ( IA DI 1)2 with df = 1
A+D

Rejection Region,
Reject Ho if, X2(hitung) > X2(tabel) (; df =1)
Small expected frequencies
If the expected frequency for the McNemar
test, (A+D)/2 , is very small less than 5-, the
binomial test should be used rather than the
McNemar test
To use binomial test, let N = A+D and x be
the smaller of the two observed frequencies,
either A or D, and use table D (binomial test)
to the test significance of x
Reject H0 if p value <
Summary Procedure (Steps in the computation of the
McNemar change test)

Cast the observed frequencies in a fourfold table


Determine the total number change, A+D. If the
total number of changes is less than 10, use the
binomial test rather than the McNemar test.
If the total frequency of changes exceeds 10,
compute the value of X2 by using chi square
distribution with the correction continuity
Determine the the significances of changes with
value as large as the observed value of X2 by
referring to table C. if X2 > X2 (; df =1), reject Ho
Example

The anemia status before and Before After Fe


after Fe consumption for women Fe
senior high school student - +
(N=500)
What is fe consumption influent
anemia status for women senior
+ 80 300
highs school student?

- 105 15
Exercise 1

Two drugs A and B are compared for the medical treatment


duodenal ulcer. If the focus is on the 100 matched pairs
consisting of male patients, then the following results are
obtained, for 52 matched pairs both drug are effective; for 35
matched pairs both drug are ineffective; for 4 matched pairs
drug A is effective, whereas drug B is ineffective; for 9 matched
pairs drug A is ineffective
1. How many concordant pairs are there among the male
matched pairs
2. How many discorcant pairs are there among the male
matched pairs
3. Perform a significance test to asses any differences in
effectiveness between the drugs among males. Report p-
value.

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