Please help with this case study: Case Study 2 Complete

Deep hypothermia with either total circulatory arrest or low-flow cardiovascular bypass is used to support the vital organs of infants during heart surgery. Low-flow bypass maintains continuous and steady circulation through brain and is preferred by most doctors during the surgery. Maximal duration of circulatory arrest that will not cause impairment of the central nervous system among infants is not known well. Studies show that heart surgery performed with circulatory arrest as the predominant support strategy is associated with a higher risk of delayed motor development and neurologic abnormalities among children than heart surgery performed with low-flow bypass as the predominant support strategy. In 1995, a project was conducted by a group of researchers in Boston, MA to study the developmental and neurologic status of one-year-old children who had undergone reparative heart surgery during the first three months of life. The primary purpose of the study was to evaluate whether circulatory arrest had more negative effects on the development of one-year old children than low-flow bypass. In addition, the study intended to examine whether breast feeding of the children was associated with child development and brain abnormality and whether there was any association between different measures of child development. One hundred sixty infants were randomized into one of the two groups, circulatory arrest or low-flow bypass during their heart surgery. The Bayley Scales of Infant Development (BSID) scores which include two indices – the Psychomotor Development Index (PDI) and Mental Development Index (MDI) were administered at one year of age. The proportions of children under or above 80 (2 SD away from the population mean PDI or MDI scores) were also determined. Magnetic resonance imaging (MRI) tests were used to evaluate whether a child’s brain was definitely abnormal, possibly abnormal or normal. In addition, the Fagan Test of Infant Intelligence (FTII) that assesses visual-recognition memory was performed. Children with a correct rate of 53% or less in the FTII were considered to have failed the test. The detailed description of the variables in this dataset is given in Table 1. Table 1 Variable Descriptions of “project.sav” Dataset Variable Names Variable Type Label Values ID String Patient ID —- x Numeric / Dichotomous Treatment 1 = “Circulatory Arrest” 0 = “Low-flow Bypass” Feeding Numeric / Categorical Infant was breast fed? = “No” = “≤ 3 Months” = “> 3 Months” Norm Numeric / Categorical Brain Normality = “Definitely Abnormal” = “Possibly Abnormal” = “Normal” PDI Numeric / Continuous Psychomotor Development Index —- PDI_cat Numeric / Dichotomous Categorical PDI 1 = “PDI ≤ 80” 0 = “PDI > 80” MDI Numeric / Continuous Mental Development Index —- MDI_cat Numeric / Dichotomous Categorical MDI 1 = “MDI ≤ 80” 0 = “MDI > 80” Fagan Numeric / Continuous Fagan Test of Infant Intelligence —- Measured in percentages Fag_cat Numeric / Dichotomous Categorical Fagan 1 = “Fagan Test ≤ 53.00” 0 = “Fagan Test >53.00” Instructions: Use one decimal when reporting means and standard deviations. Report applicable odds ratios (and 95% CI if computed) in two decimals. If p > 0.01, round them to two decimals; otherwise report 1 or 2 digits after the leading zeros, i.e. report p = 0.0045 or p = 1E-5. All p-values are two-tailed. Double click SPSS output table to activate the result table, and move your mouse on to the number in the Sig. cell for exact p values. Use the dataset “project.sav” for all your analyses in this project. Please use the first entry in Table 2 as an example when you fill in the tables. Tables 2 & 3 must be completed. Tables 4 & 5 are optional, extra credit (1 point each). Table 2 describes treatment association with developmental scores. Assignment: Section 1 What is the appropriate statistical analyses test to run on SPSS to complete Table 2 below? Table 2: Association of Treatment Type with Developmental Status of Children Variables Low-Flow Bypass (n=81) Circulatory Arrest (n=79) p-value (2-tailed) OR (95% CI)* Mean SD Psychomotor Development Index†99.8 ± 13.5 88.2 ± 17.5 p =8E-6 NA Mental Development Index Fagan Test of Infant Development Count (%) Psychomotor Development Index†> 80 ≤ 80 72 (88.9) 9 (11.1) 50 (64.1) 28 (35.9) <0.001 1.0 (Reference) 4.48 (1.95, 10.31) Mental Development Index > 80 ≤ 80 Fagan Test of Infant Intelligence > 53.00 ≤ 53.00 Brain Abnormality Definitely Abnormal Possibly Abnormal Normal NA NA NA * Odd ratios (95% Confidence Intervals) if applicable. †One missing value where “Treatment” is “Circulatory Arrest”.

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