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Ensayo clínico de no inferioridad

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Ensayo clínico de no inferioridad

  1. 1. TECNOLÓGICO Centro de Medicina Basada en EvidenciaDE MONTERREY ® Red Cochrane Iberoamericana Ensayos clínicos de no-inferioridad Carlos Cuello, MD Oxygen therapy for acute myocardial infarction (Review Cabello JB, Burls A, Emparanza JI, Bayliss S, Quinn T
  2. 2. Competencia de tiros penalties versus Cristiano Ronaldo Carlos Cuello (CR7) (CC)
  3. 3. Tiros de CR7 10 Diferencia de goles Goles 8 % Proporción 0.8Tiros de CC 10 Favorece a CC Favorece a CR Goles 4 Proporción 0.4 Diferencia 0.4 IC95% -0.04 a 0.71 100 50 0 50 100 P valor 0.17
  4. 4. Tiros de CR7 10 Diferencia de goles Goles 8 % Proporción 0.8Tiros de CC 10 Favorece a CC Favorece a CR Goles 4 Proporción 0.4 Diferencia 0.4 IC95% -0.04 a 0.71 100 50 0 50 100 P valor 0.17
  5. 5. CONCLUSIONESCarlos Cuello es mejor queCristiano Ronaldo para tirarpenalties
  6. 6. estadísticamente hablando... sípero... si tiran más penalties...
  7. 7. Tiros de CR7 20 Diferencia de goles Goles 16 % Proporción 0.8Tiros de CC 20 Favorece a CC Favorece a CR Goles 8 Proporción 0.4 ó 40% Diferencia 0.4 ó 40% IC95% 0.10 a 0.64 100 50 0 50 100 P valor 0.02
  8. 8. Tiros de CR7 20 Diferencia de goles Goles 16 % Proporción 0.8Tiros de CC 20 Favorece a CC Favorece a CR Goles 8 Proporción 0.4 ó 40% Diferencia 0.4 ó 40% IC95% 0.10 a 0.64 100 50 0 50 100 P valor 0.02
  9. 9. ¿Y si compitieran ellos?
  10. 10. Yo ya sé queambos son buenos. Tan solo demuéstrame queMessi NO es inferior a CR7
  11. 11. Messi:“yo no soy inferior a CR7...”
  12. 12. “...Tendríaque ser inferior por una diferencia mínima de 15%”
  13. 13. Diferencia de goles % Favorece a Messi Favorece a CR7 (Messi es mejor) (Messi es peor)100 50 0 50 100
  14. 14. Diferencia de goles % Umbral de inferioridad Favorece a Messi Favorece a CR7 (Messi es mejor) (Messi es peor)100 50 0 50 100 15%
  15. 15. Diferencia de goles % Umbral de inferioridad Messi NO es Messi es inferior inferior100 50 0 50 100 15%
  16. 16. POSIBLES RESULTADOS Y SU INTERPRETACIÓN
  17. 17. POSIBLES RESULTADOS INTERPRETACIONES Messi es superior a CR7 ya que el Umbral de inferioridad resultado y todo elIC95% está a favor de Messi 100 50 0 50 100 15%
  18. 18. POSIBLES RESULTADOS INTERPRETACIONES No inferior Umbral de inferioridad aunqueestadísticamente no hay diferencia, concluimosque Messi no es inferior a Ronaldo ya que no llegó a la mínima diferencia del 15% (umbral) 100 50 0 50 100 15%
  19. 19. POSIBLES RESULTADOS INTERPRETACIONES No inferior Umbral de inferioridad aunqueestadísticamente no hay diferencia, concluimosque Messi no es inferior a Ronaldo ya que no llegó a la mínima diferencia del 15% (umbral) 100 50 0 50 100 15%
  20. 20. POSIBLES RESULTADOS INTERPRETACIONES Umbral de inferioridad ¿No inferior? aunque estadísticamente CR7 le gana a Messi (contodo y el IC95%), se trata deun estudio de no inferioridad y tenemos que concluir que Messi no es inferior a Ronaldo, ya que el IC95% no llegó a la mínima diferencia del 15% (umbral) 100 50 0 50 100 15%
  21. 21. POSIBLES RESULTADOS INTERPRETACIONES Umbral de inferioridad No concluyente cualquier estimado aquí esincierto porque el IC95% es muy grande 100 50 0 50 100 15%
  22. 22. POSIBLES RESULTADOS INTERPRETACIONES No concluyente Umbral de inferioridad cualquier estimado aquí es incierto porque el IC95%, aunque no es muy grande, abarca el umbral de inferioridad y la hipótesisnula de no-diferencia (la línea vertical de la T invertida) entre ambos jugadores 100 50 0 50 100 15%
  23. 23. POSIBLES RESULTADOS INTERPRETACIONES ¿No concluyente? Umbral de inferioridadaunque CR7 le gana a Messi porque el resultado y elIC95% está por completo a la derecha del cero no podemos, aún así, concluir si Messi es inferior o no, ya que el IC95% abarca el umbral de inferioridad 100 50 0 50 100 15%
  24. 24. POSIBLES RESULTADOS INTERPRETACIONES Messi es inferior Umbral de inferioridad al fin podemos rechazar lahipótesis nula de que Messies no-inferior a CR7, porqueel resultado y el IC95% está por completo a la derecha del cero y a la derecha del umbral de inferioridad. Esdecir, CR7 le gana por más del mínimo 15% de diferencia 100 50 0 50 100 15%
  25. 25. Tamaño de muestra • ECA de superioridadSuponiendo que: (ECA común) = 25,583 penalties cada uno para demostrar que uno es superior a otro (cualquiera de los dos)Messi normalmentemete el 79% de los • ECA de No inferioridad = 102 penalties cada unopenalties y para demostrar que uno es no-inferior al otroCR7 mete el 80% (Messi es no-inferior a CR7)
  26. 26. DUDAS • Gracias • cmbe.net

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