{"id":5141,"date":"2022-08-18T17:03:59","date_gmt":"2022-08-18T17:03:59","guid":{"rendered":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/?post_type=chapter&p=5141"},"modified":"2022-08-18T17:03:59","modified_gmt":"2022-08-18T17:03:59","slug":"8e-in-class-activity","status":"publish","type":"chapter","link":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/chapter\/8e-in-class-activity\/","title":{"raw":"8E In-Class Activity","rendered":"8E In-Class Activity"},"content":{"raw":"The amount of cholesterol in a person\u2019s blood plays an important role in the health of their heart\u00a0\u00a0and blood vessels. Most adults have their cholesterol levels checked at least every five\u00a0years. To help guide treatment, medical organizations have established guidelines that define which cholesterol levels are considered healthy.[footnote]National Heart, Lung, and Blood Institute. (2021, January 4). Blood cholesterol<\/em>. https:\/\/www.nhlbi.nih.gov\/health-topics\/blood-cholesterol [\/footnote]\r\n\r\n\"\"\r\n\r\nCredit: iStock\/udra\r\n
\r\n

Question 1<\/h3>\r\nWhat statistical tools and methods do you think would be useful for medical\u00a0 organizations when defining the guidelines for healthy levels of cholesterol?\r\n\r\n<\/div>\r\n
\r\n

Question 2<\/h3>\r\nCholesterol levels for adults in the United States are normally distributed, so the\u00a0 normal distribution is a useful tool in evaluating cholesterol levels. According to the\u00a0 Centers for Disease Control and Prevention (CDC), the mean cholesterol level for\u00a0 adults is 191 milligrams of cholesterol per deciliter of blood (mg\/dL), with a standard\u00a0 deviation (SD) of 40.7.[footnote]Centers for Disease Control and Prevention. (2021, March 1). Cholesterol<\/em>. https:\/\/www.cdc.gov\/nchs\/fastats\/cholesterol.htm [\/footnote]\r\n
    \r\n \t
  1. Using the DCMP Normal Distribution tool at\u00a0\u00a0https:\/\/dcmathpathways.shinyapps.io\/NormalDist\/%20<\/a>, create a graph that\u00a0 shades the area under the curve from one SD below the mean to one SD above the mean. Sketch your results on the curve below. Be sure to include\u00a0 the labels for the mean [latex] \\pm 3[\/latex] SDs.\r\n\"\"<\/li>\r\n \t
  2. \u00a0If we tested the cholesterol of a random adult, what is the probability it would\u00a0 be within one SD of the mean?<\/li>\r\n \t
  3. A cholesterol level below 200 mg\/dL is ideal.[footnote]National Heart, Lung, and Blood Institute. (2001, May). ATP III guidelines at-a-glance quick desk reference.<\/em> https:\/\/www.nhlbi.nih.gov\/files\/docs\/guidelines\/atglance.pdf[\/footnote] Estimate the probability that a\u00a0 randomly selected adult will have a cholesterol level below 200.<\/li>\r\n \t
  4. A cholesterol level between 200 and 239 mg\/dL is borderline high.[footnote]National Heart, Lung, and Blood Institute. (2001, May). ATP III guidelines at-a-glance quick desk reference<\/em>. https:\/\/www.nhlbi.nih.gov\/files\/docs\/guidelines\/atglance.pdf[\/footnote] Estimate the probability that a randomly selected adult will have a cholesterol level between 200 and 239.<\/li>\r\n \t
  5. he CDC reports that 11.5% of adults in the United States have high\u00a0 cholesterol (over 240 mg\/dL).[footnote]Centers for Disease Control and Prevention. (2021, March 1). Cholesterol<\/em>. https:\/\/www.cdc.gov\/nchs\/fastats\/cholesterol.htm[\/footnote] How does this compare to your own analysis\u00a0 of the data?<\/li>\r\n<\/ol>\r\n<\/div>\r\n
    \r\n

    Question 3<\/h3>\r\nBlood pressure is another important indicator of heart health. Like cholesterol, blood pressure levels for adults in the United States are normally distributed. However, an individual\u2019s blood pressure also varies in a normally distributed pattern throughout\u00a0 the day based on factors such as position, activity level, and anxiety. Blood pressure is reported as the systolic pressure (heart is pumping) over the diastolic pressure (heart is relaxing).\r\n\r\nSystolic blood pressure values below 120 millimeters of mercury (mm Hg) are\u00a0 considered healthy, while values over 140 mm Hg are classified as high. Values\u00a0 between 120 and 140 mm Hg are borderline.[footnote] National Heart, Lung, and Blood Institute. (2020, May 8). High blood pressure.<\/em> https:\/\/www.nhlbi.nih.gov\/health-topics\/high-blood-pressure [\/footnote] The values of the SD also vary\u00a0 depending on the assumed mean value of the systolic blood pressure. The SD for\u00a0 individual blood pressure is 9.9% of the mean systolic blood pressure.\r\n
      \r\n \t
    1. For a patient with a mean systolic pressure of 120 mm Hg, the SD of\u00a0 individual blood pressure measurements is about 11.9.[footnote]Marshall, T. P. (2008, January 1). Blood pressure variability: The challenge of variation. American Journal of Hypertension<\/em>, 21(1), 3-4. https:\/\/academic.oup.com\/ajh\/article\/21\/1\/3\/137216[\/footnote] If a healthcare\u00a0 provider checks this patient\u2019s blood pressure, what is the probability the\u00a0 measurement will be greater than 140?<\/li>\r\n \t
    2. For a patient with a mean systolic pressure of 130 mm Hg, the SD of\u00a0 individual blood pressure measurements is about 12.9. If a healthcare\u00a0 provider checks this patient\u2019s blood pressure, what is the probability the\u00a0 measurement will be greater than 140?<\/li>\r\n \t
    3. A healthcare provider is seeing a new patient for the first time. The patient\u2019s measured systolic blood pressure is 140 mm Hg. Should the provider diagnose the patient with high blood pressure? Explain.<\/li>\r\n \t
    4. A different patient has a single systolic blood pressure reading of 170 mm\u00a0 Hg. Discuss the likelihood that this patient\u2019s actual mean blood pressure is greater than 140 mm Hg. Note that if the assumed mean is 140 mm Hg, the SD is 13.9.<\/li>\r\n<\/ol>\r\n<\/div>\r\n
      \r\n

      Question 4<\/h3>\r\nChildren\u2019s blood pressures vary with age and size, so guidelines have to account for\u00a0 that variation. Instead of providing simple numeric ranges (like we see with adults),\u00a0 the guidelines are based on where a child\u2019s blood pressure falls in the normal\u00a0 distribution of all measurements for children of the same age and height.[footnote] Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., de Ferranti, S. D., Dionne, J. M., Falkner, B., Flinn, S. K., Gidding, S. S., Goodwin, C., Leu, M. G., Powers, M. E., Rea, C., Samuels, J., Simasek, M., Thaker, V. V., & Urbina, E. M. (2017, September). Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics, 140<\/em>(3), e20171904. https:\/\/doi.org\/10.1542\/peds.2017-1904 [\/footnote]\r\n
        \r\n \t
      1. Hypertension for children is defined as an average systolic blood pressure\u00a0 over the 95th percentile for age and height. For 8-year-old boys who are 50\u00a0 inches tall, the distribution of systolic blood pressures has a mean of 97 and\u00a0 a SD of 9.4.\r\nWhat value of systolic blood pressure corresponds to the 95th percentile?\u00a0 (Use the tool for the calculation and include the proper units.)<\/li>\r\n \t
      2. Very low blood pressure is also dangerous and requires emergency medical\u00a0 treatment. Guidelines instruct healthcare providers to begin emergency\u00a0 treatment when a child\u2019s systolic blood pressure drops below the 5th percentile.[footnote]U.S. Department of Health & Human Services, Chemical Hazards Emergency Medical Management. (2021, March 8). Pediatric basic and advanced life support. https:\/\/chemm.nlm.nih.gov\/pals.htm[\/footnote]\r\nWhat value corresponds to the 5th percentile for an 8-year-old-boy who is 50\u00a0 inches tall? (Use the tool for the calculation and include the proper units.)<\/li>\r\n<\/ol>\r\n<\/div>\r\n ","rendered":"

        The amount of cholesterol in a person\u2019s blood plays an important role in the health of their heart\u00a0\u00a0and blood vessels. Most adults have their cholesterol levels checked at least every five\u00a0years. To help guide treatment, medical organizations have established guidelines that define which cholesterol levels are considered healthy.[1]<\/sup><\/a><\/p>\n

        \"\"<\/p>\n

        Credit: iStock\/udra<\/p>\n

        \n

        Question 1<\/h3>\n

        What statistical tools and methods do you think would be useful for medical\u00a0 organizations when defining the guidelines for healthy levels of cholesterol?<\/p>\n<\/div>\n

        \n

        Question 2<\/h3>\n

        Cholesterol levels for adults in the United States are normally distributed, so the\u00a0 normal distribution is a useful tool in evaluating cholesterol levels. According to the\u00a0 Centers for Disease Control and Prevention (CDC), the mean cholesterol level for\u00a0 adults is 191 milligrams of cholesterol per deciliter of blood (mg\/dL), with a standard\u00a0 deviation (SD) of 40.7.[2]<\/sup><\/a><\/p>\n

          \n
        1. Using the DCMP Normal Distribution tool at\u00a0\u00a0https:\/\/dcmathpathways.shinyapps.io\/NormalDist\/%20<\/a>, create a graph that\u00a0 shades the area under the curve from one SD below the mean to one SD above the mean. Sketch your results on the curve below. Be sure to include\u00a0 the labels for the mean [latex]\\pm 3[\/latex] SDs.
          \n\"\"<\/li>\n
        2. \u00a0If we tested the cholesterol of a random adult, what is the probability it would\u00a0 be within one SD of the mean?<\/li>\n
        3. A cholesterol level below 200 mg\/dL is ideal.[3]<\/sup><\/a> Estimate the probability that a\u00a0 randomly selected adult will have a cholesterol level below 200.<\/li>\n
        4. A cholesterol level between 200 and 239 mg\/dL is borderline high.[4]<\/sup><\/a> Estimate the probability that a randomly selected adult will have a cholesterol level between 200 and 239.<\/li>\n
        5. he CDC reports that 11.5% of adults in the United States have high\u00a0 cholesterol (over 240 mg\/dL).[5]<\/sup><\/a> How does this compare to your own analysis\u00a0 of the data?<\/li>\n<\/ol>\n<\/div>\n
          \n

          Question 3<\/h3>\n

          Blood pressure is another important indicator of heart health. Like cholesterol, blood pressure levels for adults in the United States are normally distributed. However, an individual\u2019s blood pressure also varies in a normally distributed pattern throughout\u00a0 the day based on factors such as position, activity level, and anxiety. Blood pressure is reported as the systolic pressure (heart is pumping) over the diastolic pressure (heart is relaxing).<\/p>\n

          Systolic blood pressure values below 120 millimeters of mercury (mm Hg) are\u00a0 considered healthy, while values over 140 mm Hg are classified as high. Values\u00a0 between 120 and 140 mm Hg are borderline.[6]<\/sup><\/a> The values of the SD also vary\u00a0 depending on the assumed mean value of the systolic blood pressure. The SD for\u00a0 individual blood pressure is 9.9% of the mean systolic blood pressure.<\/p>\n

            \n
          1. For a patient with a mean systolic pressure of 120 mm Hg, the SD of\u00a0 individual blood pressure measurements is about 11.9.[7]<\/sup><\/a> If a healthcare\u00a0 provider checks this patient\u2019s blood pressure, what is the probability the\u00a0 measurement will be greater than 140?<\/li>\n
          2. For a patient with a mean systolic pressure of 130 mm Hg, the SD of\u00a0 individual blood pressure measurements is about 12.9. If a healthcare\u00a0 provider checks this patient\u2019s blood pressure, what is the probability the\u00a0 measurement will be greater than 140?<\/li>\n
          3. A healthcare provider is seeing a new patient for the first time. The patient\u2019s measured systolic blood pressure is 140 mm Hg. Should the provider diagnose the patient with high blood pressure? Explain.<\/li>\n
          4. A different patient has a single systolic blood pressure reading of 170 mm\u00a0 Hg. Discuss the likelihood that this patient\u2019s actual mean blood pressure is greater than 140 mm Hg. Note that if the assumed mean is 140 mm Hg, the SD is 13.9.<\/li>\n<\/ol>\n<\/div>\n
            \n

            Question 4<\/h3>\n

            Children\u2019s blood pressures vary with age and size, so guidelines have to account for\u00a0 that variation. Instead of providing simple numeric ranges (like we see with adults),\u00a0 the guidelines are based on where a child\u2019s blood pressure falls in the normal\u00a0 distribution of all measurements for children of the same age and height.[8]<\/sup><\/a><\/p>\n

              \n
            1. Hypertension for children is defined as an average systolic blood pressure\u00a0 over the 95th percentile for age and height. For 8-year-old boys who are 50\u00a0 inches tall, the distribution of systolic blood pressures has a mean of 97 and\u00a0 a SD of 9.4.
              \nWhat value of systolic blood pressure corresponds to the 95th percentile?\u00a0 (Use the tool for the calculation and include the proper units.)<\/li>\n
            2. Very low blood pressure is also dangerous and requires emergency medical\u00a0 treatment. Guidelines instruct healthcare providers to begin emergency\u00a0 treatment when a child\u2019s systolic blood pressure drops below the 5th percentile.[9]<\/sup><\/a>
              \nWhat value corresponds to the 5th percentile for an 8-year-old-boy who is 50\u00a0 inches tall? (Use the tool for the calculation and include the proper units.)<\/li>\n<\/ol>\n<\/div>\n

               <\/p>\n

              1. National Heart, Lung, and Blood Institute. (2021, January 4). Blood cholesterol<\/em>. https:\/\/www.nhlbi.nih.gov\/health-topics\/blood-cholesterol ↵<\/a><\/li>
              2. Centers for Disease Control and Prevention. (2021, March 1). Cholesterol<\/em>. https:\/\/www.cdc.gov\/nchs\/fastats\/cholesterol.htm ↵<\/a><\/li>
              3. National Heart, Lung, and Blood Institute. (2001, May). ATP III guidelines at-a-glance quick desk reference.<\/em> https:\/\/www.nhlbi.nih.gov\/files\/docs\/guidelines\/atglance.pdf ↵<\/a><\/li>
              4. National Heart, Lung, and Blood Institute. (2001, May). ATP III guidelines at-a-glance quick desk reference<\/em>. https:\/\/www.nhlbi.nih.gov\/files\/docs\/guidelines\/atglance.pdf ↵<\/a><\/li>
              5. Centers for Disease Control and Prevention. (2021, March 1). Cholesterol<\/em>. https:\/\/www.cdc.gov\/nchs\/fastats\/cholesterol.htm ↵<\/a><\/li>
              6. National Heart, Lung, and Blood Institute. (2020, May 8). High blood pressure.<\/em> https:\/\/www.nhlbi.nih.gov\/health-topics\/high-blood-pressure ↵<\/a><\/li>
              7. Marshall, T. P. (2008, January 1). Blood pressure variability: The challenge of variation. American Journal of Hypertension<\/em>, 21(1), 3-4. https:\/\/academic.oup.com\/ajh\/article\/21\/1\/3\/137216 ↵<\/a><\/li>
              8. Flynn, J. T., Kaelber, D. C., Baker-Smith, C. M., Blowey, D., Carroll, A. E., Daniels, S. R., de Ferranti, S. D., Dionne, J. M., Falkner, B., Flinn, S. K., Gidding, S. S., Goodwin, C., Leu, M. G., Powers, M. E., Rea, C., Samuels, J., Simasek, M., Thaker, V. V., & Urbina, E. M. (2017, September). Clinical practice guideline for screening and management of high blood pressure in children and adolescents. Pediatrics, 140<\/em>(3), e20171904. https:\/\/doi.org\/10.1542\/peds.2017-1904 ↵<\/a><\/li>
              9. U.S. Department of Health & Human Services, Chemical Hazards Emergency Medical Management. (2021, March 8). Pediatric basic and advanced life support. https:\/\/chemm.nlm.nih.gov\/pals.htm ↵<\/a><\/li><\/ol><\/div>","protected":false},"author":574340,"menu_order":14,"template":"","meta":{"_candela_citation":"[]","CANDELA_OUTCOMES_GUID":"","pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-5141","chapter","type-chapter","status-publish","hentry"],"part":4997,"_links":{"self":[{"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/pressbooks\/v2\/chapters\/5141","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/wp\/v2\/users\/574340"}],"version-history":[{"count":1,"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/pressbooks\/v2\/chapters\/5141\/revisions"}],"predecessor-version":[{"id":5143,"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/pressbooks\/v2\/chapters\/5141\/revisions\/5143"}],"part":[{"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/pressbooks\/v2\/parts\/4997"}],"metadata":[{"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/pressbooks\/v2\/chapters\/5141\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/wp\/v2\/media?parent=5141"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/pressbooks\/v2\/chapter-type?post=5141"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/wp\/v2\/contributor?post=5141"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/courses.lumenlearning.com\/lumen-danacenter-statsmockup\/wp-json\/wp\/v2\/license?post=5141"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}