Statistics
Strathlcyde Graduate School of Business The aims of the assignment are to engender a good understanding of, and skills in, the following aspects of the ASDM class: · Using a spreadsheet to make sense of data; · Conducting and interpreting statistical analyses on a data set of reasonable size; · Using multi-criteria decision analysis to structure and inform a decision. · Presenting your analyses in visual and written form; The report for this assignment should have three parts. The division of marks and a page length guide for the three parts is summarised below. All parts are compulsory. The overall report length must not exceed 30 pages, including appendices. Report Part Description Marks Page Guide 1 Executive Report for Senior Management 15 2 pages 2 Technical Report on Data Analysis 45 10 pages including charts, diagrams, tables and appendices 3 Technical Report on Multi-Attribute Value Analysis 40 8 pages, including charts, diagrams, tables and appendices Note: we assume a page to be A4, single-spaced, 11 point characters - i.e. around 300 words. You should submit one report per group. You should also include: · A copy of the Excel file used for your analysis for Part 2. · A copy of your VISA file used for your analysis for Part 3. Introduction to the Assignment Context The Manager of a local hospital has asked for your help. Data has been collected for the last 4 months in the hospital on patients who have had a blood transfusion. The data have been input into a spreadsheet. Unfortunately there is no-one in the Department with the necessary skills to analyse the data. You have been asked to analyse the data and provide a suitable management report for the Manager. Note: the data provided is real and comes from a Scottish hospital but the name of the actual hospital has been kept confidential. Background to the Problem As most people are aware, blood and blood products are a key resource for a health service and are used in providing emergency treatment, in surgical treatment (operations) and in routine care. There are 4 main blood groups (known as ABO): A, B, O and AB. In addition, people either have, or do not have, the Rhesus factor on the surface of their red blood cells. This is usually indicated by 'RhD positive' (does have) or 'RhD negative' (does not have) suffix to the ABO blood group. This means that generally there are 8 main blood types. (Note; this is an oversimplification for the purpose of this assignment. There are in fact over 30 different blood types). Table 1 shows the 8 main blood types and the percentage of the UK population in each blood type category. Table 2 shows a number of international comparisons. Table 1 Blood types and UK population Source: Blood Transfusion Service website Positive Negative Total O 37% 7% 44% A 35% 7% 42% B 8% 2% 10% AB 3% 1% 4% Table 2 ABO and Rh distribution by country Source: Wikipedia ABO and Rh blood type distribution by nation (population averages) Country O+ A+ B+ AB+ O− A− B− AB− Australia 40% 31% 8% 2% 9% 7% 2% 1% Austria] 30% 33% 12% 6% 7% 8% 3% 1% Belgium 38% 34% 8.5% 4.1% 7% 6% 1.5% 0.8% Brazil 36% 34% 8% 2.5% 9% 8% 2% 0.5% Canada 39% 36% 7.6% 2.5% 7% 6% 1.4% 0.5% Denmark 35% 37% 8% 4% 6% 7% 2% 1% Estonia 30% 31% 20% 6% 4.5% 4.5% 3% 1% Finland 27% 38% 15% 7% 4% 6% 2% 1% France 36% 37% 9% 3% 6% 7% 1% 1% Germany 35% 37% 9% 4% 6% 6% 2% 1% Hong Kong SAR 40% 26% 27% 7% 0.31% 0.19% 0.14% 0.05% Iceland 47.6% 26.4% 9.3% 1.6% 8.4% 4.6% 1.7% 0.4% India 36.5% 22.1% 30.9% 6.4% 2.0% 0.8% 1.1% 0.2% Ireland 47% 26% 9% 2% 8% 5% 2% 1% Israel 32% 34% 17% 7% 3% 4% 2% 1% New Zealand 38% 32% 9% 3% 9% 6% 2% 1% Norway 34% 42.5% 6.8% 3.4% 6% 7.5% 1.2% 0.6% Poland 31% 32% 15% 7% 6% 6% 2% 1% Portugal 36.2% 39.8% 6.6% 2.9% 6.0% 6.6% 1.1% 0.5% Saudi Arabia 48% 24% 17% 4% 4% 2% 1% 0.23% Sweden 32% 37% 10% 5% 6% 7% 2% 1% Netherlands 39.5% 35% 6.7% 2.5% 7.5% 7% 1.3% 0.5% Turkey 29.8% 37.8% 14.2% 7.2% 3.9% 4.7% 1.6% 0.8% United Kingdom 37% 35% 8% 3% 7% 7% 2% 1% United States 37.4% 35.7% 8.5% 3.4% 6.6% 6.3% 1.5% 0.6% Blood Transfusion Transfusion medicine is a specialized branch of haematology that is concerned with the study of blood groups, along with the work of a blood bank to provide a transfusion service for blood and other blood products. Across the world, blood products must be prescribed by a medical doctor (licensed physician or surgeon) in a similar way as medicines. Much of the routine work of a blood bank involves testing blood from both donors and recipients to ensure that every individual recipient is given blood that is compatible and is as safe as possible. If a unit of incompatible blood is transfused between a donor and recipient, a severe acute haemolytic reaction, renal failure and shock are likely to occur, and death is a possibility. Patients should ideally receive their own blood or type-specific blood products to minimize the chance of a transfusion reaction. Risks can be further reduced by cross-matching blood, but this step may be omitted when blood is required for an emergency. Cross-matching involves mixing a sample of the recipient's serum with a sample of the donor's red blood cells and checking if the mixture agglutinates, or forms clumps. If agglutination is not obvious by direct vision, blood bank technicians usually check for agglutination with a microscope. If agglutination occurs, that particular donor's blood cannot be transfused to that particular recipient. Blood Compatibility Although ideally patients should receive matched blood products, in practice some blood group types are compatible with others. Table 3 shows the compatibility between donor and recipient. So for example, a patient who is A- can be given A- blood (their own type) but also O- blood. In fact, examination of Table 3 indicates that O- blood is compatible with all the other blood types and can be used on all patients. O- blood products are often referred to as “universal” as they can be used for all patients. This can be extremely useful, for example, in emergencies when a blood transfusion is needed urgently and there may not be time to identify the patient’s actual blood type. Table 3 Red blood cell compatibility table Source: Wikipedia Note - Assumes absence of atypical antibodies that would cause an incompatibility between donor and recipient blood, as is usual for blood selected by cross matching. Recipient[1] Donor[1] O− O+ A− A+ B− B+ AB− AB+ O− Y O+ Y Y A− Y Y A+ Y Y Y Y B− Y Y B+ Y Y Y Y AB− Y Y Y Y AB+ Y Y Y Y Y Y Y Y Blood Donations In the UK, for example, blood supplies are generally obtained through a national blood donor service where citizens voluntarily donate blood, usually twice a year. After donation, the blood goes off to specialist laboratories for routine testing. In Scotland there are two testing labs, in Glasgow and Edinburgh, both working round the clock. The following tests are carried out on every donation: · HIV - All donations are tested for antibodies to the HIV1 and HIV2 viruses which cause AIDS · Hepatitis viruses - Hepatitis is an inflammation of the liver which may cause jaundice and sometimes liver failure. All donations are tested for hepatitis B and C. · Syphilis - Syphilis, a sexually transmitted disease, can be passed on through blood, so all donations are tested. Typically a donation will have been processed and tested and ready for use within 48 hours. Blood has a very short shelf life of around 35 days and has to be stored and distributed under stringent conditions. The Situation The hospital manager you have been asked to help faces a difficulty. Although O- blood is universal, in the sense that it can be used safely with virtually all patents, it is also in short supply. Table 1 indicates that only around 7% of the UK population is O- and, by implication, only around 7% of blood donations will be O-. The manager would prefer medical staff to be using appropriately matched blood wherever possible and restricting the use of O- blood to those patients who really need it: those patients who are actually O- (since from Table 3 there are no other compatible blood types) and patients who require emergency blood transfusion where there is no time to check their blood type. On the other hand, the manager does not want donated blood to be wasted, which can happen if blood is not used within its shelf life (each unit of blood is marked with an expiry date). As a result, she has carried out some data collection in the hospital over the last six months. A record has been kept of every patient who received O- blood during that period. The following data has been collected on each patient (and is available in the accompanying Excel file for this assignment). ID: a patient identifier Gender: Male/Female Age: of the patient in years ABO: Blood group of the patient – O, A, B, AB Rh: POS(itive) or NEG(ative) Emergency: whether the patient was an emergency admission and so needed an O- transfusion. Y for Yes, otherwise blank Units: total number of units of blood transfused Reason: for patients whose blood group was not O-, the reason (if known) they were given O- blood. · X means they were given O- blood because the blood available was close to its expiry date and would otherwise have been thrown away · N means that the hospital blood bank had no supplies of the patient’s actual blood type in stock and so O- blood was used instead · Z means there was some other medical reason for giving the patient O- blood; Note for some patients there is incomplete data and some cells may have been left blank/empty. Assignment Tasks Part 1: Executive Report (15 marks) The Executive Report will be used by the manager as well