NONPARAMETRIC ANALYSIS

OF NECK CANCER
PREPARED BY:
HANIM AFIQAH BINTI IBRAHIM
HERTI ADIBAH BINTI JAMAL
SITI HAJAR BINTI NORDIN
WAN NURUL NAIMAH BINTI WAN AZIMI
NOR HIDAYAH BINTI MAT SAAD

INTRODUCTION
The data set contains part of the data for a study of oral condition
of cancer patients conducted at the Mid-Michigan Medical Center.
The oral conditions of the patients were measured and recorded:
Method A (at the initial stage)
Method B (at the end of the second week)
Method C (at the end of the fourth week)
Method D (at the end of the sixth week)
The cancer stage of the patients was recorded
Stage 1, stage 2, stage 3, and stage 4
Patients were received a placebo and the aloe juice treatment.
Sample size, n = 23 patients with neck cancer.

PROBLEM STATEMENT
The researcher wants to know the oral condition
of the patients at which stage (stage 1,stage 2,
stage 3 or stage 4) of cancer react when they
received placebo and aloe juice treatment.
The researcher want to determine at which week
of oral condition (the initial stage, at the end of
week 2, at the end of week 4 or at the end of
week 6) that react with the placebo and aloe
vera treatment.

LITERATURE REVIEW
Head and neck cancer includes cancers of the mouth, nose, salivary glands, throat, and lymph nodes in the
neck. Most begin in the moist tissues that line the mouth, nose and throat. The symptoms include a swelling or
sore that does not heal, a sore throat that does not go away, trouble swallowing, a change or hoarseness in the
voice.
A placebo is simulated or otherwise medically ineffectual treatment for a disease or other medical condition
intended to deceive the receiver. Sometimes patients given a placebo treatment will have a perceived or actual
improvement in a medical condition, a phenomenon commonly called the placebo effect or placebo response.
Aloe vera is a plant remedy used for a wide range of problems. Oral Aloe vera juice has been tested as a cancer
treatment but studies are too preliminary to tell whether it is effective. Numerous unhelpful events are on
record but they are generally mild and reversible.
Researchers from Indias Sibar Institute of Dental Sciences and the College of Dental Sciences & Hospital and
Lahey Hospital & Medical Center, Burlington, 2014 have confirmed that aloe vera significantly treats an
inflammatory condition in the mouth and also with active genital herpes. After three months, the group
receiving aloe vera treatments had significant improvement in every parameter tested. These included
decreased burning sensation, increased cheek flexibility and an increased ability to open the mouth.

A research of 2-week, double-blind, placebo-controlled trial enrolled 60 men with active genital herpes
conducted by Lahey Hospital & Medical Center, Burlington, 2014. Use of aloe cream reduced the time necessary
for lesions to heal (4.9 days versus 12 days). This also increased the percentage of individuals who were fully
healed by the end of 2 weeks (66.7% versus 6.7%).
So, in summary of the two researches, using aloe Vera as a treatment can cure the patients faster.

LITERATURE REVIEW
Based on the study test on head and neck cancer patients by University of California, San Francisco, August 1993 and
a double-blind study, patients that received placebo treatment take a longer time to cure. Based on the result, the
treatment group at received 5 mg of pilocarpine three times daily had the best overall outcome compared to 10 mg of
pilocarpine and placebo with respect to saliva production and the relief of symptoms, when both sides effects and
effectiveness are considered.
According to a double-blind study that enrolled 60 men and women with mild to moderate symptoms of itchy,
participants were treated with either current aloe extract (0.5%) or a placebo cream, applied 3 times daily for 4
weeks. Placebo produced significantly poorer results than aloe vera, and these results were said to endure for almost
a year after treatment was stopped.
So, in summary of the two researches, using placebo as a treatment is not effective compared to other treatment.
If any of these null hypotheses is rejected then the original null hypothesis is rejected. Note that if you set= 0.05
for each of the three sub-analyses then the overall alpha value is.14 since1 (1 )3= 1 (1 0.05)3= 0.142525
(see Example 6 ofBasic Probability Concepts). This means that the probability of rejecting the null hypothesis even
when it is true (type I error) is 14.2525%.
Some alternative cancer experts rate aloe a "Stage IV Supplemental" treatment, to be used with highly potent
"Stage IV" protocol, like chemotherapy. One patient from the trial also had advanced liver cancer and was given less
than two months to live. His liver was four times normal size. He kept drinking the juice, improved gradually and one
year later his tumors were gone.
The researcher believe on the chance that its cancer fighting properties really are greater, and based on its standing
as a "Stage IV Supplemental treatment"
More patients who had the aloe vera survived for 3 years than patients who just had chemotherapy. The researchers
knew which patients were receiving aloe vera and they may have influenced the results. The study also involved
patients who were quite ill with metastatic cancer. It is not clear how well aloe vera would work in patients with earlier

METHOD
Data From Three Or More Independent Sample:
1. KRUSKAL-WALLIS ANALYSIS OF VARIENCE BY RANKS
Objective For testing the null hypothesis that several samples have been drawn from the same
or identical populations.
Test
statistics

H = 121.0044

Decision
Rule

Reject HO if H(calc) > H (table)

H(calc) = 121.0044 > H (table) x2(1-0.05),(4-1) = 7.815
Reject H0

Conclusio We do not have enough evidence to conclude that there are No difference among the
n
four stage.

METHOD
2. MULTIPLE COMPARISON PROCEDURE FOR USE WITH KRUSKALWALLIS
Objective

When a hypothesis testing procedure such as Kruskall-Wallis test leads us to reject the
null hypothesis, and thus conclude that not all sample populations are identical, we
naturally question which populations are different from which others. One way to
overcome this problem is to use multiple comparisons procedure.

Test
statistics

Decision
Rule

Conclusio
n

Experiment wise error rate = 1 (1 )^n = 1 (1 0.05)^4 = 0.19

Given the experiment wise error rate is 0.19, therefore Z= 0.19/(4(4-1)) = 0.0158 =
Comparisons
Ri-Rj

Decision
Conclusion
2.15
Sample 1 and 5.0000
2
Sample 1 and 12.167
3
0
Sample 1 and 7.7667
4
Sample 2 and 7.1670
3
Sample 2 and 3.2670
All4the method are
Sample 3 and 3.9000
4

6.4300

Fail to reject HO

No Significant Difference

15.1773

Fail to reject HO

No Significant Difference

7.7619

Reject HO

Significant Difference

15.3708

Fail to reject HO

No Significant Difference

8.1335

Fail to reject HO

No Significant Difference

15.9736

Fail to reject HO

No Significant Difference

no significant difference except sample 1 and sample 4.

METHOD
Data From Three Or More Related Sample:
13. FRIEDMAN TWO-WAY ANAYLYSIS OF VARIANCE BY RANKS
Objective To determine if we may conclude from sample evidence that there is a difference
among treatment effects.
Test
statistics
Decision
Rule

RA =19.5 , RB =30, RC =38 , RD =32.5

W = 0.2507, in table A.14 b=12 and k=4 are not in table, so we use chi-square to test
compare chi-square
Reject H0 if

Therefore we reject H0.

(1-0.05) , 9.0252 7.815

Conclusio We do not have enough evidence to conclude that there are No difference among the
n
four methods.

METHOD

14. MULTIPLE COMPARISON PROCEDURE FOR USE WITH FRIEDMAN

Objective To compare all possible differences between pairs of sample, when the experiment
TEST
wise error rate is and the number of block is large.

Test
statistics

RA =19.5 , RB =30, RC =38 , RD =32.5

Decision
Rule

Conclusio All |Rj Rj | are no significantly different except method A and C.

n

RESULT AND FINDINGS

From data three or more independence sample, we can

conclude that at the method B has only one data that is
difference which is stage 1 and stage 4.
the reaction to the treatment happened at the stage 1 or stage
4.

From data three or more related sample, we can conclude

that at stage 1 has only one data that is difference which
is method A ( oral condition at the initial stage) and
method C (oral condition at the end of week four)
the reaction to the treatment happened at the end of week four
using placebo and aloe vera treatment.

CONCLUSION
The previous researcher state that the reaction to the
treatment happens at stage 4.
Our result found out that the reaction to the treatment also
happens at stage 4.

At the previous researcher state that the reaction of

treatment happens at the end of week 2. But in our
research we found that the reaction of treatment
happens at week 4. So, that is difference between the
results of previous research and our research.
Maybe, the difference occur because of the eating lifestyle and
smoking habits of the patients.