Multiple myeloma paired t-test


Assignment:

Multiple myeloma, or blood plasma cancer, is characterized by increased blood vessel formulation (angiogenesis) in the bone marrow that is a predictive factor in survival. One treatment approach used for multiple myeloma is stem cell transplantation with the patient's own stem cells. The following data represent the bone marrow microvessel density for patients who had a complete response to the stem cell transplant.

The measurements were taken immediately prior to the stem cell transplant and at the time thee complete response was determined:

Patient   Before After
1    158    284
2    189    214
3    202    101
4    353    227
5    416    290
6    426    176
7    441    290

a. At the 0.5 level of significance, is there evidence that the mean bone marrow microvessel density is higher before the stem cell transplant than after the stem cell transplant?

b. Interpret the meaning of the p-value in (a).

c. Construct and interpret a 95% confidence interval estimate of the mean difference in bone marrow microvessel density before and after the stem cell transplant.

d. What assumption is necessary about the population distribution in order to perform the test in (a)?

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