Page 21 - Recommendations-for-biostatisticians-in-managing-and-conducting-medical-research-consultations

to poor glucose control. Instead, the researcher will be able to understand that the reverse
is true, in that poor glucose control are risk factors for the development of diabetic
complications.

Based on Figure 1, it is clear that without a proper understanding of the disease
progression, a biostatistician might erroneously classify a disease complication as one of its
risk factors for poor glucose control as shown by an elevated HbA1c, which will lead to
wrong conclusions being drawn from the statistical analysis of data. Although it may well
be coincidental for a significant p-value to be observed which indicates a close relationship
to exist between glucose control and diabetic complications, however this finding which
concludes that diabetic complications are contributing to poor glucose control is both
illogical and erroneous.

Figure 1: An illustration of the temporal relationship between the important processes or
events that have occurred for patients with type 2 diabetes mellitus (T2DM)

In this case, TEV is very useful tool for guiding the biostatistician in the selection of the
appropriate variables to be regarded as the risk factors for poor glucose control (by
ensuring that the relevant variables can only be regarded as risk factors of T2DM if they
occur before an assessment of glucose control can be made). Medical doctors will naturally
understand the disease progression because of their medical training, however the
biostatistician without any medical background might require a suitable tool for him/her
to understand the nature and flow of data collection.

Here, the TEV is just a simple sketch of the visualization for a particular disease in
relation to time. The purpose of using TEV is to enable a biostatistician to improve
his/her understanding of subject matter so that a proper statistical consultation can
be offered to the research client. The significance of the TEV lies in the fact that the
specific details of the disease presentation which is being investigated in the new
research proposal (such as the sequence of events that occur during the disease