Xr14-76 Headaches are one of the most common, but least understood, ailments. Most people get headaches several times per month; over-the-counter medication is usually sufficient to eliminate their pain. However, for a significant proportion of people, headaches are debilitating and make their lives almost unbearable. Many such people have investigated a wide spectrum of possible treatments, including narcotic drugs, hypnosis, biofeedback, and acupuncture, with little or no success. In the last few years, a promising new treatment has been developed. Simply described, the treatment involves a series of injections of a local anesthetic to the occipital nerve (located in the back of the neck). The current treatment procedure is to schedule the injections once a week for 4 weeks. However, it has been suggested that another procedure may be better—one that features one injection every other day for a total of four injections.

In addition, some physicians recommend other combinations of drugs that may increase the effectiveness of the injections. To analyze the problem, an experiment was organized. It was decided to test for a difference between the two schedules of injection and to determine whether there are differences between four drug mixtures. Because of the possibility of an interaction between the schedule and the drug, a complete factorial experiment was chosen. Five headache patients were randomly selected for each combination of schedule and drug. Forty patients were treated, and each was asked to report the frequency, duration, and severity of his or her headache prior to treatment and for the 30 days following the last injection.

An index ranging from 0 to 100 was constructed for each patient, with 0 indicating no headache pain and 100 specifying the worst headache pain. The improvement in the headache index for each patient was recorded and reproduced in the accompanying table. (A negative value indicates a worsening condition.)

(The author is grateful to Dr. Lorne Greenspan for his help in writing this example.)

a. What are the factors in this experiment?

b. What is the response variable?

c. Identify the levels of each factor.

d. Analyze the data and conduct whichever tests you deem necessary at the 5% significance level to determine whether there is sufficient statistical evidence to infer that there are differences in the improvement in the headache index between the two schedules, differences in the improvement in the headache index between the four drug mixtures, or interaction between schedules and drug mixtures.

Improvement in Headache Index Drug Mixture Schedule 1 2 3 4 One Injection 17 24 14 10 Every Week 6 15 9 1

(Four Weeks) 10 10 12 0 12 16 0 3 14 14 6 1 One Injection 18 2 20 2 Every Two Days 9 0 16 7

(Four Days) 17 17 12 10 21 2 17 6 15 6 18 7