EP401 - MCU COD SY 2021-2022

Introduction to Biostatistics

Edbert P. Solano, DMD, DDPH, MAED

EP401 - MCU COD SY 2021-2022

Learning Objectives

ORIGIN AND DEFINITION OF REASONS TO TYPES OF DATA GRAPHICAL FREQUENCY

DEVELOPMENT OF STATISTICS AND KNOW ABOUT REPRESENTATION DISTRIBUTION OF
BIOSTATISTICS BIOSTATISTICS BIOSTATISTICS OF A DATA A DATA
EP401 - MCU COD SY 2021-2022

Definition of Statistics
Different authors have defined statistics differently. The best definition
of statistics is given by Croxton and Cowden according to whom
statistics may be defined as
the science, which
deals with collection, presentation, analysis
and interpretation of numerical data.
The science and art of dealing with variation in data through collection,
classification, and analysis in such a way as to obtain reliable results. —(John
M. Last, A Dictionary of Epidemiology )
Branch of mathematics that deals with the collection, organization, and
analysis of numerical data and with such problems as experiment design and
decision making. —(Microsoft Encarta Premium 2009)
EP401 - MCU COD SY 2021-2022

Definition of Biostatistics= Medical statistics

Biostatistics may be defined as application of statistical methods

to medical, biological and public health related problems.

It is the scientific treatment given to the medical data derived from

group of individuals or patients
• Collection of data.
• Presentation of the collected data.
• Analysis and interpretation of the results.
• Making decisions on the basis of such analysis
EP401 - MCU COD SY 2021-2022

“Statistics is the science which deals

with collection, classification and
tabulation of numerical facts as the
basis for explanation, description and
comparison of phenomenon”.

------ Lovitt
EP401 - MCU COD SY 2021-2022

Origin and development

of statistics in Medical
Research

In 1929 a huge paper on application of statistics was published in

Physiology Journal by Dunn.
In 1937, 15 articles on statistical methods by Austin Bradford Hill, were
published in book form.
In 1948, a RCT of Streptomycin for pulmonary tb., was published in which
Bradford Hill has a key influence.
Then the growth of Statistics in Medicine from 1952 was a 8-fold increase
by 1982.
EP401 - MCU COD SY 2021-2022

C.R. Rao
Douglas Altman Ronald Fisher Karl Pearson

Gauss -
EP401 - MCU COD SY 2021-2022

“BIOSTATISICS”
(1) Statistics arising out of biological
sciences, particularly from the fields of
Medicine and public health.
(2) The methods used in dealing with
statistics in the fields of medicine, biology
and public health for planning, conducting
and analyzing data which arise in
investigations of these branches.
EP401 - MCU COD SY 2021-2022

Reasons to
Medicine / Dentistry is becoming
increasingly quantitative.
The planning, conduct and interpretation of
know about much of medical research are becoming
increasingly reliant on the statistical

biostatistics: methodology.
Statistics pervades the medical literature.
 EP401 - MCU COD SY 2021-2022

Role of Statistics in Clinical Practice

(Medicine and Dentistry)
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EP401 - MCU COD SY 2021-2022

Role of statisticians
E To guide the design of an experiment or survey prior
to data collection

: To analyze data using proper statistical procedures

and techniques

* To present and interpret the results to researchers

and other decision makers
 The conclusions (inferences) we draw
The Role of always come with some amount of
uncertainty due to these

Statistics unobserved/unanticipated issues.

We must quantify that uncertainty in order
to know how “good” our conclusions are.
This is the role that statistics plays in the
scientific process.
• P-values (significance levels)
• Level of confidence
• Standard errors of estimates
• Confidence intervals
• Proper interpretation (association versus
causation)
The Role of
Scientists use statistical inference to help
model the uncertainty inherent in their
investigations.

Statistics
sample

x1
x2
? x3
population X
population model (reality) S histogram
(imagination) (observation)
xn

goal: statistical inference

(uncertainty measured by probability)
Evidence-
Evidence-based practice in medicine
involves
gathering evidence in the form of scientific
based Practice data.
applying the scientific method to inform
in Medicine / clinical practice, establishment or
development of new therapies, devices,

Dentistry programs or policies aimed at improving

health.
Types of
Scientific evidence: “empirical evidence,
gathered in accordance to the scientific
method, which serves to support or counter

Evidence a scientific theory or hypothesis”

Type I: descriptive, epidemiological
Type II: intervention-based
Type III: intervention- and context-based
Evidence-
Evidence-based practice results in a high
likelihood of successful patient
outcomes and more efficient use of

based health care resources.

Medicine
The Scientific
Method
Observe Revise

Experiment
Clinical
Evaluation Evidence
Revise
Design &
(Data)
Hypothesis

Run
Experiment
Types of
Purpose of research
1) To explore
2) To describe or classify
Studies 3)
4)
To establish relationships
To establish causality

Strategies for accomplishing these

purposes:
1) Naturalistic observation
2) Case study
Ambiguity

3) Survey
Control

4) Quasi-experiment
5) Experiment
Generating
Evidence Studies

Descriptive Analytic
Studies Studies

Populations Individuals Observational Experimental

Case Case Cross Case

Cohort RCT
Reports Series Sectional Control

Complexity and Confidence

Observation
A designed experiment involves the
investigator assigning (preferably randomly)
some or all conditions to subjects.

versus An observational study includes

conditions that are observed, not assigned.

Experiment
EP401 - MCU COD SY 2021-2022

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EP401 - MCU COD SY 2021-2022

Role of Statistics in
Public Health and Community Dentistry
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EP401 - MCU COD SY 2021-2022

CLINICAL
Documentation of medical and dental
history of diseases.
Planning and conduct of clinical studies.
Dentistry Evaluating the merits of different
procedures.
In providing methods for definition of
“normal” and “abnormal”.
EP401 - MCU COD SY 2021-2022

To provide the magnitude of any health

PREVENTIVE problem in the community.
To find out the basic factors underlying the

DENTISTRY ill-health.
To evaluate the health programs which was
introduced in the community
(success/failure).
To introduce and promote health legislation.
EP401 - MCU COD SY 2021-2022

Planning
WHAT DOES Design
Execution (Data collection)
STAISTICS Data Processing
Data analysis
COVER ? Presentation
Interpretation
Publication
EP401 - MCU COD SY 2021-2022

Design of study
HOW A Sample size & power calculations
“BIOSTATISTICIAN” Selection of sample and controls
Designing a questionnaire
CAN HELP ? Data Management
Choice of descriptive statistics & graphs
Application of univariate and multivariate
statistical analysis techniques
STRUCTURING

Data Colllection

Inferential Statistiscs
Descriptive Statistics
Data Presentation
Estimation Hypothesis Univariate analysis
Measures of Location
Tabulation Testing
Measures of Dispersion
Diagrams Ponit estimate Multivariate analysis
Measures of Skewness &
Graphs Inteval estimate
Kurtosis

EP401 - MCU COD SY 2021-2022

EP401 - MCU COD SY 2021-2022

TYPES OF DATA QUALITATIVE DATA

DISCRETE
QUANTITATIVE
CONTINOUS
QUANTITATIVE
EP401 - MCU COD SY 2021-2022

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EP401 - MCU COD SY 2021-2022

DATA VARIABLES
EP401 - MCU COD SY 2021-2022

QUALITATIVE Nominal
Example: Sex ( M, F)
Exam result (P, F)
Blood Group (A,B, O or AB)
Color of Eyes (blue, green,
brown, black)
EP401 - MCU COD SY 2021-2022

ORDINAL
Example:
Response to treatment
(poor, fair, good)
Severity of disease
(mild, moderate, severe)
Income status (low, middle,
high)
EP401 - MCU COD SY 2021-2022

QUANTITATIVE (DISCRETE)

Example: The no. of family members

The no. of heart beats
The no. of admissions in a day

QUANTITATIVE (CONTINOUS)

Example: Height, Weight, Age, BP, Serum

Cholesterol and BMI
EP401 - MCU COD SY 2021-2022

Discrete data -- Gaps between possible values

Number of Children

Continuous data -- Theoretically,

no gaps between possible values

Hb
EP401 - MCU COD SY 2021-2022

CONTINUOUS DATA

DISCRETE DATA

wt. (in Kg.) : under wt, normal & over wt.

Ht. (in cm.): short, medium & tall
EP401 - MCU COD SY 2021-2022

Table 1 Distribution of blunt injured patients

according to hospital length of stay
hospital length of stay Number Percent
1 ñ 3 days 5891 43.3
4 ñ 7 days 3489 25.6
2 weeks 2449 18.0
3 weeks 813 6.0
1 month 417 3.1
More than 1 month 545 4.0
Total 14604 100.0
Mean = 7.85 SE = 0.10
EP401 - MCU COD SY 2021-2022

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ŒNumerical presentation
Graphical presentation
ŽMathematical presentation
EP401 - MCU COD SY 2021-2022

1- Numerical presentation
Tabular presentation (simple – complex)
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EP401 - MCU COD SY 2021-2022

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EP401 - MCU COD SY 2021-2022

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EP401 - MCU COD SY 2021-2022

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EP401 - MCU COD SY 2021-2022

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EP401 - MCU COD SY 2021-2022

2- Graphical presentation
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EP401 - MCU COD SY 2021-2022

Line Graph

MMR/1000 Year MMR

60
1960 50
50
40 1970 45
30 1980 26
20
10 1990 15
0 2000 12
Year
1960 1970 1980 1990 2000

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EP401 - MCU COD SY 2021-2022

Frequency polygon
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EP401 - MCU COD SY 2021-2022

Frequency polygon

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%
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35
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15 4,( -5/0 -+1/0 41
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Age
25 35 45 55 65

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EP401 - MCU COD SY 2021-2022

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8 Female
7 Male

6
Frequency

5
4

0
20- 30- 40- 50- 60-69
Age in years
EP401 - MCU COD SY 2021-2022

Distribution of a group of cholera patients by age

Age (years) Frequency %

Histogram 25-
30-
40-
3
5
7
14.3
23.8
33.3
45- 4 19.0
% 35
60-65 2 9.5
30 Total 21 100

25
20
15
10
5
0
0

25

30

40

45

60

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Age (years)
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EP401 - MCU COD SY 2021-2022

Bar chart
%
45
40
35
30
25
20
15
10
5
0
Single Married Divorced Widowed
Marital status
EP401 - MCU COD SY 2021-2022

Bar chart
%
50
Male
40 Female

30
20
10
0
Single Married Divorced Widowed
Marital status
EP401 - MCU COD SY 2021-2022

Pie chart
Deletion
Inversion
3%
18%

Translocation
79%
EP401 - MCU COD SY 2021-2022

Doughnut chart

Hospital B

DM
Hospital A IHD
Renal
EP401 - MCU COD SY 2021-2022

3-Mathematical presentation
Summery statistics
Measures of location
1- Measures of central tendency
2- Measures of non central locations
(Quartiles, Percentiles )
Measures of dispersion
EP401 - MCU COD SY 2021-2022

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1- Measures of central tendency (averages)

Midrange
Smallest observation + Largest observation
2

Mode
the value which occurs with the greatest frequency i.e. the most common
value
EP401 - MCU COD SY 2021-2022

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1- Measures of central tendency (cont.)

šMedian
the observation which lies in the middle of the ordered observation.

šArithmetic mean (mean)

Sum of all observations
Number of observations
EP401 - MCU COD SY 2021-2022

ÜRange

Measures of ÜVariance
ÜStandard deviation
dispersion ÜSemi-interquartile range
ÜCoefficient of variation

Ü“Standard error”
EP401 - MCU COD SY 2021-2022

Standard Deviation SD
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EP401 - MCU COD SY 2021-2022

Standard error of mean SE

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Task for the Day
Using your Studies on hand
1. Using the Structuring , Identify the
things we discussed
2. Recognized and Organize the Data
and Variables Present

EP 401 SY 2021-2022 MCU-COD 60