Lectures of STA 231: Biostatistics

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Lectures of STA 231: Biostatistics Second Semester Academic Year 2016/2017 Text Book Biostatistics: Basic Concepts and Methodology for the Health Sciences (10 th Edition, 2014) By Wayne W. Daniel Prepared By: Dr. Ahmed Jaradat Associate Professor Department of Family & Community Medicine Dr. Ahmed Jaradat, AGU 1

Course Objectives Familiarity with basic Medical Statistical terms. Ability to summarize data and do basic statistical analyses using SPSS. Ability to understand basis statistical analyses in published journals. Understanding of key concepts including statistical hypothesis testing. Foundation for more advance analyses. Dr. Ahmed Jaradat, AGU 2

Chapter 1: Introduction to Biostatistics Key words: Statistics Data Biostatistics Variable Measurements Scale Population Sample Sampling Techniques Learning Outcomes: After studying this chapter, you will Understand the basic concepts and terminology of biostatistics. Be able to select a simple random sample and other scientific samples from a population of subjects. Dr. Ahmed Jaradat, AGU 3

1.1-1.2 Introduction and Basic Concepts Statistics is a field of study concerned with: 1. Collection, organization, summarization, presentation and analysis of data. 2. Drawing of inferences (conclusions) about a body of data (population) when only a part of the data (sample) is observed. Statisticians try to interpret and communicate the results to others. The tools of statistics are employed in many fields: Business, Education, Psychology, Agriculture, Economics, etc. When the data analyzed are derived from the biological science and medicine, we use the term Biostatistics to distinguish this particular application of statistical tools and concepts. Dr. Ahmed Jaradat, AGU 4

Types of Statistics: Descriptive statistics consists of the collection, organization, summation and presentation of data. Inferential statistics consists of generalizing from samples to populations, performing hypothesis testing, determining relationships among variables, making predictions, interpreting results and drawing conclusions. Data: The raw material of statistics is called data. We may define data as numbers. numbers that result from the process of counting or from taking a measurement. For example: When a hospital administrator counts the number of patients (counting) When a nurse weighs a patient (measurement) Dr. Ahmed Jaradat, AGU 5

Source of Data: Data can be numbers, images, words, figures, facts or ideas. Data sources are broadly classified into primary (own generated) and secondary (already generated) data. Primary: where the investigator is the first to collect the data. Sources include: medical examinations, questionnaires, surveys, interviews, observations, etc.. Secondary: where the data is collected by Others, for other purposes that those of the current study. Sources include: individual records (medical/employment); group records (census data, vital statistics) or electronically stored information. Dr. Ahmed Jaradat, AGU 6

Types of Variables:- Variable: is a characteristic (that can be measured) of population or sample that is of interest for us and assumes different values for different elements (persons, places or things). Examples: Heart rate, Blood pressure, Body temperature, Age, The waiting time for medical services, Hair color, Smoking, Gender, Data: are the values (measurements or observations) that the variables can assume. Variables whose values are determined by chance are called random variables Dr. Ahmed Jaradat, AGU 7

Types of Variables Cont d A variable may be classified as: Quantitative or Qualitative QuantitativeVariables (Numerical) A quantitative variable is a variable that can be measured numerically in the usual sense. Discrete Variable: A quantitative variable whose values are countable. It is characterized by gaps in the values that it can assume. In other words, there are no possible intermediate values between its consecutive values. Examples: Number of patients, # of white blood cells, # of missing teeth, # of accidents, # of illnesses in a time period Continuous Variable: A quantitative variable that can assume any numerical value over a certain interval or intervals assumed by the variable. It does not possess the gaps or interruptions characteristic. Examples: Weight, Height,Temperature, Survival time, Operation time. Dr. Ahmed Jaradat, AGU 8

Types of Variables Cont d Qualitative (Categorical)Variables Qualitative variables: any variable that is not numerical (values have no numerical meaning) but can be classified into two or more nonnumeric categories. Categories must not overlap and must cover all possibilities. Measurements made on qualitative variables convey information regarding attribute. Examples: Gender, Eye color, Blood type, Health status as poor, good, very good or excellent. Dr. Ahmed Jaradat, AGU 9

1.3 Measurement and Measurement Scales The Nominal Scale of measurement: consists of naming observations (data) or classifying them into different categories. In other words, classifying them into various mutually exclusive and collectively exhaustive categories. The value does not imply any ordering of the cases Examples: Gender, Marital status, Eye color, Blood type (A, B, AB, O). The Ordinal Scale of measurement: applies to data that are divided into different categories that can be ranked (ordered) according to some criterion. Differences between categories not considered equal. The interval between values is not interpretable Examples: Degree of illness ( none, mild, moderate, acute, chronic), Pain Severity (no pain, slight pain, moderate pain severe pain), Intelligence (Above average, average, below average). Dr. Ahmed Jaradat, AGU 10

Measurement Scales Cont d The Interval Scale of measurement: in interval measurement the distance between attributes does have meaning. For example, when we measure temperature (in Fahrenheit), the distance from 20-30 is same as distance from 50-60. The interval between values is interpretable. But ratios don't make any sense - 60 degrees is not twice as hot as 30 degrees.the zero point is not necessarily a true zero. Examples:Temperature, IQ score The Ratio Scale of measurement: is the highest level of measurement. The ratio scale applies to data that possess all the characteristics of interval scale data and for which a ratio of two measurements has a meaning. The zero point is a true zero and has a meaning Examples:Weight, Height, Cholesterol level Dr. Ahmed Jaradat, AGU 11

1.4 Sampling and Statistical Inference Population: is the totality of all subjects that have certain common characteristics Examples: former hospital patients, public schools in a city, private hospitals, newborn live babies, Sample: is a subset or part of the population Examples: 100 patients selected from all hospital patients, water samples from different water resources, blood samples of patients in a hospital, a sample of radio stations, Sampling: is the process of selecting a small number of elements from a larger defined target group of elements such that the information gathered from the small group will allow judgments to be made about the larger groups. Dr. Ahmed Jaradat, AGU 12

Sampling Techniques Population: a set which includes all measurements of interest to the researcher (The collection of all responses, measurements, or counts that are of interest) Sample: A subset of the population Why Sampling? Get information about large populations Less costs Less field time More accuracy, i.e. can do a better job of data collection When it s impossible to study the whole population Dr. Ahmed Jaradat, AGU 13

Sampling Techniques Simple Random Sampling Stratified Sampling Systematic Sampling Clustered Sampling Convenience Sampling Dr. Ahmed Jaradat, AGU 14

Simple Random Sampling Simple random sampling: is a method of probability sampling in which every unit has an equal nonzero chance of being selected. It is used when we have homogeneous population. Steps Use of Random Table 1. Give number to each member of population 2. Determine total population size (N) 3. Determine Sample size (n) 4. Drop one finger on Random Table with eyes closed 5. Drop one finger with eyes closed on direction to be chosen Up/Down/Right/Left 6. Determine first number within 0 to N 7. Determine other numbers till Sample size (n) Once a number is chosen do not repeat it again Dr. Ahmed Jaradat, AGU 15

Simple Random Sampling Dr. Ahmed Jaradat, AGU 16

Simple Random Sampling: Example Let Population Size: N=300 Sample Size: n=30 296, 38, 80, 86, 255, 138, 275, 222, 126, 283, 183, 9, 231, 81, 75, 184, 214, 165, 67, 248, 93, 295, 291, 21, 249, 3, 49, 164, 107, 196. Dr. Ahmed Jaradat, AGU 17

Stratified Random Sampling Stratified random sampling: is a method of probability sampling in which the population is divided into different subgroups (strata) and samples using simple random are selected from each stratum. It is used when the population is heterogeneous. Strata 1 Strata 2 Strata k Sample random sample Sample random sample Sample random sample When we sample a population with several strata, we generally require that the proportion of each stratum in the sample should be the same as in the population. Dr. Ahmed Jaradat, AGU 18

Stratified Random Sampling Dr. Ahmed Jaradat, AGU 19

Systemic Random Technique Systematic sampling is a method of sampling in which the defined population is ordered and the sample is selected according to position using a skip interval The selection of sample follows a systematic interval of selection Find serial interval (K) = total population/sample size 1st observation through simple random sampling among 1to K. Next observation = (1st +K)th Observation Next observation = (2 nd +K)th Observation -------------so on till Number of observations = Sample Size Example: N=100 (Given), n=20 (Estimated) K=N/n =100/20 =5 1st observation between 1 to 5 though SRS e.g. 2. Every 5th observation from 2 rd observation will be included sample population So, sample will be: 2, 7, 12, 17, 22, 27, 32, 37, 42, 47, 52, 57, 62, 67, 72, 77, 82, 87, 92, 97observation. Population 1 21 41 61 81 2 22 42 62 82 3 23 43 63 83 4 24 44 64 84 5 25 45 65 85 6 26 46 66 86 7 27 47 67 87 8 28 48 68 88 9 29 49 69 89 10 30 50 70 90 11 31 51 71 91 12 32 52 72 92 13 33 53 73 93 14 34 54 74 94 15 35 55 75 95 16 36 56 76 96 17 37 57 77 97 18 38 58 78 98 19 39 59 79 99 20 40 60 80 100 Dr. Ahmed Jaradat, AGU 20

Systemic Random Technique Dr. Ahmed Jaradat, AGU 21

Cluster Sampling Cluster sampling is a sampling technique where the entire population is divided into groups, or clusters, and a random sample of these clusters are selected. All observations in the selected clusters are included in the sample. Cluster sampling is typically used when the researcher cannot get a complete list of the members of a population they wish to study but can get a complete list of groups or 'clusters' of the population. It is also used when a random sample would produce a list of subjects so widely scattered that surveying them would prove to be far too expensive, for example, people who live in different postal districts in Bahrain. Dr. Ahmed Jaradat, AGU 22

Cluster Sampling Dr. Ahmed Jaradat, AGU 23

Cluster Sampling Section 1 Section 2 Section 3 Section 5 Section 4 Dr. Ahmed Jaradat, AGU 24

Convenience (Accidental) Sampling A sample chosen on the basis of accessibility, expediency, cost, efficiency, or other reason not directly concerned with sampling parameters. A convenience sample is a sample where the patients are selected, in part or in whole, at the convenience of the researcher. The researcher makes no attempt, or only a limited attempt, to insure that this sample is an accurate representation of some larger group or population. The classic example of a convenience sample is interviewing people at a shopping mall and selecting shoppers as they walk by to fill out a survey. This is easy because you just choose it, without any random mechanism. Sometimes the people could ignore you so it all depends what your surveying. Or if you want to choose 5 people from a class of 50. You could choose : First 5 students who raise their hand. First 5 students in the first row. Five tallest students. Dr. Ahmed Jaradat, AGU 25