Medical Statistics

The concept of evidence based medicine: why is it important?

Statistics is the tool by which numerical information is turned into evidence
Statistical analysis allows us to investigate samples and draw conclusions about
underlying population

Some uses of statistics:

Investigate research: risk factors and diseases

Diagnosis: development of gold standard, most accurate test
Treatment: policy decisions on treatments
Preventions: policy decisions on preventions
Monitoring: prevalence

Exercise

The following data are birth weights in grams for 20 babies born in a unit. Summarise the
data to be presented at a team meeting.

3680, 3420, 3080, 3500, 3375, 3300, 3980, 2980, 3880, 3620,

Possibility:

Summary statistics
o Mean (Average)
o Median
o Range
o Standard Deviation
o Number below 2500g
Tabulation
Histogram
Box and whisker plot
Stem and leaf
Dot Plot

Types of Data:

Categorical data : gender

Discrete data: number of people, number of asthma attacks
Continuous data: height, weight, blood pressure
o Continuous datanya berkelanjutan, makin tinggi makin apa
Shapes of distribution:

Symmetrical

Skew to the right

Skew to the left

Bimodal

Summary Statistics

Median < Mean == SKEW TO THE RIGHT

Median > Mean == SKEW TO THE LEFT
Median = Mean == SYMMETRICAL
RANGE

- It is also useful to have a measure of degree of variability

- Range is the difference between lowest and highest values
- Has Limitations:
o Depends only on extreme values
o Depends on sample siza

VARIANCE AND STANDARD DEVIATION

Variance informally measures how far a set of random numbers are spread out from
their mean
The greater the variance, the larger the overall data range
It has a central role in statistics descriptive statistics, statistical inference, and more.
Variance: Divide sum of d2 with (n-1)

<<EXERCISE:>>

4, 7, 8, 9, 3, 3, 5, 6, 0

REORDER = 0,3, 3, 4, 5, 6, 7, 8, 9

Mean: 45/9 = 5

d = Data - Mean

VARIANCE : (d)2/(n-1)

Data d d2
0 -5 25
3 -2 4
3 -2 4
4 -1 1
5 0 0
6 1 1
7 2 4
8 3 9
9 4 16

Variance : SUM(d2)/(n-1) == 64/(9-1) = 8 = 8

Variance : Divide sum of d2 with (n-1)

Use previous example
Standard Deviation (SD) is simply he square root of variance, restored to its original
NORMAL DISTRIBUTION and SD

Many biological variable follow normal distribution

Normal distribution has useful features realting to its mean and SD
95% data lies within mean 2SD
68% data lies within mean 1SD
Used for normal ranges

ANALYTICAL STUDIES

>> Descriptive Studies: Generate hypothesis

>> Analytic Studies: Test hypothesis

Study Designs in Epidemiology

Epidemiological studies associate exposure status and outcome status of groups of

individuals
Association between exposure and outcome
Outcome is more frequent in groups where the exposure is more frequent

Ecological Studies

Cross Sectional Studies

Aim is to describe a population or a subgroup within the population with respect to

an outcome and a set of risk factors

COHORT

CASE CONTROL

<< SAMPLE AND POPULATION >>

In statistics, a sample consists of a number of individuals taken from a population

To allow us to generalize from the sample to the population, the sample should be
representative of the population, e.g. a random sample
Features of the sample can then be used to estimate corresponding features of the
population. For example
IN Clinical Testing:
o Population: All patitent with the characteristic of interest, typically
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