Prof.

Abdelmoniem Dawah Bio-Statistics 2019-2020

1

Medical statistics

• Statistics: Is the science of numbers which gives accurate

presentation of facts
• Medical statistics: Is the science which applies the principles of
statistics in the field of health.

• Constant data: observations, which do not vary from one person

to the other.

• Variable data: observations, which vary from one person to the

other

• Weight is Quantitative continuou variables

• pulse rate is Quantitative discrete variables

• They are only of an integer value (no fractions).
• Like family number, number of pregnancies,.
• Social class is Qualitative ordinal variables
• Marital status is Qualitative nominal variables

• AvailableSource of data includes:

a - Census

b- Records of health office

c - Annual statistical reports

d -all

• Epidemiological studies includes

a) Descriptive

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 Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

b) Analytic
c) Intervention
d) All
• Intervention studies in animals refers as experimental studies
• Intervention studies in human refers as clinical trials
• Observational studies includes:
a- Descriptive.
b- Analytic.
c- clinical both
• Intervention studies includes::
a) Clinical trials on human
b) Experimental in animals.
c) both
• Desciptive studies describes the epidemiological features of a
particular disease.

The collected data are used to describe:

a) Pattern of distribution of the disease.

b) Management of the problem.
c) Comparison of morbidity & mortality in between different
population,
d) All of the above
• Advantages of desciptive studies:

a) Inexpensive.
b) Takes short time.
c) Gives a basic picture of the disease.
d) All of the above
❖ Survey study is cross sectional study,

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 Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

❖ A cross- sectional (prevalence) survey is a descriptive field study

Descriptive studies:

a. Measure the prevalence of a disease.

b. Describe the present condition

c. both

• Pilot study is valuable to test the questionnaire

❖ Errors with surveys includes:

a) Subject error:
b) Observer error:
c) Technical error:
d) All
Advantages of analytics studies are:

a) Good for rare diseases

b) Can examine diseases with a long latency
c) Can examine many potential risk factors
d) All
Disadvantages of analytics studies are:

a) Cannot obtain prevalence estimates

b) Recall bias
c) Cannot measure disease onset
d) all
• Presence of association between risk factors and occurrence of diseases is
measured by
a- Chi2 test

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 Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

b- P-value

c- both

• Magnitude of association risk factors and occurrence of diseases is

measured by
a- Odds ratio (OR)
b- 95% confidence interval

c- both

Odds ratio-Interpretation

a- OR = 1: No association

b- OR  1: Increased odds (increased risk).

c- OR  1: Reduced odds (reduced risk ).

• Concept of a cohort is A group of individuals that is all similar in

some trait and move forward as a unit.

• Advantages of cohort studies:

a) Temporality
b) Efficient for rare exposures
c) Multiple outcomes
d) Minimizes recall bias
e) all
• Disadvantages of cohort studies:

a) Expensive (large sample)

b) Inefficient for rare diseases
c) Time consuming
d) Open to selection bias

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 Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

e) all
• clinical trialsThese are studies on human for the effectiveness of
new drugs, vaccines or particular scheme of treatment,
• Sampling is used in place of census for epidemiological study.

• Sampling is drawn from the whole population, when population is

examined for group of characteristics.

• Advantages of Sampling are :

a) Cheaper.
b) Quicker.
c) More accurate.

• Sample size is not fixed.

• Sample size is Determined by:

a- available resources,

b- prevalence of the disease,

c- number of variables studies.

d- All

• Types of samples includes:

a- Judgment
b- Convenient sample
c- Random sample
d- all.
• Types of random samples are:

a- Simple random sample:

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 Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

b- Stratified random sample:

c- Systematic random sample:

d- Cluster sample
e- Multistage sample:
f- All

• Simple random sample: It allows each individual (unit) an equal chance

to be chosen.

• In Stratified random sample The target population is divided into strata

according to a predetermined characteristic.

• In systematic random sample: The first sample unite is chosen

randomly,Then every nth is taken, where n is any number (5,10,15,….) till
the and of the group.

• In Cluster sample The sample unite is a group of population.

• Multistage sample used for wide spread studies (national studies).

• Multistage sample is composed of series of clusters.
• Screening test is simple non invasive investigation (test) of
apparently healthy individual for case finding in asymptomatic phase
or in early stages of disease.
• Reliability of screening test is the ability of the test to give the same
results when repeated on the same person using same procedures,
under the same conditions.
• Validity of screening test is the ability of the test to give true
identification of the condition
• Sensitivity of screening test is the ability of the test to give positive
results with true cases.

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Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

• Specificity of screening test is the ability of the test to give negative

results with truly free individuals

• Positive predictive value of screening test is the probability of being

diseased in a person who receives a positive test result.

• Negative predictive value of screening test is the probability of freedom

from disease in a person who receives a negative test result.

• Accuracy of screening test is The test should give true

identification of the condition from the non diseased (true screening

test negative) .

• The main methods of presentation of data are:

a. Simple tables
b. Frequency distribution tables
c. Cumulative frequency distribution tables
• Graphic presentations of data are :
a- Bar charts •
b- Histogram
c- Frequency polygon
d- Line Diagram
e- Pie charts
f- Pictogram
• Mathematical presentations of data are
a. Measurement of central tendency
b. Measurement of dispersion
c. Both

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 Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

• Bar charts are way of presenting a set of numbers by

the length of a bar.
• Histogram is a pictorial diagram of frequency distribution. It
consists of a series of blocks.
• Frequency polygon is obtained by joining the mid-points of the
histogram blocks
• Line diagram are used to show the trend of event with the passage
of time.
• Pie Charts is The distribution of the component are based upon a
percentage
• Pictogram is Pictorial illustrations showing relative and
proportional sizes.
• Measurement of central tendency are:

a- Mid-range.
b- The Arithmetic mean
c- The median
d- The mode.
e- All
• Weights of 5 Persons is 43, 20, 40, 36, 19 Kg.
19 + 43
Mid-range = = 31
2 Kg.
2- The Arithmetic mean:

Is the sum of the values in a set of data divided by the number of the
values in the set.

• The median is the central value of a set of observations when

those observations are arranged in order of magnitude.

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Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

• The mode is the most frequently occurring value in a series of

data.

• Various measures of dispersion are available:

a- Range.
b- Mean deviation (M.D.)
c- Variance.
d- Standard deviation (S.D.)
e- All
• The normal distribution curve is the distribution of quantitative
variables is usually normal

• The Normal Distribution has mean = median = mode

• The normal curve is described by the mean and SD.

• Characteristics of curve:

a- Symmetrical

b- The mean, median and mode coincide

c- both

• Mean + 1 SD of observation within the normal distribution =

68.26% of observations.

• Mean + 2 SD of observation within the normal distribution =

95.45% of observations.

• Mean + 3 SD of observation within the normal distribution =

99.73% of observations.

• Standard score (Z) can be calculated to show the percent of values

which lie within or outside specified limits from the mean.
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Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

• Calculation of standard score:

Standard score = Value- mean/SD

Z= X-X- /SD

• Vital Rates is the branch of medical statistics concerned with

registration and presentation of vital events of human life
• Vital rates are indices of:

a) Health status of vulnerable groups & population.

b) Community development.
c) Health care delivery system.
d) All
• Mid-year population of the same locality & year is the demonator
of Crud Birth Rate

• Crud Birth Rate is the No. of live births of a certain locality and
year

• Fertilityt is the reproductive performance of women.

• A woman is considered fertile when she has ever born a baby.

• Crude death rate is the total number of deaths per 1000

population of a certain locality (or country).
• Infant Mor ality Rate (IMR) is No of deaths of babies (<
1y of life) in certain locality and year

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Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

• -Novonatal period → infant in the 1st week of life.

• -Neonatal period → infant in the 1st months of life.

• -Posteneonatal period → infant in the next 11 months.

• Stillbirth is a viable foetus delivered after the 28 th weeks of

pregnancy, without showing any sign of life after being
completely expelled from mother.

• Perinatal Maternal Mortality is an index of maternal

care and early neonatal care.

• No of live and dead births in the same year & locality Is

the dominator of Maternal Mortality Rate

• No of live births in the same year & locality Is the

dominator of Maternal Mortality Ratio

• Maternal Mortality Rate is No. of deaths of mothers due to

causes related to pregnancy, Labour & puerperium in
certain locality and year x 1000

• Maternal mortality ratio is the number of women who die during

pregnancy and childbirth, per 100,000 live births..

• Case fatality rate is No of deaths of a particular disease in certain

locality & year

• Incidence of chronic diseases is No. of new cases of a particular

disease reported during a given time

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Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

• Prevalence rate: used for chronic diseases.

Prevalence rate is No. of total of diseases diagnosed by survey study
during a defined period of time

• Demography is the science of population studies.

• Population census is a process carried out at intervals, usually
every 10 years for:
• Methods of population census includes:
a- De facto methods:
b- De jure method:
c- both

• In De facto of population methods the people are enumerated at

the areas where they are found at the time of census (used in
Egypt).
• In De jure method the enumerated people are refereed
to their actual residence.
• Methods of population Estimation includes:
a) Natural increase method:
b) Arithmetic methods:
c) Geometric method
d) Graphic methods
e) all
• Graphic methods is a Plotting successive census population on
a graph
• Geometric method of population Estimation is The most accurate
• Base layers of pyramid population representing the age
groups below 15 years

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Prof. Abdelmoniem Dawah Bio-Statistics 2019-2020

• Base layers of pyramid population in Egypt are broad, due

to high birth rate.

• Top of pyramid population is narrow in developing countrires

• Top of population pyramid is flat In developed countries

• Body of pyramid made of strata in between the base and top,

• Life expectancy is the average number of years an individual of
given age of going to live.
• Factors influence growth of population includes:
a) Natural increase of population.
b) Migration
c) both
• Rate of natural increase of population (RNI) is the difference
between birth rate and death rate.

• Fertility of a given population is measured by:

a) birth rate,
b) general fertility rate
c) both

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