Biostatistics

Bio life Statistics- from the Latin word status meaning manner of standing or position Science which deals with the collection organization, analysis and interpretation of data

Biostatistics
Biostatistics- the scientific discipline concerned with the application of statistical methods to problems in biology or medicine

STATISTICS in singular sense: - is a body of methods in analyzing data

BRANCHES OF STATISTIC - Descriptive Statistics - Inferential Statistics

Branches of Statistics
Descriptive Statistics a set of statistics techniques whose main objective is to summarize and present data in a form that will make them easier to analyze and interpret

Branches of Statistics
Inferential Statistics A branch of statistics concerned with making estimates, predictions, generalizations and conclusions about a target population based on information from a sample 1. Estimation Point estimate Interval estimate lower limit, higher limit 2. Hypothesis testing

Processes Involved in Inference

1. Statement of an objective 2. Data collection -measurement -methods of data collection -sampling 3.Analysis and interpretation 4.drawing inferences regarding the population

Uses of Statistics
a. A data reduction technique b. A tool for objective appraisal and evaluation c. A tool in the decision making process

Statistics in Plural sense: -is a set of data,mass of information USES of Statistics: P.H. Statistics- for planning and monitoring of health status Vital statistics- data related to vital events like birth. Health Statistics health status of an individual or community Hospital or Clinic Statistics-e.g. # of beds: drug distribution Service statistics e.g family planning

Role of Statistics in Research

Aids the researcher in: 1. designing a research project 2. How to process, organize, and summarize research data 3. Quantifying variability 4. In interpreting results and drawing valid conclusions.

Phenomenon of Variation the tendency of a measurable characteristic to change From one individual or one setting to another; or Within the same individual or setting at different periods of time Statistics is necessary to analyze variability

NATURE OF STATISTICAL DATA

1. Expressed numerically 2. Treated as a mass or group of observations 3. Subject to variation

CONSTANTS -non-changing; applicable to the physical sciences -speed of light, #minutes in an hour

VARIABLE -may vary or change -measurement or characteristics -things that changes within a category
-the value of which varies from one individual to within the same individual at different periods of time - example:Age,gender

Types of Variables 1. Qualitative Variables - categories are merely expressed as labels to distinguish one group form another - Numerical representation of the categories are for labeling/coding and not for comparison (greater or less) - E.g sex, educational level, occupation, religion,place of residence,disease status

Types of Variables
2. Quantitative Variables - values indicate a quality or amount and can be expressed numerically - Values can be arranged according to magnitude - E.g. age, height, weight, #of students

2. Quantitative Variables
May be discrete (can assume only integral values or whole numbers)
e.g. number of children in the family number of beds in the hospital May be continuous (can attain any value including fractions or decimals) e.g. age, height, blood pressure

Levels of Measurements
1. Nominal
A classificatory scale where the categories are used as labels only; (does not represent qty) Number or names which represent a set of mutually exclusive and exhaustive classes to which individuals or objects (attributes) may be assigned e.g. sex (male, female) race, blood grups, seatbelts in car, psych diagnosis ( manic, depressive)

2. Ordinal
Same characteristics as for nominal scales with the additional feature that the classes can be ordered or ranked, however the distance between two categories cannot be clearly quantified. e.g. psychosocial scales ( strongly disagree, disagree, agree, strongly agree), age groups ( infant, child, teenager, adult)

3. Interval
same characteristics as for scales with the additional feature that the distances between all adjacent classes are equal Conceptually, these scales are infinite, in that they have neither beginning nor ending Zero point is arbitrary and does not mean absence of the characteristics e.g. Temp, calendar, time, IQ

4. Ratio
same characteristics as for ordinal scales with the additional feature that the meaningful zero point exists. e.g. weight, blood pressure, height, doctor visits

Sampling
The act of studying or examining only a segment of the population to represent the whole. Whatever findings we get for this segment of the population, we generalized to the total population.

Advantages of Sampling
Cheaper- only a part of the population is on study Faster- shorter time spent for data collection and gathering Better quality of information can be collected- the data collectors are trained and supervised closely.

 More Comprehensive Data- Detailed questions on a specific topic require a lot of time to collect. It is the only possible method for destructive procedures- e.g. blood sample

Definition of Terms
Population- refers to the entire group of individuals or items of interest in the study Target population- is the group from which representative information is desired and to which inferences will be made. Sampling population- population from which a sample will actually be drawn

 Elementary unit or element- is an object or a person on which a measurement is actually taken or observation is made. Sampling Unit- refers to the units which are chosen in selecting the sample, and maybe made up of non-overlapping collection of elements or elementary units. Sampling frame- collection of sampling unit

 Sampling error- This refers to the difference between the value of the parameters being investigated, and the estimates of this value based on the different samples.

Example
Research- Prevalence of disability on 6-10 yr old children Population- Children Target population- 6-10 yrs old children Sampling Frame available- list of pupil Sampling poln- 6-10 yrs old students

 Sampling Error- The difference between the population value of the parameter being investigated and the estimate of this value based on the different samples Population Average = (1+2+3)/3=2 (true value) Sample 1&2 = 1.5 Sample 2&3 = 2.5 Sample 1&3 = 2

Criteria of a good sampling design

The sample to be obtained should be a representative of the target population The sample size should be adequate Practicality and feasibility of the sampling procedure. Should be sufficiently simple and straightforward so that it can be carried out substantially as planned. Economy and efficiency of the sampling designed- most information at the smallest cost.

General / Basic types of sampling designs

A. Non - Probability Sampling DesignProbability of each member of the population being selected as part of the sample cannot be determined B. Probability Sampling Design each member of the population has a known non-zero chance of being selected as a sample e.g. P=1/n

A. Non-Probability Sampling Design

Judgmental or Purposive Accidental or Haphazard Quota Sampling Snowball technique Convenience Sampling

Judgmental or Purposive - A representative sample of the population is selected based on an experts subjective judgment or some pre-specified criteria e.g. autism subject Accidental or Haphazard The sample is made up of those come at hand or who is available e.g. ambush interview Quota Sampling Sample of a fixed size (quota) are obtained from predetermined subdivisions of the population ( e.g. religion research)

 Snowball Technique- The sample is obtained by a process whereby an individual to be included is identified by a member who was previously included (e.g. Drug abuse) Convenience Study unit that are easily accessible are selected as samples (e.g. clinic studies)

 Advantages of Non-Probability Sampling

Easier to execute The only possible means

Disadvantages of Non-probability Sampling designs

More likely to produce biased results No defined rules to compute for estimates Cannot compute reliability of estimates

B. Probability Sampling Designs

Simple Random Sampling Systemic Sampling

Stratified Random Sampling

Cluster sampling Multi-stage Sampling Design

 Simple Random Sampling

The most basic type of sampling design. Every element in the population has an equal chance of being included in the sample.

How to do an SRS? Make a numbered list of all the units in the population from which you want to draw a sample Decide on the size of the sample Select the required number of sampling units using a lottery method a table of random numbers or the RAN function of a calculator

Advantages of SRS Simple design Simple analysis Disadvantages of SRS Not cost efficient because elementary units maybe too widespread Requires a sampling frame listing all elementary units of the population

 Systematic Sampling Samples are chosen at regular intervals (for example every fifth) from the sampling frame. The researcher computes for the sampling interval (k=N/n)

Example Population Size (N) = 80 household; Sample Size (n)= 10\ Sampling interval k = N/n = 80/10 = 8 Draw a number between 1-10 (inclusive). The number drawn will be the starting point of the sampling. The succeeding sample is the next kth member of the population. Therefore, if number 4 is picked, the every 8th household will be included in the sample, starting with household number 4 until 10

Advantages of Systematic Sampling Less time consuming and easier to perform Can be used even in the absence of the sampling frame Sometimes can result in a more representative sample a good representation or good distribution

Disadvantages of Systematic Sampling Units are widely spread Systematic bias (e.g in clinic attendance, systematic sampling with a sampling interval of 7 days would be inappropriate as all the days would fall on the same day of the week)

 Stratified Random Sampling

The population is first divided into nonoverlapping groups called (stratum) strata and then a simple random sampling is done for each stratum. (e.g. different level of high school students).
Advantages of Stratified Random Sampling Ensure subgroups are adequately represented Accurate estimates for each stratum can be obtained Produces more reliable results

Disadvantages of Stratified Random Sampling

May require a very large sample if reliable estimates for each stratum are wanted

Cluster Sampling The selection of groups of study units (clusters) instead of the selection of study units individually (e.g. population maybe clustered per barangay)

 Multi-stage Sampling Design

- a procedure carried out in phases and usually involves more than one sampling method. - The population is divided into sets of primary or first stage sampling units and then a random sample of secondary stage units is obtained from each of the selected clusters in the first stage. - Combination of sampling designs maybe applied. - Often used in community- based studies.

Example: Nationwide survey of all the 15 regions (stratified) Sample unit province- primary sampling unit (Simple Random) 1 urban and 1rural brgy secondary sampling unit (stratified) One cluster of 35 household-tertiary sampling unit (cluster) Choose the household elementary unit (Systematic) Sampling design Is:4- stage stratified systematic; cluster,simple random sampling design

Advantages of Cluster & Multi-Stage Sampling Cost efficient design Sampling frame for all elementary units not required Sample easier to select

Disadvantages of Advantages of Cluster & MultiStage Sampling

More complicated design to implement More complicated analysis Need for bigger sample size to achieve sample precision units are widely spread

BIAS IN SAMPLING 1. Non-response

Pre-test data collection tool Follow up Study non-respondents separatelymaybe they are more at risk Increase sample size

BIAS IN SAMPLING 1. 2. 3. 4. 5. Studying volunteers only. Sampling of registered patients only Missing cases of short duration Seasonal Bias Tarmac Bias due to convenience sampling

ETHICAL CONSIDERATIONS Representativeness Truth in publication Care in drawing conclusions and recommendations