Introduction to Biostatistics

Yasmin Parpio

Objectives
By the end of this session, learners would be able to:
 Define the terms: Statistics and Biostatistics

 Discuss the importance of biostatistics

 Differentiate between Population & Sample and Parameter

& statistics

 Identify the various sources of data collection

 Explain the types of variables

 Explore the different types of Measurement scales

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1
 What if NUMBERS are not there in
life?

A routine scenario in Nursing

Profession!
• You, as a Head Nurse/ Supervisor, have been
requested by AKUH Senior Management to
provide information about the ages of the
patients admitted in the hospital last year
(during 2013) in a 2 minutes presentation.

How would you respond to this request?

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Patients admitted at AKUH in 2013 versus their
Age

Wards No. of Less than 15 15-45 years More than 45

patients years years
admitted
B1 56 6 30 20
B2 425 0 339 86
A2 250 0 150 100
C1 512 50 325 137
C2 511 25 450 36
PW1 205 14 185 6
PW2 175 12 100 63
Total 2134 107 1579 448

Patients admitted in AKUH in 2013 versus their

Age
1 2
• 2134 patients were admitted in AKUH
in 2013. Analysis of cases revealed that
1579 patients were in the age group of <15 years
15-45 years, 448 were above 45 years 15-45 years

while remaining 107 were below 15 >45 years

years of age.

80
70
60
50
40
% of
patients 30
20
10
0
<15 15-45 >45

Age in years 6

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 What is Statistics?
The science of data!

• Collection of information
• Classification of information
• Summarization of information
• Organization of information
• Interpretation of information

Statistics is science & art of dealing with variation in the data

(information, facts) in such a way as to obtain reliable results.

What is Bio-Statistics?

• Collection of information
• Classification of information
• Summarization of information
• Organization of information
• Interpretation of information

If related to Biological or Health sciences called “Biostatistics”

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 Why do we need to study Biostatistics
course?
To learn how to deal with numbers.

To assess evidence from different studies.

To understand published scientific papers.

To do research and write papers in scientific

journals.

Definitions
Population vs. Sample
• Population
– The set of all measurements of interest to the
investigator
– It varies with the problem or situation

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5
 Example of population

• Monthly income of households in Pakistan

• Households in Karachi who have death of at
least one family member in past one year
• Number of TB Patients in Pakistan
• All patients visited certain clinic in the year
2010

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Population vs. Sample

• Sample
– Any subset of all measurements selected from the
population.
– A random sample is a good representative of
population

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6
 Example of Sample

• A survey of 1,000 households taken from all

parts of Pakistan to assess their monthly income

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Define population or Sample from each of the

following scenarios?
• More than 1 in 4 united state children (<5years) have
cholesterol levels of 180 milligrams or higher (source: The
American Health Foundation)
• A survey of 500 households conducted in Karachi to know
whether they have death of at least one family member in past
one year
• A survey of 2500 TB patients conducted at different TB clinics
in Pakistan
• Number of TB Patients in Pakistan
• When older people (65 years and above) with mild to moderate
hypertension in Canada were given the mineral salt for six
months, the average blood pressure reading dropped by eight
points systolic and three points diastolic (source: Prevention,
March 1995, p. 19)
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 Parameter vs. Statistics
• Parameter :
– The characteristics of interest to the researcher in
the population is called a parameter.
E.g. average household size and percent of
households with modern sanitation as reported in
the 1998 census of Karachi
• Statistic :
– The characteristics of interest to the researcher in
the sub-set of population is called a statistic.
E.g. average household size and percent of
households as reported from a sample survey of
6,000 households in Karachi, 2010
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Examples
Parameter:
• Average monthly income of households in Pakistan
• Proportion of households in Karachi who have at
least one special child at their residence
• Prevalence of TB in Pakistan
Statistic:
If taken from a sample each one of above is
called statistic
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8
 Read and reflect!
Study 1:
Title:
Knowledge of and attitudes toward tuberculosis
of Turkish nursing and midwifery students
Aim:
The aim of the study was to describe the level of knowledge and
the attitudes of Turkish nursing and midwifery students toward
tuberculosis in an attempt to understand and determine whether
there is a need for improvement in nursing and midwifery
education regarding tuberculosis.
Reference: Akin S, et al , 2011
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Read and reflect!

Study 2:
Title:
Hand Contamination of Anesthesia Providers Is an
Important Risk Factor for Intraoperative Bacterial
Transmission
Aim:
“We have recently shown that intraoperative bacterial transmission to patient IV
stopcock sets is associated with increased patient mortality. In this study, we
hypothesized that bacterial contamination of anesthesia provider hands before
patient contact is a risk factor for direct intraoperative bacterial transmission”.
Reference: Loftus R.W, et al , 2011

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9
 Statistics

Descriptive Inferential

Descriptive vs. Inferential Statistic

• Descriptive Statistic :
– Utilizes numerical and graphical methods to find
patterns in a data set, summarizes the information,
and present information in a convenient form.
• Inferential Statistic :
– Utilizes a (sub) set of the data (sample) to make
estimates, decision, or prediction about a larger set
of data (population). It consists of Estimation and
Hypothesis testing.

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10
 Statistics
Statistics

Descriptive Inferential

Hypothesis
Estimation
testing

Point
Estimation

Interval
Estimation
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Source of Data Collection

• Natural observation :
– Go out into the field and observe phenomena
(People, animal), and if possible without
interfering with the phenomena itself
• Survey
– It is also kind of observational study. You are just
collecting information without having any control

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 Source of Data Collection (Contd.)

• Case study :
– One unusual individual is intensively studied.

• Experiment :
– The investigator controls or modifies the
environment and observes the effect on the
variable under study. One variable is deliberately
manipulated. It is a kind of research plan that have
another group called controls.

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Identify a survey or an experiment?

• Cancer research institute is interested in determining
the effectiveness of a new drug for the treatment of
cancer.

• The cardio-vascular department is interested in

knowing the prevalence of Rheumatic heart disease
(RHD) in rural and urban areas of Pakistan.

• The Goldberger and his colleague’s trail studying

dietary etiology and prevention of pellagra. They
studied the effect of protective diet in two orphanages
and two wards of state mental institutions. They used
one of each type for dietary intervention and the other
served as control.
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 Data and Variables

Variable:
Any characteristic that varies from one member of
a population to another.
A simple example is height in centimeters, which
varies from person to person.
Data : The value of observations recorded for
variables example: 168, 169, 170 cms

Types of Variables

There are two basic types of variables: Quantitative

(Numerical) and Qualitative (categorical) variables.

Numerical Variables: variables to which a number

is assigned as a quantitative value.

Categorical Variables: variables defined by the

classes or categories into which an individual
member falls.

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 Examples

Qualitative Data Quantitative Data

 Severity of pain (mild  Height (in cm)
moderate, or sever)  Weight (in Kg)
 Level of education (illiterate,  Age (in year)
can read or write, primary,  Year of Schooling
secondary, metric,
intermediate, graduate, post  Duration of disease
graduate)  I Q of a person
 Sex (Male, Female)  Number of children
 Medical Record number  Grade points
 Grades (A,B,C or D) (1,2,3,4)
 Nationality (Pakistani, Afghani
etc)
 Passport Number

Summary of Scales

Data

Qualitative Quantitative

Nominal Ordinal interval Ratio scale

Discrete

Continuous

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 Types of Quantitative (Numerical) variables
Interval scale:
 Differences between values have meaning.
 There is an arbitrary zero (zero has some value, no
true 0)
Example: Temperature in Celsius.
Ratio scale:
 Ratio between values have meaning
 Zero is the absence of the characteristic being
measured
Example height, weight, age

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Types of Quantitative (Numerical) variables

Ratio scale:
Discrete: Reflects a number obtained by counting—no
decimal.
Example: Number of children
Continuous: Reflects a measurement; the number
of decimal places depends on the precision of the
measuring device.
Example: Vitamin D level, and HB

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 Ratio Scale

Qualitative (Categorical) Variables

Defined by the classes or categories into which an

individual member falls.

• Nominal Scale: Name only--Gender, hair

color, ethnicity

• Ordinal Scale: Nominal categories with an

implied order--Low, medium, high.

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 NOMINAL SCALE

b. Appearance of plasma: b.

1. Clear……………………… 1.

2. Turbid…………………… 2.

9. Not done………………… 9.

ORDINAL SCALE
81.Urine protein (dipstick reading): 81.

1. Negative………………… 1.

2. Trace……………………. 2.

3. 30 mg% or +…………… 3.

4. 100 mg% or ++………… 4.

5. 300 mg% or +++………… 5.

6. 1000 mg% or ++++……… 6.

If urine protein is 3+ or above, be

sure subject gets a 24 hour urine
collection container and instruction

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 Likert Scale

Question: Compared to others, what is your

satisfaction rating of the National Practitioner Data
Bank?
1 2 3 4 5

Very Somewhat Neutral Somewhat Very

Satisfied Satisfied Dissatisfied Dissatisfied

Typical Data Table

OBS AGE BMI FFNUM TEMP( 0F) GENDER EXERCISE LEVEL QUESTION
1 26 23.2 0 61.0 0 1 1
2 30 30.2 9 65.5 1 3 2
3 32 28.9 17 59.6 1 3 4
4 37 22.4 1 68.4 1 2 3
5 33 25.5 7 64.5 0 3 5
6 29 22.3 1 70.2 0 2 2
7 32 23.0 0 67.3 0 1 1
8 33 26.3 1 72.8 0 3 1
9 32 22.2 3 71.5 0 1 4
10 33 29.1 5 63.2 1 1 4
11 26 20.8 2 69.1 0 1 3
12 34 20.9 4 73.6 0 2 3
13 31 36.3 1 66.3 0 2 5
14 31 36.4 0 66.9 1 1 5
15 27 28.6 2 70.2 1 2 2
16 36 27.5 2 68.5 1 3 3
17 35 25.6 143 67.8 1 3 4
18 31 21.2 11 70.7 1 1 2
19 36 22.7 8 69.8 0 2 1
20 33 28.1 3 67.8 0 2 1

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 Identify Types of Variables
• AGE: Age in years
• BMI: Body mass index, weight/height2 in kg/m2
• FFNUM: The average number of times eating “fast food”
in a week
• TEMP: High temperature for the day
• GENDER: 1- Female 0- Male
• EXERCISE LEVEL: 1- Low 2- Medium 3- High
• QUESTION: Compared to others, what is your satisfaction
rating of the National Practitioner Data Bank?
1- Very Satisfied 2- Somewhat Satisfied 3- Neutral
4- Somewhat dissatisfied 5- Dissatisfied

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