GOOD MORNING

APPLICATION OF
APPLICATION OF BIOSTATISTICS
BIOSTATISTICS

DR JIPPY
23/12/2014

DR. Jj
 This session covers :
 Introduction

 History

 Basis of Biostatistics

 Applications of Biostatistics

 Conclusion

 References

 Previous year Questions

 Statistics
It is the science which deals with
collection, classification and tabulation of
numerical facts as the basis for explanation,
description and comparison of phenomenon.
- Lovitt
BIOSTATISTICS

O It is the branch of statistics concerned with

mathematical facts and data related to

biological events.

O It is the science that helps in managing

medical uncertainties.
O Biostatistics covers applications and contributions not

only from health, medicines and, nutrition but also

from fields such as genetics, biology, epidemiology,
and many others.

O It is mainly consists of various steps like generation

of hypothesis, collection of data, and application of

statistical analysis.

Indian J Pharmacol. 2012 Jul-Aug; 44(4):

435–442.
O Any science needs precision for its

development.

O Precision is all the more important when it

comes to health sciences. For precision; facts,

observations or measurements have to be
expressed in figures.
O Medicine is essentially an empirical science. It

depends on observations and not on theories or

theorems.

O As a part of clinical practice or research we

deal with many observations, which when

systematically arranged, are called Data.
O The process of converting data into information

requires a special approach called statistics.

O ‘Statistic’ means a measured or counted fact or

piece of the information, stated as a figure such as

height of one person, birth weight of a baby etc.
 Branches of Biostatistics
O Descriptive Biostatistics

 Methods of producing quantitative summaries

of information in biological sciences.

 Tabulation and Graphical presentation

Branches of Biostatistics…
Inferential Biostatistics
Methods of making generalizations about a
larger group based on information about a sample of
that group in biological sciences.
Primarily performed in two ways:
O Estimation

O Testing of hypothesis
 HISTORY
O Sir Francis Galton

is considered as the

Father of Biostatistics.
O He was the first to apply statistical methods to

the study of human differences and inheritance

of intelligence, and introduced the use of
Questionnaires and Surveys for collecting data
on human communities, which he needed for
genealogical and biographical works and for
his anthropometric studies.
 Origin and development of
statistics in medical research
O In 1929,a huge paper on application of

statistics was published in physiology journal

by Dunn.

O In 1937, 15 articles on statistical methods by

Austin Bradford Hill, were published in book

form.
O In 1948, a RCT of streptomycin for pulmonary

tb., was published in which Bradford Hill

has a key influence.

O Then the growth of statistics in Medicine from

1952 was a 8-fold increase by 1982.

Basis of Biostatistics
Sources of medical Uncertainties
O Intrinsic due to biological, environmental and
sampling factors.
O Natural variation among methods, observers
and instruments etc.
O Errors in measurement or assessment or errors
in knowledge.
O Incomplete knowledge.
Intrinsic variation as a source of
medical uncertainties
O Biological due to age, gender, heredity, party,
height, weight etc. Also due to variation in
anatomical, physiological and biomechanical
parameters.
O Environment due to nutrition, smoking, pollution,
facilities of water and sanitation, road traffic,
legislation, stress and strain etc.
O Sampling fluctuations because the entire world

cannot be studied and at least future cases can

never be included.

O Chance variation due to unknown or complex

to comprehend factors.
O Biostatistics is the term used when tools of statistics are

applied to the data that is derived from biological

sciences such as medicine.

O Any science demands precision for its development,

and so does medical science.

O For precision,facts,observations, or measurements have

to be expressed in figures.
O Everything in medicine be it research, diagnosis or

treatment, depends on counting or measurement.

O High or low blood pressure has no meaning, unless it

is expressed in figures.

O Thus medical statistics or biostatistics can be called

Quantitative medicine.
O In nature, blood pressure, pulse rate, action of a
drug or any other measurement or counting varies
not only from person to person but also from group
to group.
O The extent of this variability in an attribute or a
character, whether it is by chance i.e. biological or
normal, is learnt by studying statistics as a science.
O Variation more than natural limits may be

pathological, i.e., abnormal due to the play of

certain external factors. Hence biostatistics
may also be called a science of variation.
O The data after collection, lying in a haphazard
mass are of no use, unless they are properly sorted,
presented, compared, analyzed and interpreted.

O For such a study of figures, one has to apply

certain mathematical techniques called statistical
methods.
It is the science which deals with development and

application of the most appropriate methods for the:

 Collection of data.

 Presentation of the collected data.

 Analysis and interpretation of the results.

 Making decisions on the basis of such analysis.

O Statistics arising out of biological sciences, particularly

from the fields of Medicine and Public health.

O The methods used in dealing with statistics in the fields

of medicine, biology and public health for planning,

conducting and analyzing data which arise in
investigations of these branches.
ROLE OF BIOSTATISTICIANS
Identify and develop treatments for disease and estimate
their effects.
Identify risk factors for diseases.
Design, monitor, analyze, interpret, and report results of
clinical studies.
Develop statistical methodologies to address questions
arising from medical/public health data.
Locate , define & measure extent of disease
Ultimate objective  improve the health of individual &
community
APPLICATION OF BIOSTATISTICS

As a Science

As Figures
As a Science
In Physiology And Anatomy

O To define what is normal or healthy in a

population.

O To find the limits of normality in variables such

as weight and pulse rate etc. in a population.
O To find the difference between means and

proportions of normal at two places or in

different periods.

O Eg : The mean height of boys in Gujarat is less

than the mean height in Punjab. whether this

difference is due to chance or a natural
variation or because of some other factors
such as better nutrition playing a part, has to
be decided.
O To find the correlation between two

variables X and Y such as height and

weight.

 whether weight increases or decreases

proportionately with height and if so by how

much, has to be found.
 IN
PHARMACOLOGY
O To find the action of drug – a drug is given to

animals or humans to see whether the changes

produced are due to the drug or by chance.
O To compare the action of two different drugs

or two successive dosages of the same drug.

O To find the relative potency of a new drug with

respect to a standard drug.

 IN
MEDICINE
O To compare the efficacy of a particular drug,

operation or line of treatment – for this, the

percentage cured, relieved or died in the
experiment and control groups, is compared and
difference due to chance or otherwise is found by
applying statistical techniques.
O To find an association between two attributes such

as cancer and smoking or filariasis and social class

–an appropriate test is applied for this purpose.
O To identify signs and symptoms of a disease
or syndrome.

O Cough in typhoid is found by chance and fever

is found in almost every case.

O The proportional incidence of one symptom or

another indicates whether it is a characteristic
feature of the disease or not.
O To test usefulness of sera and vaccines in

the field – percentage of attacks or deaths

among the vaccinated subjects is compared
with that among the unvaccinated ones to find
whether the difference observed is statistically
significant.
O In epidemiological studies – the role of

causative factors is statistically tested.

O Deficiency of iodine as an important cause of

goiter in a community is confirmed only after

comparing the incidence of goiter cases before
and after giving iodized salt.
 Modern medicine
O For decades, Biostatistics has played an integral role in

modern medicine in everything from analyzing data to

determining if a treatment will work to developing
clinical trials.

O The University of North Carolina's Gillings School of

Global Public Health defines biostatistics as "the

science of obtaining, analyzing and interpreting data
in order to understand and improve human health.”
[source: UNC School of Public Health,USA.]
O Most people have heard the statistic that

Heart disease is the leading cause of death in

America today*.

O But how do we know this fact to be true?

O Where did that information come from?

* [source: Center for Disease Control, USA]

O Back in 1948, when a lot wasn't known about the

factors leading to heart disease and stroke, a health

research study -- known as the Framingham
Heart Study -- was done on 5,209 people living in
the town of Framingham, Mass.

O These participants hadn't developed any known

symptoms of cardiovascular disease and hadn't had

a stroke or heart attack.
O They agreed to be followed over a period of time to

help researchers learn what factors lead to both

conditions.

O The study was landmark in several ways. It showed

that there was no one cause for getting a heart attack,

and combining information about several risk factors
could estimate the risk of someone getting the disease.
O Thanks to the Framingham Study, (which is still

going on today), we now know the major risk factors

that lead to cardiovascular disease.

O To reach these conclusions, researchers simply

followed the numbers -- the Biostatistics numbers to

be exact.
 CLINICAL MEDICINE
O Documentation of medical history of diseases.

O Planning and conduct of clinical studies.

O Evaluating the merits of different procedures.

O In providing methods for definition of

‘normal’ and ‘abnormal’.
 PREVENTIVE MEDICINE
O To provide the magnitude of any health problem in
the community.

O To find out the basic factors underlying the ill-

health.

O To evaluate the health programs which was

introduced in the community(success/failure).

O To introduce and promote health legislation.

Role of Biostatistics in Health
Planning and Evaluation
O Statistics arising out of biological sciences,

particularly from the fields of Medicine and

Public health.

O The methods used in dealing with statistics in

the fields of medicine, biology and public

health for planning, conducting and analyzing
data which arise in investigations of these
branches.
O In carrying out a valid and reliable health situation

analysis, including in proper summarization and

interpretation of data.

O In proper evaluation of the achievements and failures of a

health programs.
 Biotechnology
O Biotechnology can focus on a whole range of
topics, from genetic modification of plants and
animals to gene therapy, medicine and drug
manufacturing, reproductive therapy, and even
energy production.

O In all cases, research is carried out by developing

something and testing whether or not it has the
desired performance.

O Determining performance requires statistical

analysis of results.
IN COMMUNITY MEDICINE
AND PUBLIC HEALTH
O To evaluate the efficacy of sera and vaccines in the

field.

O In epidemiological studies-the role of causative

factors is statistically tested.

O To test whether the difference between two

populations is real or a chance occurrence.

O To study the correlation between attributes in the same
population.

O To measure the morbidity and mortality.

O To evaluate achievements of public health programs.

O To fix priorities in public health programs.

O To help promote health legislation and create

administrative standards for oral health.
O It helps in compilation of data, drawing

conclusions and making recommendations.

O For students of medicine/dentistry

O By learning the methods in biostatistics a student

learns to critically evaluate articles published in

medical and dental journals or papers read in

medical and dental conferences.

O To understand the basic methods of observation

in clinical practice and research.

In GENETICS
O Statistics and Human Genetics are twin
subjects, having grown with the century
together, and there are many connections
between the two.
O Some fundamental aspects in particular the
concept of Analysis of Variance, first arose in
Human Genetics, while statistical and
probabilistic methods are now central to many
aspects of analysis of questions is human
genetics.
O The most common areas where one can find

an extensive applications of statistical methods

in human genetics is

* Human Genome Project

* Linkage Analysis

* Sequencing
 IN Environmental science
Environmental statistics covers

a number of types of study:

O Baseline studies to document the present state of an

environment to provide background in case of unknown

changes in the future.
O Targeted studies to describe the likely impact

of changes being planned or of accidental

occurrences.

O Regular monitoring to attempt to detect

changes in the environment.

In NUTRITION
O Over the past 2 decades, there have been
revolutionary developments in life science
technologies characterized by high throughput, high
efficiency, and rapid computation.
O Nutritionists now have the advanced methodologies
for the analysis of DNA, RNA, protein, low-
molecular-weight metabolites, as well as access to
bioinformatics databases.
O Biostatistics, which can be defined as the process of

making scientific inferences from data that contain

variability, has historically played an integral role in
advancing nutritional sciences.

O Currently, in the era of systems biology statistics has

become an increasingly important tool to

quantitatively analyze information about biological
macromolecules.
O Appropriate statistical analyses are expected

to make an important contribution to solving

major nutrition-associated problems in humans
and animals (including obesity, diabetes,
cardiovascular disease, cancer, ageing, and
intrauterine growth retardation).
Application and Uses of
Biostatistics As Figures
O Health and vital statistics are essential tools in

demography, public health, medical practice

and community services.

O Recording of vital events in birth and death

registers and diseases in hospitals is like book

keeping of the community, describing the
incidence or prevalence of diseases, defects or
deaths in a defined population.
O Such events properly recorded form the eyes

and ears of a public health or medical

administrator.
O What are the leading causes of death?

O What are the important cause of sickness?

O Whether a particular disease is rising or falling

in severity and prevalence? etc.

 USES OF STATISTICS IN DENTAL SCIENCE:
O 1. To find the statistical difference between means of
two groups. Ex: Mean plaque scores of two groups.

O 2. To assess the state of oral health in the community

and to determine the availability and utilization of dental
care facilities.

O 3. To indicate the basic factors underlying the state of

oral health by diagnosing the community and find
solutions to such problems.
O 4. To determine success or failure of specific
oral health care programs or to evaluate the
program action.

O 5. To promote oral health legislation and in

creating administrative standards for oral
health care delivery.
 Conclusion:
O Bio-statistical techniques can assure that the results

found in such a study are not merely because of

chance.

O In every case of our life, Statistics plays a major role

for better gaining and accurate results.

O A well-designed and properly conducted study is a

basic prerequisite to arrive at valid conclusions.

 “ He who accepts statistics
indiscriminately, will often be duped
unnecessarily. But he who distrusts
statistics, indiscriminately will often
be ignorant, unnecessarily.”

WA Wallis and HV Roberts, in Nature of Statistics. The

Free Press, New York, 1965
REFERENCES
 Biostatistics – A foundation for Analysis in
the Health Sciences: Wayne W. Daniel,
Seventh Edition, Wiley Students Analysis.
 A First Course in Statistics with Application:
A.K. P. C Swain, Kalyani Publishers
 Methods in Biostatistics sixth edition : BK
Mahajan
 Fundamentals of Biostatistics : Sanjeev BS
 Rao KV. Biostatistics: A manual of statistical
methods for use in health, nutrition and
anthropology. 2nd ed. New Delhi: Jaypee
Brothers Medical Publisher (P) ltd; 2007.
PREVIOUS YEAR QUESTIONS

 Discuss the utilization of biostatistics in Public

health dentistry?(RGUHS 2006, 20 marks)

 Discuss the role of biostatistics in oral health

research ?(RGUHS 2011, 10 marks)

THANK
YOU