Sampling and Sample Size Calculation: Lazereto de Mahón, Menorca, Spain September 2006

Sampling and Sample Size
Calculation
Lazereto de Mahón, Menorca,
Spain
September 2006
Sources:
-EPIET Introductory course,
Thomas Grein, Denis Coulombier, Philippe Sudre, Mike Catchpole, Denise Antona
-IDEA
Brigitte Helynck, Philippe Malfait, Institut de veille sanitaire
Modified: Viviane Bremer, EPIET 2004, Suzanne Cotter 2005,

Richard Pebody 2006
Objectives: sampling
• To understand:
• Why we use sampling
• Definitions in sampling
• Sampling errors
• Main methods of sampling
• Sample size calculation
Why do we use sampling?
Get information from large populations with:

– Reduced costs
– Reduced field time
– Increased accuracy
– Enhanced methods
Definition of sampling
Procedure by which some members

of a given population are selected as
representatives of the entire population
Definition of sampling terms
Sampling unit (element)

• Subject under observation on which
information is collected
– Example: children <5 years, hospital discharges,
health events…
Sampling fraction
• Ratio between sample size and population
size
– Example: 100 out of 2000 (5%)
Definition of sampling terms
Sampling frame
• List of all the sampling units from which
sample is drawn
– Lists: e.g. children < 5 years of age, households,
health care units…
Sampling scheme
• Method of selecting sampling units from
sampling frame
– Randomly, convenience sample…
Survey errors
• Systematic error (or bias)

Sample not typical of population
– Inaccurate response (information bias)
– Selection bias
• Sampling error (random error)

Representativeness (validity)
A sample should accurately reflect distribution of
relevant variable in population
• Person e.g. age, sex

• Place e.g. urban vs. rural
• Time e.g. seasonality
Representativeness essential to generalise
Ensure representativeness before starting,
Confirm once completed

Sampling and representativeness
Sampling
Population
Sample
Target Population
Target Population  Sampling Population  Sample

Sampling error
• Random difference between sample and
population from which sample drawn
• Size of error can be measured in probability
samples
• Expressed as “standard error”
– of mean, proportion…
• Standard error (or precision) depends upon:
– Size of the sample
– Distribution of character of interest in population
Sampling error
When simple random sample of size ‘n’ is selected
from population of size N, standard error (s) for
population mean or proportion is:

σ p(1-p)
n n
Used to calculate, 95% confidence intervals
X Z
Estimated 95%
confidence  2  s or X  2  s x
interval x
Quality of a sampling estimate
Precision No precision Precision but

& validity no validity
Random Systematic
error error (bias)
Survey errors: example
Measuring height:
179
• Measuring tape held differently by different
178
investigators
177
→ loss of precision
176
– Large standard error
175
• Tape shrunk/wrong
174
→ systematic error
173
– Bias (cannot be corrected afterwards)
Types of sampling
• Non-probability samples
• Probability samples
Non probability samples
• Convenience samples (ease of access)
• Snowball sampling (friend of friend….etc.)
• Purposive sampling (judgemental)

• You chose who you think should be in the study
Probability of being chosen is unknown

Cheaper- but unable to generalise, potential for bias
Probability samples
• Random sampling
– Each subject has a known probability of being
selected
• Allows application of statistical sampling
theory to results to:
– Generalise
– Test hypotheses
Methods used in probability samples
• Simple random sampling

• Systematic sampling
• Stratified sampling
• Multi-stage sampling
• Cluster sampling
Simple random sampling
• Principle
– Equal chance/probability of drawing each unit
• Procedure
– Take sampling population
– Need listing of all sampling units (“sampling frame”)
– Number all units
– Randomly draw units
• Advantages
– Simple
– Sampling error easily measured
• Disadvantages
– Need complete list of units
– Does not always achieve best representativeness
– Units may be scattered and poorly accessible
Example: evaluate the prevalence of tooth
decay among 1200 children attending a school
• List of children attending the school

• Children numerated from 1 to 1200
• Sample size = 100 children
• Random sampling of 100 numbers between 1
and 1200
How to randomly select?

EPITABLE: random number listing
EPITABLE: random number listing
Also possible in Excel

Systematic sampling
• Principle
– Select sample at regular intervals based on sampling
fraction
• Advantages
– Simple
– Sampling error easily measured
• Disadvantages
– Need complete list of units
– Periodicity
Systematic sampling
• N = 1200, and n = 60
 sampling fraction = 1200/60 = 20
• List persons from 1 to 1200
• Randomly select a number between 1 and 20

(ex : 8)
 1st person selected = the 8th on the list
 2nd person = 8 + 20 = the 28th etc .....
Systematic sampling
Stratified sampling
• Principle :
– Divide sampling frame into homogeneous
subgroups (strata) e.g. age-group, occupation;
– Draw random sample in each strata.

Stratified sampling
• Advantages
– Can acquire information about whole population and
individual strata
– Precision increased if variability within strata is less
(homogenous) than between strata
• Disadvantages
– Can be difficult to identify strata
– Loss of precision if small numbers in individual strata
• resolve by sampling proportionate to stratum population
Multiple stage sampling
Principle:
• consecutive sampling
• example :
sampling unit = household
– 1st stage: draw neighborhoods
– 2nd stage: draw buildings
– 3rd stage: draw households
Cluster sampling
• Principle
– Sample units not identified independently but in a
group (or “cluster”)
– Provides logistical advantage.

Cluster sampling
• Principle
– Whole population divided into groups e.g.
neighbourhoods
– Random sample taken of these groups (“clusters”)
– Within selected clusters, all units e.g. households

included (or random sample of these units)
Example: Cluster sampling
Section 1 Section 2
Section 3
Section 5
Section 4
Cluster sampling
• Advantages
– Simple as complete list of sampling units within population
not required
– Less travel/resources required
• Disadvantages
– Potential problem is that cluster members are more likely
to be alike, than those in another cluster (homogenous)….
– This “dependence” needs to be taken into account in the

sample size….and the analysis (“design effect”)
Selecting a sampling method
• Population to be studied
– Size/geographical distribution
– Heterogeneity with respect to variable
• Availability of list of sampling units
• Level of precision required
• Resources available
Sample size estimation
• Estimate number needed to

• reliably measure factor of interest
• detect significant association
• Trade-off between study size and resources….
• Sample size determined by various factors:
• significance level (“alpha”)
• power (“1-beta”)
• expected prevalence of factor of interest
Type 1 error
• The probability of finding a difference with our
sample compared to population, and there
really isn’t one….
• Known as the α (or “type 1 error”)
• Usually set at 5% (or 0.05)

Type 2 error
• The probability of not finding a difference that
actually exists between our sample compared
to the population…
• Known as the β (or “type 2 error”)
• Power is (1- β) and is usually 80%

A question?
Are the English more intelligent than the Dutch?
• H0 Null hypothesis: The English and Dutch

have the same mean IQ
• Ha Alternative hypothesis: The mean IQ of

the English is greater than the Dutch
Type 1 and 2 errors
Truth
Decision H0 true H0 false
Reject H0 Type I error Correct decision
Accept H0 Correct Type II error

decision
Power
• The easiest ways to increase power are to:
– increase sample size
– increase desired difference (or effect size)
– decrease significance level desired e.g. 10%

Steps in estimating sample size
for descriptive survey
• Identify major study variable
• Determine type of estimate (%, mean, ratio,...)
• Indicate expected frequency of factor of interest
• Decide on desired precision of the estimate
• Decide on acceptable risk that estimate will fall outside
its real population value
• Adjust for estimated design effect
• Adjust for expected response rate
Sample size for
descriptive survey
Simple random / systematic sampling
z² * p * q 1.96²*0.15*0.85
n = -------------- ---------------------- = 544
d² 0.03²
Cluster sampling
z² * p * q 2*1.96²*0.15*0.85
n = g* -------------- ------------------------ = 1088
d² 0.03²
z: alpha risk expressed in z-score

p: expected prevalence
q: 1 - p
d: absolute precision
g: design effect
Case-control sample size:
issues to consider
• Number of cases
• Number of controls per case
• Odds ratio worth detecting
• Proportion of exposed persons in source
population
• Desired level of significance (α)
• Power of the study (1-β)
– to detect at a statistically significant level a
particular odds ratio
Case-control:
STATCALC Sample size
Case-control:
Risk of alpha error 5%

Power 80%
Proportion of controls exposed 20%
OR to detect >2
Case-control:
Statistical Power of a
Case-Control Study
for different control-to-case ratios and odds ratios
(with 50 cases)
1
0.8
Power
0.6 OR=2
0.4 OR=4
OR=3
0.2
0
1 2 3 4 5 6 7 8 9 10
Control-Case Ratio
Conclusions
• Probability samples are the best
• Ensure
– Representativeness
– Precision
• …..within available constraints

Conclusions
• If in doubt…
Call a statistician !!!!

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Sampling and Sample Size

Modified: Viviane Bremer, EPIET 2004, Suzanne Cotter 2005,

Get information from large populations with:

Procedure by which some members

Sampling unit (element)

• Systematic error (or bias)

• Sampling error (random error)

• Person e.g. age, sex

Representativeness essential to generalise

Ensure representativeness before starting,

Confirm once completed

Target Population  Sampling Population  Sample

Used to calculate, 95% confidence intervals

Precision No precision Precision but

• Convenience samples (ease of access)

• Snowball sampling (friend of friend….etc.)

• Purposive sampling (judgemental)

Probability of being chosen is unknown

• Simple random sampling

• List of children attending the school

How to randomly select?

Also possible in Excel

• List persons from 1 to 1200

• Randomly select a number between 1 and 20

– Draw random sample in each strata.

– Provides logistical advantage.

– Random sample taken of these groups (“clusters”)

– Within selected clusters, all units e.g. households

– Less travel/resources required

– This “dependence” needs to be taken into account in the

• Estimate number needed to

• Known as the α (or “type 1 error”)

• Usually set at 5% (or 0.05)

• Known as the β (or “type 2 error”)

• Power is (1- β) and is usually 80%

• H0 Null hypothesis: The English and Dutch

• Ha Alternative hypothesis: The mean IQ of

Accept H0 Correct Type II error

– increase desired difference (or effect size)

– decrease significance level desired e.g. 10%

z: alpha risk expressed in z-score

Risk of alpha error 5%

• Probability samples are the best

• …..within available constraints

Call a statistician !!!!

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