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University of Gondar

College of medicine and health science


Department of Epidemiology and Biostatistics

Basic Biostatistics for Medical Laboratory students


By : Tesfa S. (BSc.- Public Health, MPH- Biostatistics)
E-mail: tesfasewunet23@gmail.com

03/09/2021 Tesfa S. 1
Course Outline

Chapter one: Introduction

Definitions of terms

Variable types

Scales of measurement

Sources of data

Methods of data collection

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Course Outline

Chapter two: Organization and presentations of Data

Tabular presentation

Graphical presentation

Chapter three: summarization of Data

Measures of Central Tendency

Measures of Spread

Measures of Position

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Course Outline

Chapter Four: Probability and Probability distributions

Definitions

Rules: addition and multiplication

Random variables

Common probability distributions

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Course Outline

Chapter Five: Sampling technique and sample size

Definitions terms

Sampling techniques

Sample size, power, and precision

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Course Outline

Chapter six: Statistical Inference

sampling distribution 

probability and its role in decision making 

normal distribution, z-scores, t-scores, χ2-scores

confidence intervals

hypothesis testing

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Course Outline

Chapter Seven: Demography and Health Service Statistics

Definitions of terms/concepts in demography

Measures of mortality

Measures of fertility

Measures of population projection, census

Hospital indices

03/09/2021 Tesfa S. 7
What is expected from you

 100% attendance

Active participation

Feedback towards lecturing method

Submission of assignment on time

Punctuality

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Assessment criteria

Continuous assessment =50%

Quiz1 – 5%

Mid exam – 25%

Quiz2 -5%

Individual assignments– 15%

Final Written exam =50%

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Reference

1. Getu Degu , Fasil Tessema :Biostatistics lecture note for health


sciences, University of Gondar, January 2005

2. Bland, Martin: Introduction to Medical Statistics, An, 3rd Edition,


St George's Hospital Medical School, London

3. Wayne W. Daniel: A Foundation for Analysis in the Health Sciences


8th edition, George State University

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Chapter-one
Introduction to Biostatistics

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Objectives

At the end of this chapter ,the student should be able to


Define Statistics /Biostatistics
Identify the types of statistics/Biostatistics
Identify the type of a variable
Describes and illustrate the scales of measurement
Identify source of data
Describe the different methods of data collection

03/09/2021 Tesfa S. 12
Definitions of statistics/ biostatistics

Statistics Biostatistics
 The application of
 It is the science of statistical methods to the
 collecting, fields of biological and
health sciences.
 organizing,
 When the data are derived
 Presenting,
from biological science
 Analysing, and medicine
 Interpretation and
 Drawing conclusion
(inferences) from data

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Rationale for studying Biostatistics

Facts are now measured quantitatively in medicine and public


health.

The planning, conduct, and interpretation of much of medical/public


health research are becoming increasingly reliant on statistical
technology. E.g.;

Is the new drug better than the commonly used one? How much
better?

Which group of the population is more affected by Goiter? Etc.

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Limitation of statistics

It deals on aggregates of facts : no importance to individual


items

Statistical data are only approximately : not mathematically


correct

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Types of statistics

Biostatistics

Descriptive Inferential

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Types of statistics
 Descriptive statistics
 summarize and organize numerical
information or data in to meaningful forms
 Helps to identify the general features and
trends in a set of data
 by using table, graphs ,measure of central
tendency, and measure of dispersion

03/09/2021 Tesfa S. 17
Types of statistics
 Inferential statistics
 It is a set of methods used to make conclusions
(inference) from sample data to population
 Statistical summaries which are common in
inferential statistics:
 Principles of probability,
 estimation and confidence interval,
 hypothesis testing, etc.

03/09/2021 Tesfa S. 18
Types of statistics
 Inferential statistics
 Produce statistical inferences about a population based on
information from a samples taken from the population

samp populati
le on

03/09/2021 Tesfa S. 19
Basic Terms in statistics
 Population: complete collection of all elements
(scores, people, measurements, and so on to be studied.
 Sampling: is the technique of selecting
representative portion of the entire population
 Sample: A subset of the population selecting by
sampling techniques
 Census: is the collection of data from every
member of the population.

03/09/2021 Tesfa S. 20
Basic Terms in statistics

• Parameter: a descriptive measure computed from the data of a
 
population.
 Represented by Greek letters
 population mean(μ),population standard deviation (δ)
Statistic: a descriptive measure computed from the data of a
sample.
Represented by Roman letters
sample mean ( ), mode , median, SD(S), Variance, etc.
Data: are observations (measurements) that have been
collected.
It is the raw material for statistics.
03/09/2021 Tesfa S. 21
Variable
A characteristic which takes different values in different
persons, places, or things.
 Any aspect of an individual or object that is measured (e.g.,
BP) or recorded (e.g., age, sex) and takes any value.
 Variables can be broadly classified into:
 Categorical or Qualitative and

 Quantitative or numerical variables.

03/09/2021 Tesfa S. 22
Types of variable
 Qualitative variable
 a variable or characteristic which can not be
measured or expressed in numerical form
 but can only be sorted by name or categories
 The notion of magnitude is absent or implicit.

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Types of variable
 Quantitative variable
 A variable that can be measured and
expressed numerically.
 Height, weight, # of children, etc.
 Has the notion of magnitude.
 This data can be continuous or discrete.

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 Discrete: It can only have a limited number of
values.
 Characterized by gaps or interruptions in the values
 the values aren’t just labels, but are actual
measurable quantities.
 Can assume only whole numbers
• Examples
– # of bacterial colonies on a plate
– # of accidents in a time period
– # of malaria relapse in a time period

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 2. Continuous variable: It can have an infinite number
of possible values
 Can take any value within a defined range
 Does not possess the gaps or interruptions

• Examples – blood pressure, height, weight, time;

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Types of variables

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Types of variables
Variables based on research can be classified
 Dependent Variable: variables which can be affected by
explanatory variable and it is the outcome of a study.
 Independent variables: are any variables that explain the
response variable.
 Confounding variables : Variable that systematically
varies with Independent Variable

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Example
1. In a study to determine whether surgery or
chemotherapy results in higher survival rates
for a certain type of cancer,
Which is the explanatory variable and which
is the response variable?

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Scales of measurement

 All measurements are not the same.


 Measuring weight = eg. 40kg
 Measuring the status of a patient on scale =
“improved”, “stable”, “not improved”.
 There are four types of scales of
measurement.

03/09/2021 Tesfa S. 30
1. Nominal scale:
 The simplest type of data, in which the values fall
into unordered categories
 Uses names, labels, or symbols to assign each
measurement.
– Examples: Blood type, sex, race, marital status,
etc.
 The mode is the only appropriate measure of
central tendency
 The obvious descriptive summary measure is the
proportion or percentage

03/09/2021 Tesfa S. 31
2. Ordinal scale:
 Assigns each measurement to one of a limited
number of categories that are ranked in terms of
order.
 They have a natural ordering
 medians, quartiles and percentiles are the most
appropriate measures of centre and spread
E.g.: Patient status, cancer stages, Likert scales etc.

03/09/2021 Tesfa S. 32
3. Interval scale:
 Measured on a continuum and differences between
any two numbers on a scale are of known size.
Example: Temp. in oC on 4 consecutive days
Days: A B C D
Temp. oc: 45 50 55 60
For these data, not only is day A with 45o cooler than
day D with 60o, but is 10o cooler.
 It has no true zero point. “0” is arbitrarily chosen and
doesn’t reflect the absence of temp.

03/09/2021 Tesfa S. 33
4. Ratio scale:
 Measurement begins at a true zero point
- Examples: Height, age, weight, BP, etc.
 Note on meaningfulness of “ratio”
 A 80 kg is two times as heavy as someone who
weighs 40 kg.
 This is true even if weight had been measured
in other measurements.
 For interval or ratio data, the mean and
standard deviation are appropriate methods
of summarization

03/09/2021 Tesfa S. 34
03/09/2021 Tesfa S. 35
Scales of measurement

 Nominal = Naming
 Ordinal = Naming + Order
 Interval = Naming + Order + Equal Intervals
 Ratio = Naming + Order + Equal Intervals +
True Zero

03/09/2021 Tesfa S. 36
Degree of precision in measuring Nomin
al

Ordinal

Interval

Ratio

03/09/2021 Tesfa S. 37
Exercise:- Consider the following
Scales of measurement (types of data)
1. Blood group
2. Temperature (Celsius)
3. Sex
4. Job satisfaction index (1-5)
5. Number of heart attacks
6. Calendar year
7. Serum uric acid (mg/100ml)
8. Number of cases of each reportable disease reported by a
health worker
9. The average weight gain of 6 1-year old dogs with a special
diet supplement was 950 grams last month.
10. Injury severity (a score between 1and 3 is allocated
depending on the severity) – scores 1 and 3 show mild and
very severe respectively.
03/09/2021 Tesfa S. 38
Source of Data

Source of data

Internal External
source source

Primary Secondary
source source

03/09/2021 Tesfa S. 39
Internal and External Source of Data

Internal Sources of Data External Sources of Data


 Many institutions and o When information is
departments have collected form outside
information about their agencies, it is called
regular functions, for their external source of data.
own internal purpose. o Such type of data are
 When those information is
either Primary or
used in any survey, it’s
Secondary.
called Internal Source Of
Collection of Data.
o This type of information
 E.g.., Public health Institutes can be collected by Census
& Nursing association or Sampling method by
members etc. conducting surveys
03/09/2021 Tesfa S. 40
Primary Data
 Primary data are those which are collected
for the first time.
 It is real time data which are collected by
the researcher himself.
 This Data originated by the researcher
specifically to address the research problem

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Secondary Data
 Secondary data are those that have already
been collected by others.
 This Data collected for some purpose other
than the problem at hand.
 Secondary data may be available in the
published or unpublished form.
 When it is not possible to collect the data by
primary method, the investigator go for
Secondary method.

03/09/2021 Tesfa S. 42
Difference between Primary and
Secondary Data
Primary Data Secondary Data
• Real time data. • Past data.
• Sure about sources • Not sure about
of data. sources of data.
• Help to give • Refining the problem.
results/finding • Cheap and No time
• Costly and Time consuming process.
consuming process. • Can not know in data
• Avoid biasness of biasness or not
response data
• Less Flexible.
• More flexible.

03/09/2021 Tesfa S. 43
Data collection methods?

03/09/2021 Tesfa S. 44
Data collection methods
 Before any statistical work can be done data must
be collected.
 Data collection techniques allow us to
systematically collect data about our objects of
study
 Data collection is a crucial stage in the planning
and implementation of a study.
 In the collection of data we have to be systematic.
If data are collected haphazardly, it will be difficult
to answer our research questions in a conclusive
way.

03/09/2021 Tesfa S. 45
Data collection methods…

 The methods of data collection also depends on the


types information to be collected from the source.

 Quantitative
• Interview (Interview – administered /Self – administered)
• Observation

 Qualitative
• In-depth interview
• Focus Group Discussion (FGD)
• Observation

03/09/2021 Tesfa S. 46
1) Observation

 Observation is a technique that involves


systematically selecting, watching and recoding
behaviors of people or other phenomena

 It includes all methods from simple visual


observations to the use of high level machines
and measurements, sophisticated equipment or
facilities, such as radiographic, biochemical, X-ray
machines, microscope, clinical examinations, and
microbiological examinations.

03/09/2021 Tesfa S. 47
Observation…

 Advantages: Gives relatively more accurate data on


behavior and activities
 Disadvantages: Investigators or observer’s own
biases, prejudice, desires, and etc. and needs more
resources and skilled human power during the use of
high level machines.

03/09/2021 Tesfa S. 48
2. Interviewing

 It involves questioning of respondents,


either individually or as a group

 Answers can be recorded by writing


them down or by tape-recording the
responses, or by a combination of them.

 Interviews can be conducted with


varying degree of flexibility (high degree
of flexibility Vs low degree of flexibility)

03/09/2021 Tesfa S. 49
3. Interviewing cont’d…
A) High degree of flexibility /unstructured. :
 Usually used when studying sensitive issues or
when the researcher has little understanding of the
problem
 Is frequently applied in exploratory studies
 (e.g teenage pregnancy, sexual issue, criminal
issues
 It is often possible to come back to a topic
discussed earlier in a later stage of the interview

03/09/2021 Tesfa S. 50
3. Interviewing cont’d…

B) Low degree of flexibility / highly structured


interview.
 Useful when the researcher is relatively
knowledgeable about expected answers or
 when the number of respondents being
interviewed is relatively large

 Questionnaires may be used with a fixed list of


questions in a standard sequence, which have
mainly fixed or pre-categorized answers

03/09/2021 Tesfa S. 51
Interview Techniques
 Interviewer – administer questionnaire (either
face-to-face or telephone, or other electronic
media such as online internet)
 Suited for illiterate study subjects, complex
questions that need further clarifications and
non-private or non-sensitive issues
 Self – administer questionnaire (i.e. filled by the
study subjects themselves at spot or through
mails)
 suitable for literate study subjects, simple
questions and sensitive matters (e.g. sexual
issues, criminal activities,
03/09/2021 Tesfa S.
substance abuse) 52
Types of Questions

Open-ended questions
 Open-ended questions permit free responses
that should be recorded in the respondent’s own
words.
 The respondent is not given any possible answers to
choose from.
Such questions are useful to obtain information on:
 Facts with which the researcher is not very
familiar,
 Opinions, attitudes, and suggestions of
informants, or
 Sensitive issues.
03/09/2021 Tesfa S. 53
Closed Questions
 Closed questions offer a list of possible options or
answers from which the respondents must choose.
 When designing closed questions one should try
to:
 Offer a list of options that are exhaustive and
mutually exclusive

 Keep the number of options as few as possible.

 Closed questions are useful if the range of


possible responses is known.
03/09/2021 Tesfa S. 54
Closed Questions…

For example
Have you ever gone to the local village health
worker for treatment?
1. Yes
2. No
 Closed questions may also be used if one
does not want to waste the time of the
respondent and interviewer by obtaining
more information than one needs.

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Requirements of questions

 Must have face validity


 Must be clear and unambiguous
 Must not be offensive
 The questions should be fair

03/09/2021 Tesfa S. 56
Thank you

03/09/2021 Tesfa S. 57

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