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ABNORMALITY

Putri Eyanoer, MD.,Ms.Epi,Ph.D.

NUMERICAL NFORMATION
ALLOWS BETTER
CONFIRMATION
QUANTITATIVE
PREDICTION EXACT
PROBABILITIES
Symptomatic coronary disease
occur in 1 in 100 middle aged men
per year
Cigarettes smoking doubles ones
risk of dying at all ages
Extrogenos estrogens reduce the
risk of fractures from osteoporosis
by half

SCALE

CHARACTERISTIC

EXAMPLES

CATEGORICAL
Nominal

Occur in categories without any


inherent order

Race, religion, occupation

Ordinal

Posses some inherent


ordering/rank

Level of education, salary

Interval

Posses inherent ordering and the


interval between successive
values is equal

Temperature

Ratio

Similar to that of interval BUT


with existing absolute zero

Height, weight, age

NUMERICAL

HIGH

VALIDITY

LOW

FREQUENCY

RELIABILITY

HIGH

LOW

MEASUREMENT

VALIDITY
the degree to which the data measure what they
were intended to measure
the result of a measurement correspond to the true
state
accuracy

RELIABILITY
Reliability=the extent that repeated measurement of
a stable phenomenon by different people and
instrument, at different time/place get similar
results

INSTRUMENT
MEASUREMENT
OBSERVER
VARIATIONS
WITHIN
INDIVIDUALS
BIOLOGIC
AMONG
INDIVIDUALS

Number of Observations

Monitored fetal heart


rate 130-150

Monitored fetal heart


rate < 130

Monitored fetal heart


rate >150

-50

40 30 20 10
UNDERESTIMATE

10

20 30 40 50+
OVERESTIMATE

400 -

300 200 DAY 1


DAY 3

100 -

DAY 2

0NOON

6 PM

MIDNIGHT

6 AM

SOURCE OF
VARIATIONS
MEASURE
MENTS

CONDITION OF MEASUREMENTS

DISTRIBUTIONS

1 patients, 1 observer, repeated


observation at one point in time
1 patient, many observers, at one time

BIOLOGIC
and
MEASURE
MENT

1 patient, 1 observer at many times of


the day
Many patients

DIASTOLIC BP (mmHg)

BLINDED :
SINGLE
DOUBLE
TRIPLE

CALIBERATED
INSTRUMENTS

ASSOCIATED
WITH DISEASE

TREATABLE

ASSESING NORMALITY

Based in statistical theory and has no necessary relationship to natural distribution

KURTOSIS

SKEWNESS

+3s

+2s

-s

68%
95%
99%
www.psychlotron.org.uk

+s

+2s

+3s

Based in statistical theory and has no necessary relationship to natural distribution

Average IQ in the
population is 100pts.

frequency

The further from 100


you look, the fewer
people you find

70
www.psychlotron.org.uk

100
IQ Scores

130

Many statistical methods require that the


numeric variables we are working with have
an approximate normal distribution.

For example, t-tests, F-tests, and


Standardized
regression analyses all require
in some
normal distribution
sense that the numeric variables
are rule
with empirical
percentages.
approximately normally distributed.

Histogram and Boxplot


Normal Quantile Plot
(also called Normal Probability Plot)
Goodness of Fit Tests
Shapiro-Wilk Test (JMP)
Kolmogorov-Smirnov Test (SPSS)
Anderson-Darling Test (MINITAB)

The cholesterol levels of the


patients appear to be
approximately normal,
although there is some
evidence of right skewness
as the mean is larger than
the median.
The red curve represents a
normal distribution fit to
these data and the blue
curve the density estimate
for these data, these curves
should agree if our data is
normally distributed.

The systolic volumes of the


male heart patients in this
study suggest that they come
from a right skewed
population distribution.
Outliers are not
consistent with
normality.

The red curve represents a


normal distribution fit to these
data and the blue is the
estimated density from the
data which does not agree with
the imposed normal.

Ho: The distribution of systolic volume


is normal
HA: The distribution of systolic volume
is NOT normal

Because p < .0001 we have


strong evidence against
normality for the systolic
volume population
distribution using the
Shapiro-Wilk test.

Ho: The distribution of systolic volume


is normal
HA: The distribution of systolic volume
is NOT normal
We do not have evidence at
the = .05 level against the
normality of the population
systolic volume distribution
when using the KolmogorovSmirnov test from SPSS.

Ho: The distribution of cholesterol level


is normal
HA: The distribution of cholesterol level
is NOT normal

We have no evidence
against the normality of
the population
distribution of
cholesterol levels for
male heart patients (p =
.2184).