Nature of Biostatistics
Phase 0 laboratory,
I. Introduction
• Bio: life
• Statistics: deals with the collection, organization, analysis and
interpretation of numerical data. (This is the scientist’s bread-and-
butter because this is where they earn income and it is always use
in education to give more accurate data)
2 Important properties of the research
Validity: Yielded data are real numbers
Reliability: Significant of the result
A. Usage
• Public Health (Generalization or the community, More on control
and prevention)
– Used in planning, monitoring and evaluating
programs
– Used in determining vital and health statistics
• Vital statistics: number of births, deaths and marriages
(madadagdagan ng population), immigration and emigration
• Health statistics: morbidity data, hospital and clinic statistics,
service statistics
• Biology
– Determine the efficacy of a test substance as an alternative to
commercially available products (antibacterial (Antibacterial
resistance) (zone of inhibition test), antihypertensive, antilarva,
antihelminthes etc)
– Establish occurrence of microevolution in a specific area
– Determine the extent of speciation in a given area
– Establish correlation between phenotype and certain
environmental factors
• Medicine (clinical setup, in hospital, Outpatient, Diagnosis and
treatment)
– Establish correlation between a specific condition and certain
risk factors
– Determine the efficacy of certain tx/tx programs
B. Applications in Policy Making
1. Biostat is a tool needed in information-based decision-making
Primary investigator: Ikaw lang ang mag-cocontrol ng content
MDA: Mass Drug Administration
• Ex. Mass Administration of a drug/vaccine
• Is it as good as the standard tx? STH (soil-transmitted helminths
due to airborne of egg) Cyst or trophozoites
• Did it pass the 4 phases of clinical trials?
phase 1 for animal model, 2 for soldiers voluntary, 3 for small
community voluntary 4 several communities voluntary
• What are the adverse effects?
Informed consent – consent needed for parents with different side
effect and have an option to get out of the study. You must
translate or said it to the participant to clearly know what’s the
research about. African Sleeping Sickness, trypanosoma brucei.
Many side effect but must be good.
• Do the pros outweigh the cons?
2. Biostat techniques are used in the design and evaluation of
research projects
• Ex. Philippine Lymphatic Filariasis (LF) Elimination Project
(1998) 2 billion pesos. Compare the epidemiology before and after
Less than 1 out of 1000 are affected it means it is eliminated.
Failed in data dessimination and education program
• Design was based on LF programmes from
Western Africa
• Evaluation: will it achieve the targeted
Prevalence rate before 2020?
– 9.7%/1000 population
3. Biostat is used by health administrators/planners/workers in the
systematic collection of data from w/c health indicators can be
derived and used as tools for decision-making
– Problem identification (Mosquito bite, 4 genera of mosquito,
Culex, Aedes (Dengue), Anopheles (malaria), etc.) wrong
dissemination (nausea, after eating meal)
– Needs assessment
– Allocation of limited resources (What is more prevalent, more
children died in waterborne diseases)
– Program evaluation
C. Branches (1st sem – Descriptive, 2nd sem – inferential)
1. Descriptive statistics: summarizes and presents data in forms
that will make them easier to analyze and interpret.
Narrative – Kung konti nakuha mong data, Tabular – kapag
marami nakuha mong data, Graphs – comparing population
Example
 Central tendencies
 Prevalences (quartile etc.)
 Variance and standard variation
2. Inferential statistics: refers to methods involved in order to make
generalizations and conclusions about a target population based on
results from a sample population.
Target population or population and sample: Inferential: sample
population, prevalence HIV
a. Estimation of parameters
Parameters: properties of your target population
b. Testing of hypothesis
D. The Phenomenon of Variation
• Variation- refers to the tendency of a measurable characteristic to
change from one individual or one setting to another, or from one
instant of time to another instant within the same individual or
setting
E. Types of Data
• Biostatistics deals with both qualitative and quantitative data
Constants- a phenomenon whose value remains the same from
person to person, from time to time or from place to place
Ex: 1hr=60mins 𝜌=3.14159 1dozen=12pcs
Variable- a phenomenon whose values or categories cannot be
predicted w/ certainty
Ex: Infection status, Parasitaemia, Length of gestation,
Weight/Height Educational attainment
F. Types of Variables
1. Qualitative: categories are used as labels to distinguish one
group fr. another. One group is not better than the other.
Ex: Sex (presence of Y chromosome), Urban/rural, Religion,
Region, Disease status.
2. Quantitative: categories can be measured and ordered according
to quantity/amount
Categories can be expressed numerically
Ex: Population size Birthweight Number of hospital beds
2. Quantitative
Subtypes:
a. Discrete- can only assume integral values
E.g., household size, hospital capacity, parasitaemia (number of
parasites per ml of blood)
b. Continuous- includes fractions and decimals
E.g., birthweight, arm circumference, age
Some variables are always qualitative in nature
E.g., sex, occupation, disease status
Some variables can be measured qualitatively
or quantitively
in rounding of age, 9 years and 363 days, 9 years
E.g., height: measured in cm or categorized as
short, medium, tall
G. Types of Variables According to Scale of Measurement
1. Nominal
Gr. Nomos = name
Qualitative
E.g., gender, sex, disease status, immune status
2. Ordinal
Variables that can be ranked/ordered
Can be qualitative or quantitative
Ex. Severity of disease, Intensity of infection (number of eggs)
3. Interval
Exact distance between categories can be measured
but 0 is arbitrary (0 doesn’t necessarily mean zero) like
temperature, or location, or longitude
4. Ratio
Exact distance between categories can be measured
0 is fixed (weight, height) (For applied science)
“What is the purpose of classifying variables?”
To know what to use for the tool or methodology for the research.
Linear Regression - Quantitative
Logistic, Chi-Square – Qualitative
Quantitative Discrete (1 variable) – Bar graph (with spaces)
Quantitative Continuous (1 variable) – Histogram
Time elements – Line graph
2 variables for correlation – Scatterplot
Data collection
I. Categories of Data According to Sources
A. Primary
• Data obtained by the investigator
• Advantage:
• investigator can control the quality of data, the design of your
study is tailor-fitted to your objectives.
• Disadvantage: - Data collector and subjects give them reward or monetary reward

• more time consuming and more expensive

B. Secondary (Meta-analysis, Record’s review) (by other C. Questionnaires

investigators)
• If an interview is not possible, questionnaires can be given to the
• Existing data obtained by other people for the purposes not respondents
necessarily those of the investigator’s
• Instruments: Questionnaire
• Advantages:
• Advantages:
• Pre-collected data
• Less expensive
• Cheaper
• Timesaving (simultaneous, 50 subjects)
• less tedious
• Disadvantages:
• Timesaving
• Lower yield of respondents
Disadvantages (the quality will suffer)(past collector has different
objectives) such as for description purposes. - 1-2 pages must be done and not 4-5 pages

• The user has no control how the data were collected (what if not - Itapon mga answer
well-trained data collector)
- data is bad, sample size must be doubled
Trophozoites, cyst and pseudoparasite because not well-trained
III. Qualities of Statistical Data (Validity and Reliability)
• Problems in timeliness (20 years ago or 10 years ago)
A. Timeliness (Be ready for assholes)
• Problems in confidentiality (STD, do not release for hospital)
(Primary source) • Interval between the date of occurrence of the different events
considered and the time the data is ready to be used or
• The objectives behind the collected data differ from those of the disseminated
researcher
• Reasons for delay:
• The definition of terms may differ from the researcher
• Numerous forms that need to be filled-up and filed
Amoebiasis – parasite is present, change physiology of the host
• Difficulty in completing sample size (high sample size)
Definition of amoebiasis – parasite present and acidic diarrhea
• Problem in transportation and communication
Basic – viral or bacterial diarrhea
• Bureaucracy
II. Methods of Data Collection
• Accomplishment of too many permits
A. Physical observations (using senses for collecting data)
• Lack of funds, manpower etc.
• Investigator may directly or indirectly (hiring research assistant)
(i.e. thru Ras/trained data collectors) observe the sample B. Completeness
population/experimental subjects
• 2 components:
• Instruments:
• Completeness of coverage 99/100 = incomplete, 6 districts
• Cameras, Recorders, Laboratory apparatus, Diagnostic kits must have 6 districts people, High school student = hindi nag-
aaral or lagay sa scope and limitation
B. Interview
• “Do the data cover the entire geographic area and target
• One on one interaction between the subject and the investigator population within the area of interest?”
(High response rate and lower rate of lying) (low temptation of
lying) • Completeness in accomplishing all the items in every form

• Conducted if some variables (e.g. subjects’ opinions/feelings) are • Incomplete questionnaires

not amenable to observation
C. Accuracy = Validity of the research
• Answers should be written verbatim (word for word)
External validity – data collected from the sample description can
• Instruments: be extrapolated from the target population

• Interview schedule Internal validity – Research has biases, Free from confounding,
low natural errors.
 • Key to attaining relevance

• Having well-defined objectives for data collection

Researches Bias – can be controlled by blinding • There should be constant communication between data producers
and data
Single Blinding – treatment didn’t know the medication
Users
Double blinding – data collector didn’t know the medication
F. Adequacy (Enough data to answer all of the objectives)
Triple blinding – data processor/epidemiologist/statistician didn’t
know it. • “Do the collected data provide all the basic information needed to
meet the requirements of the user?”
Natural error – innate in research, it’s always present
Steps in Planning and Conducting Research
How to control natural error: You increase the sample size

Confounders can be controlled after data collection

Another way to improve accuracy: Probability sampling – all the
population has the opportunity to become one
Non-Probability
Purposive sampling – it is a bias sampling such as barangay.
Conveniences. Classmates
Quota sampling – 100 people, it’s fine na
• Refers to how close the measurement or the data is to its true
value
Research
• Systematic (we follow the scientific method)), objective (must
know the outcome even failed)
Researcher’s Bias: Negative and not will publish or manipulate
and reproducible activity
• Systematic: follows the scientific method of inquiry
• Objective: conclusions based on empirical evidence
• Reproducible: repeatable

• “Do data reflect the true situation?” - Do what you love

Improve your research design Steps in Conducting Research

2 Types of Research I. Identify the problem/topic

1. Experimental A. Selection of topic

2. Observational B. Formulation of objectives

 Cross Sectional – sample population without II. Review of related literature

classifying the exposure and outcome status
(simultaneous), you cannot establish causation, only III. Statement of the problem
correlation)
 Case Control – Retroactive, based on their outcome IV. Formulating testable
(who’s positive or not) after that they’ll talk about the
hypothesis
exposure variable
 Cohort – Most valid, sampling population and divided V. Research design
it in their exposure status (expose and non-expose).
Effect of smoking to cervical cancer; After 20 years, VI. Tools for data collection
Causal. Losses to follow up. Funding.
VII. Plan for data analysis
Exposure variable = Independent variable
VIII.Data collection
Outcome variable = dependent variable
IX. Data processing
D. Precision/Consistency = Reliability = Repeatability
X. Data analysis
• Refers to the extent to which similar information is obtained
when a measurement is performed or an observation is made more XI. Written report
than once (different population and comparable in result) (quality
setting) XII. Dissemination

E. Relevance XIII. Utilization

• Consistency of the data produced with the needs of the data users I. Identify the problem/topic
(fund of agency)(must be lower province or Manila only)
A. Selection of topic
1. Researcher characteristic (Topic Interest, you will pick what is
your topic) and pick an adviser
a. Personal interest and inclination
b. Training
c. Previous experience (OJT so it will have normal experience)
Bureau of Plants
2. Nature of topic to be investigated
a. Timeliness (must not be outdated)
b. Relevance (Topics that the academe wanted) (magbasa ng
papers of journals) (8 am – 12 noon)
c. Duplication (must not be redundant)
d. Applicability or practical value of results (Do you have an
outcome?) (Dapat may pondo)
e. Cost-effectiveness (Molecular characteristics of Narra)
3. Feasibility (will not graduate on time because of research due to
their feasibility)
a. Availability of subjects/test organisms
b. Availability of special equipment
c. Necessity for special working conditions (sterile environment,
every day with UV light)
d. Degree of sponsorship or administrative cooperation required
e. Hazards, handicaps to be encountered
f. Time requirements or duration of the project
g. Availability of research funds
B. Formulation of research objectives (the Why)
• The objectives should reflect the questions whose answers the
investigator wants the study to yield
- Used as guides in specifying the variables of the study
Ex.
 To determine the relationship between music genre and
pulse rate
 What is the relationship between music genre and pulse
rate?
* Categories of research objectives
General objective- generic statement w/c describes in broad terms
what the study wishes to accomplish, (use layman terminology)
Ex:
• To determine the antimicrobial potential of Mangifera indica
(mango) leaf extract
• To determine the risk factors associated with Entamoeba
histolytica infection
• To determine the antihelminthic potential of Tabernaemontana
pandacaqui bark extract
• Specific objectives (Most substantial form, most simple form
possible and measurable)
 Limit it like using methanolic extract only
 Bacteria: Gram positive, Gram negative, fungal species
 Loophole is bad
Example: To identify the gastrointestinal parasite present in fishes.
(This is wrong)
• Identify in detail and in measurable terms the aims of the
research
• Breaks down what needs to be accomplished into smaller logical
components
• Indicators that will make the objectives measurable should be
included here
General: To determine the antimicrobial potential of Mangifera
indica leaf extract
• To determine which of the following concentrations, 25%, 50%,
75% and 100% of the aqueous leaf
extract will exhibit the largest zone of inhibition against
Staphylococcus aureus, Escherichia coli and Candida albicans
• To determine which among the aqueous, methanolic or ethanolic
leaf extract will produce the largest zone of inhibition against
Staphylococcus aureus, Escherichia coli and Candida albicans
General: To determine the risk factors associated with Entamoeba
histolytica infection (Risk factors: Sex, Age, Occupation, Water
supply, Socio-economic status, Type of school)
Specific: To determine the correlation between type of water
source and EH infection among Barangay 123 (among grade
school student of Manila Elementary school in Barangay 686).
General: To determine the antihelminthic potential of
Tabernaemontana pandacaqui bark extract.
To determine the antihelminthic potential of pandacaqui
methanolic bark extract against Helicobacter using the L3 larva
assay.
* Notes on identifying specific objectives
1. Review theories and research related on the topic (Always check
recommendation)
2. Replicate earlier studies to verify the results
If ginawa sa 123, gawin nalang sa 124
• Ensure that the topic is not over-studied
3. Repeat past researches but with modifications (sample studies –
call centers -> factory workers)
Rapid Diagnostic Tests – Use it to other types of infection
Rapid diagnostic tests (RDTs) are a type of point-of-care
diagnostic, meaning that these assays are intended to provide
diagnostic results conveniently and immediately to the patient
while still at the health facility, screening site, or other health care
provider.
4. Methods used in one area can be applied into other related areas.
3. Characteristics of research objectives
a. Objectives should be phrased clearly, unambiguously and
specifically
b. Objectives should be stated in measurable and operational terms
Ex:
•To determine effect of poverty (Household income, socio-
economic status) on the rate (prevalence- over population size,
incident-specific time period over person time (hours of at risk of
exposure to patient)) of sth infection
II. Review of related literature
Significance
• To know current state of knowledge re selected topic
• To identify gaps in knowledge
• To integrate and criticize other related studies
Note the ff when writing the rrl
• Who have done work on the research topic being planned
• Research design utilized
• Study results
- 56 students are low, public and private must-have
• Problems encountered during research
 How the problems were resolved
III. Statement of the problem (refinement or tuning of your specific
objectives)
• Involves defining the actual problem for investigation in clear
specific terms
• Purpose
• Further refinement of objectives
• Narrows the scope of the study
• Restricts and limits the coverage of the study
Research algorithm – flowchart (For experimental)
Research Paradigm – Theoretical and not experimental
Ex
• Gen Obj: To determine the morbidity of sth among children
• Spc Obj: To determine the specific prevalence rates of sth among
pre-school and grade school children in Intramuros.
• Statement of the problem: To determine the specific prevalence
rates of Ascaris lumbricoides, Trichuris trichiura and hookworm
infection among the 3-6 and 7-12-year-old residents of Brgy 654,
Intramuros, Manila
IV. Formulate testable hypothesis and define basic concepts and
variables
• Hypothesis: assertion/proposition about the relationship between
two or more variables (Must be parallel to the objectives)
Number of specific objectives = Number of hypothesis and Parallel
• Each specific objective should have its own hypothesis
• Each hypothesis should be expressed clearly
• Hypothesis should be expressed in observable and
measurable terms w/c would allow objective evaluation
Categories of variables (test statistics)
1. Independent variable: presumed to cause, influence or simulate
the outcome (Xs, X-axis)
• AKA exposure variable, cause, risk factor
2. Dependent variable: refers to the output, the outcome or
response variable, disease
3. Control variable: a variable that may influence the result of the
study.
Covariate -Randomize study location and increase sample size
Exposure and Outcome
• May interfere with the interaction between the IV and DV
• Thus, needs to be controlled, held constant or randomized to
neutralize/cancel out the effect
3. Control variable
• Can be a covariate or a confounder
• Covariate- characteristic of the population that may be related to
the outcome
• May or may not be associated with the DV
• Confounder- characteristic of the population that may interfere
with the interaction between the IV and DV
• Associated with both the IV and the DV
Sex and malaria – Sex (independent/Exposure), Malaria
(Dependent/Outcome), Occupation (Confounder).
Covariate – associated with the outcome variable.
Confounder – associated with the exposure and the outcome
variable.
Examples
• Prevalence of Trichomonas vaginalis infection among 16-66 yo
women
Age (Exposure), diseases status/Infection status (Outcome),
Number of sex numbers, frequency of intercourse, location (mas
adventurous), Urban/Rural area (Covariate)
• Antihelminthic potential of Tabernaemontana pandacaqui
aqueous
- methanolic and ethanolic leaf extracts against the L3 of
Caenorhabditis elegans, E= type of extract (methanolic etc.) O=
L3 or mortality rate of the larvae C= Area where your leaf get.
• Sex as a risk factor for malaria
• The effect of exercise on colon cancer
E= Level of exercise/activity O= disease status C= Weight, age
• Diabetes as a risk factor for dementia
E= Diabetes (type 1 or type 2) O= Dementia C= Age
Research Design (90% of your methodology)
• Represents the strategy of the researcher in answering the
objectives of the study
• Should be based on:
• The objectives
• Feasibility
• Ethics (Getting all permits – Invasive or non-invasive, benefits,
objectives, risk, compensation, in local dialect, English – para sa
institution)
• Economy and efficiency (Time-frame)
Components:
• Sampling method (probability sampling and what type? and non-
probability, why would you pick this?)
• Sample size (Formula) N=56 Can be used, It will depend on your
indicator. Mean? Proportion? Percentage? Different proportion?
If sample size, you can use other paper for it.
• Strategies for controlling and manipulating relevant variables
• Evaluation criteria for outcome instrumentation (Questionnaires,
Translated, and tested)
Research Design
- The research design should be able to ensure the external
(represent your target (and internal validity (biases) of the research
and control confounder
External validity – Sample population = good representation of the
target population.
Internal validity – Real relationship or the accurate relationship
between your Independent and dependent variable
-> To determine how close your acquired value from the real value
If Correlation study = Interaction between E (Independent) and O
(Dependent) variable
How to know? Eliminate 3 variable
1. Bias – systematic error committed by the researcher. (Non-
probability or sample size is small) (Blindings)
2. Natural Error – Explanation due to chance; to decrease this,
increase the sample size, Alpha of your study, allowable error.
3. Effect of Confounder
Design the tools for data collection
• Can be based on related studies or can be designed by
the investigator
• Ex: interview schedule, questionnaire, experimental set-up
VII. Design the plan for data analysis
• Dummy tables- skeleton tables drawn to help conceptualize how
the data will be organized and presented (To ensure that all of your
objectives will be answered) No dummy table = Kulang sa data
(what if di nagawa sa raining season). To prevent it, construct
dummy table but the E and O variable is plotted. Prevalence during
July – August, Prevalence during Oct-Nov. Test for different
proportion.
VIII Data collection (methodology must be good)
• Most expensive and most time-consuming phase of the research
project
• Problems/handicaps depend on how well steps 1-7 are executed
• If research involves human subjects, the community must be well
oriented before data collection.
Invasive – Pagkuha ng dugo ; Non-invasive – Stool collection.
IX. Data Processing (Data editing)
- Encoding the data
Data editing – Questionnaire kapag di nasagutan, alisin
Data doctoring – Papalitan mo yung sagot para mastisfy neto. If
negative result, do not doctor.
Legibility of entries – discarded from the start.
Cause of death – Cervical cancer and Procorpio
• Raw data is transformed into information
• Where data is edited and responses/observations are coded
• Editing: investigator checks the data collection tool for:
• completeness,
• legibility of entries
• Consistency of responses
• Purpose: facilitate data analysis and interpretation
X. Data Analysis (What would be the statistical test available)
- Parametric (ANOVA, P-Test or T-test. If probability sampling or
normal distribution, Equal distribution of variance,) and Non-
Parametric (non Probability)
• Involves quantification, description and classification of data the Exposure variable) EMM – you don’t have to correct but
explain.
• Researcher must know the basic concepts, procedures and
limitations of each statistical test (Decision tree)

XI. Write the research report Is there an assoc between variable and outcome?

• 3 copies of your written report (overall and separately among exposed and unexposed)

- Investigator is required to submit a report of all research-related If Yes: Is there an assoc between variable and exposure (Must not
activities he’s done and his findings be biological)

XII. Result dissemination (You have to contribute to the pool of No: Variable is not a confounder
knowledge)
If yes (2): Variable is a confounder
• Via scientific journals, scientific fora
No: Variable is not a confounder
• Beware of predatory conferences/publishers (maniningil lang ng
convention fee and certificate) https://beallslist.weebly.com/

XIII. Result utilization (Based on number of citations)

The best way to determine value of a research is through the extent

to w/c the results are utilized

• Baseline study results= used in determining the effects of an Noncausal

intervention

• Needs assessment study results= “””“ design for interventions Causal, unidirectional
• Clinical trials/experimental study results= “”” recommendations but not sure.
for most

effective Tx
Causal,
Confounding unidirectional
Internal Validity: association between exposure and outcome is
true if the study rules out the 3 alternative explanations Odd’s Ratio = odds of the cases to be exposed over the odds of the
controls being exposed (unexposed group)
 Bias- systematic error in the investigator’s design or
conduct of the study that leads to false assoc. between AD/CB
exposure and outcome
 Random error- probability that the observed result is Epidemiology – Case can be also called “deceased”
due to chance (Increase sample size to minimize
random error) - Control (non-deceased)
 Confounding
Criterion (3)
Confounding: third/extraneous/nuisance variable that distorts the
 The confounder is not an intermediate variable in the
relationship between exposure and outcome
causal pathway between exposure and outcome
 Can be an independent risk factor for the outcome  The variable should not be affected by exposure or
outcome, although it may affect exposure or outcome
Covariance (Other risk factors that you’re not interested in), EMM
(Effect measure modifier -, you cannot be corrected, only Sex and Malaria – EMM (Chromosomes of Y)
explained) diseased
Malaria and Occupation – 5.31 Odd’s Ratio (531% higher)
Criteria
Protective – Anemia (negative or lower than 1)
1. The variable is causally associated w/ the outcome
III. Identifying Confounders (If you know the Confounder)
2. The variable is causally or noncausally associated with the
1. Strength/Magnitude of association Less than 5% - huwag
exposure (double-headed), Tumilaok manok, walang sun pero
galawin
baliktad

3. The variable is not an intermediate step in the causal pathway

between exposure and outcome (It shouldn’t be a substep if not
biological or physical in nature interaction) (if you’re c precedes
 = Underestimate the interaction to the exposure and outcome

Adjusted for L. loa parasitaemia OR A = 5x more severe

(Qualitative confounding) Opposite

= exposed to protective factor (1.78 – first world) (adjusted: lower

than 0.72 (lower than 28%) )

S= Substeps (EMM)

Orc = Confounding

ORa = Adjusted

There is a confounder if the association seen across the strata are of

similar magnitude but different from the crude estimate.

2. Direction of Confounding

 Confounding pulls the observed association away from

true association
 It exaggerates true association (Positive Confounding)
OR u > OR A

2. Direction of Confounding

 It hides true association (Negative Confounding) OR u

< OR A
 O. volvulus patients taking Ivermectin VS Severe
Adverse Effect OR u = 1
 Adjusted for L. loa parasitaemia OR A = 5

2. Direction of Confounding It inverses the direction of the

association (Qualitative Confounding)

a 1+ d 1 a 2+d 2
+
n1 n2
b 1+ c 1 b 2+c 2
+
n1 n2
(Positive Confounding) OR u > OR A

= The confounder actually exaggerates the relationship between

the exposure and outcome (Unadjusted is bigger)

(Negative confounding) OR u < OR A