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A comparison of parametric and non-parametric statistical tests

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DOI: 10.1136/bmj.h2053

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BMJ 2015;350:h2053 doi: 10.1136/bmj.h2053 (Published 17 April 2015) Page 1 of 2

Endgames

ENDGAMES

STATISTICAL QUESTION

A comparison of parametric and non-parametric

statistical tests
Philip Sedgwick reader in medical statistics and medical education
Institute for Medical and Biomedical Education, St George’s, University of London, London, UK

Researchers investigated the effectiveness of corticosteroids in
reducing respiratory disorders in infants born at 34-36 weeks’
gestation. A randomised placebo controlled trial was performed.
The intervention was treatment with betamethasone, 12 mg
intramuscularly daily for two consecutive days at 34-36 weeks
of pregnancy. Participants were 320 women at 34-36 weeks of
pregnancy who were at risk of imminent premature delivery.
Women were randomised to the intervention (n=163) or placebo
(n=157).1
The primary outcome was the incidence of neonatal respiratory
disorders, including respiratory distress syndrome and transient
tachypnoea. Secondary outcomes included perinatal
measurements in the infant, including birth weight, plus Apgar
score at five minutes. Statistical hypothesis testing used a two
sided alternative and a critical level of significance of 0.05 (5%).
Distributional assumptions were verified before statistical
testing. The rate of respiratory distress syndrome was higher in
the intervention group than in the control group (two (1.4%) v
one (0.8%)), although the difference was not significant
(P=0.54), as was the rate of transient tachypnoea (34 (24%) v
29 (22%); P=0.77). Babies born to mothers in the intervention
group had a higher mean birth weight, although the difference
was not significant (2640 (standard deviation 445) v 2627 (452)
g; Student’s t test P=0.80). There was no difference between
the intervention and control groups in Apgar scores at five
minutes (median 9 (interquartile range 9-10) v 9 (9-10);
Mann-Whitney U test P=0.77).
The researchers concluded that antenatal treatment with
corticosteroids at 34-36 weeks of pregnancy does not reduce
the incidence of respiratory disorders in newborn infants.
Which of the following statements, if any, are true?
a) The use of the Student’s t test assumed that birth weight
was normally distributed in the population for each treatment
group
b) The use of the Mann-Whitney U test assumed that the
variance of Apgar scores at five minutes was equal between
treatment groups in the population
c) Non-parametric tests can be used to analyse data measured
on a continuous or ordinal scale
d) The Student’s t test had greater statistical power than the
Mann-Whitney U test to detect a difference in mean birth
weight between groups
Answers
Statements a, c, and d are true, whereas b is false.
The aim of the study was to test the effectiveness of
corticosteroids in reducing respiratory disorders in infants born
at 34-36 weeks’ gestation. A randomised placebo controlled
trial was performed. Traditional statistical hypothesis testing
was used to establish whether differences existed between
treatment groups in the perinatal measurements, therefore
confounding the association between treatment and the primary
outcome.2 Two broad categories of statistical methods were
used—parametric and non-parametric tests. When using
parametric tests it is necessary to make assumptions about the
distribution of the data, whereas no such assumptions need to
be made when using non-parametric methods. Non-parametric
methods are sometimes referred to as distribution-free methods
or methods of rank order. When comparing two independent
groups, as in the study above, the parametric test that is usually
used is the Student’s t test, and the non-parametric tests that can
be used are the Mann-Whitney U test or Wilcoxon rank sum
test.
The treatment groups were compared in mean birth weight using
the Student’s t test, also known as the independent samples t
test. Described in a previous question,3 the Student’s t test
compares two independent groups with regard to the mean of
a variable measured on a continuous scale. The test is a
parametric method; such methods make the assumption that the
variable being analysed has a particular distribution in the
population, typically a Normal distribution. The Normal
distribution, described in a previous question,4 is a theoretical
distribution described by its mean and standard deviation. In
particular, the application of the Student’s t test assumed that
the distribution of birth weight was normal in the population

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 BMJ 2015;350:h2053 doi: 10.1136/bmj.h2053 (Published 17 April 2015)
for each treatment group (a is true). A further assumption was
that the variance in birth weight was equal in the treatment
groups in the population.
The distributional assumption of normality of birth weight in
the population was verified using the sample measurements of
birth weight. A formal statistical test could have been used but
it is not always accurate. Therefore, it is generally recommended
that the assumption is confirmed by inspection of the histogram
for the sample measurements of each treatment group. The
distribution of a variable can be assumed to be normal if the
distributions are not extremely skewed. Nonetheless, the
independent samples t test is remarkably robust with regard to
departures in normality, particularly if the numbers of
participants in the two groups are similar. If the distribution of
the sample data is skewed then a transformation—for example,
a logarithmic transformation—may make the data suitable for
analysis using parametric methods.5 The assessment of equal
variance in birth weight between the treatment groups in the
population would have been verified by comparison of the
sample standard deviations. A statistical test—for example,
Levene’s test, which is provided routinely by statistical
software—would have been used. However, as a rule of thumb
the variances will be considered equal if the ratio of the larger
to the smaller standard deviation is no more than two. However,
if the variances are not equal then the software will typically
make an adjustment in the application of the test. Although it
was not essential for the two treatment groups to have equal
variance in birth weight, and therefore not essentially an
assumption of the data, it was important that equality of
variances was investigated before statistical testing. If the
assumptions cannot be verified then non-parametric methods,
as described below, should be used.
The Apgar score at five minutes was measured on an ordinal
scale; therefore, the distributional assumption of normality could
not be made and the Student’s t test could not be used. The
Mann-Whitney U test—the non-parametric equivalent of the
Student’s t test—was used instead. Non-parametric methods
make no assumptions about the distribution of data or equality
of variances between groups in the population (b is false).
Although non-parametric methods make no assumptions about
the distribution of data, the data may have a particular
distribution; however, it is typically not of interest in itself.
Non-parametric methods still use traditional statistical
hypothesis testing; the Mann-Whitney U test involved a null
hypothesis that stated that the distribution of the Apgar scores
at five minutes was similar for each of the treatment groups in
the population. The Mann-Whitney U test was based on ranking
the sample values of the Apgar scores regardless of treatment
group. Under the null hypothesis, if the distribution of Apgar
scores was similar for each treatment group in the population
then the average rank of the scores would be expected to be
equal for the treatment groups in the sample. The Wilcoxon
rank sum test is sometimes used instead of the Mann-Whitney
U test. It is also a non-parametric test and the two tests give the
same P value, so the same conclusion would be made with
respect to statistical hypothesis testing.
As described above, when using parametric methods it must be
assumed that the variable being compared between groups is
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ENDGAMES
normally distributed in the population. Therefore, parametric
methods should be used only to analyse data that are measured
on a continuous scale. If the assumptions cannot be verified
then non-parametric methods should be applied. Variables
measured on an ordinal scale, such as an anxiety rating scale,
should be analysed using non-parametric methods only because
the distributional assumption of normality cannot be made.
Hence, non-parametric tests can be used to analyse data
measured on a continuous or ordinal scale (c is true). Sometimes
variables measured on an ordinal scale with a potentially large
spread in values are analysed using parametric methods, but
such testing would probably be meaningless. Hypothesis testing
would be based on the sample estimate for the population
parameter of the mean difference in the outcome measure.
However, ordinal scales consist of categories with natural
ordering and measurements are therefore inherently discrete
rather than continuous; differences between points on the scale
have little, if any, inherent meaning or value.
Non-parametric methods can be used in all circumstances,
regardless of whether the distributional assumption of normality
in the population can be made for the variable being analysed.
However, it would not be sensible to do this. If all the
assumptions underlying the parametric test are satisfied, then
parametric methods are preferable to non-parametric ones
because they will have greater statistical power to detect a
difference between treatment groups in an outcome if it exists
in the population (d is true). Statistical power has been described
in a previous question.6 Furthermore, non-parametric methods
are limited because they are primarily tests that result in
dichotomous decisions of significance; unlike parametric
methods they typically do not permit statements about the
population based on the sample estimate and confidence interval
for the population parameter.
The independent samples t test and Mann-Whitney test are used
to compare two independent groups as described. When there
are three or more independent groups the parametric and
non-parametric methods used are analysis of variance and the
Kruskal-Wallis test, respectively.7 8 The parametric and
non-parametric methods used to analyse two related groups—for
example, an outcome measured before and after an intervention
designed to help weight loss in patients with osteoarthritis of
the knee—have been described in previous questions.9 10
Competing interests: None declared.
1 Porto AMF, Coutinho IC, Correia JB, et al. Effectiveness of antenatal corticosteroids in
reducing respiratory disorders in late preterm infants: randomised clinical trial. BMJ
2011;342:d1696.
2 Sedgwick P. Understanding statistical hypothesis testing. BMJ 2014;348:g3557.
3
4
Sedgwick P. Independent samples t test. BMJ 2010;340:c2673.
Sedgwick P. The Normal distribution. BMJ 2010;341:c6085.
5 Sedgwick P. Log transformation of data. BMJ 2012;345:e6727.
6 Sedgwick P. The importance of statistical power. BMJ 2013;347:f6282.
7 Sedgwick P. One way analysis of variance. BMJ 2012;344:e2427.
8 Sedgwick P. Non-parametric statistical tests for independent groups: numerical data. BMJ
2012;344:e3354.
9 Sedgwick P. Parametric statistical tests for two related groups: numerical data. BMJ
2014;348:g124.
10 Sedgwick P. Non-parametric statistical tests for two related groups: numerical data. BMJ
2012;344:e2537.
Cite this as: BMJ 2015;350:h2053
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