26/02/2020

Lecture 4 – Introduction

• Explanation of:
Lecture 4 – Normal distribution
– Standard normal curve
The normal distribution
– Areas in the tail(s)

• Worked examples using statistical tables

• Reference Range

[See Kirkwood & Sterne: Chapter 5 – The normal distribution]

1 2

Carl Friedrich Gauss (1777-1855) The normal curve

Population Sample

3 4

The normal curve The normal curve

5 6

1
 26/02/2020

The normal curve The normal curve - Height

Melbourne men, aged 40-69 years

7 8

Area under the normal curve Example - Melbourne men, aged 40-69 years

Melbourne men, aged 40-69 years

• The total area under the normal curve

– equals 1 (if expressed as proportion)

– or equals 100% (if expressed as percentage). 1 (or 100%)

9 10

Example - Melbourne men, aged 40-69 years Example - Melbourne men, aged 40-69 years

≈0.70 (or 70%) ≈0.95 (or 95%)

11 12

2
 26/02/2020

Research question Research question

• What proportion of Melbourne men, aged 40-69 years, • What proportion of Melbourne men, aged 40-69 years,
are obese (BMI≥30)? are obese (BMI≥30)?

• To use the normal curve we have the assumptions:

– BMI is normally distributed
– Sample mean of BMI and sample standard deviation
of BMI provide reasonable estimates of m and s
respectively

13 14

Study sample – Melbourne Collaborative Cohort

The normal curve
Study (MCCS)
15

x ~ 27.2 kg/m2 15 m = 27.2 kg/m2

s ~ 3.5 kg/m2 s = 3.5 kg/m2

10
10

Percentage
Percent

5
5

0
0

15 20 25 30 35 40 45
15 20 25 30 35 40 Body Mass Index (kg/m2)
Body Mass Index

15 16

The normal curve The standard normal distribution

m = 27.2 kg/m2 What proportion of

s = 3.5 kg/m2 Melbourne men, aged
40-69 years, are obese
(BMI≥30)?
• The standard normal distribution has a mean of zero and
standard deviation of one
• Any normally distributed variable can be related to the
standard normal distribution

17 18

3
 26/02/2020

Standard normal deviates Computing z scores for BMI

m ~ 27.2 kg/m2 m~0

s ~ 3.5 kg/m2 s~1
• The standard normal deviate is the value on a
standardised normal distribution corresponding to the
observed value of a variable Area Area
x−m
z − score =
s -3 -2 -1 0 1 2 3

– x is the original variable with mean m, and standard BMI = 27.2 kg/m2 z = (27.2 – 27.2) / 3.5 = 0
deviation s BMI = m + s = 30.7 kg/m2 z = (30.7 – 27.2) / 3.5 = 1

BMI = m − 2s = 20.2 kg/m2 z = ??

19 20

Areas under the Standard Normal curve Areas under the Standard Normal curve

z Area between –z Area in two tails Area in one tail z Area between –z Area in two tails Area in one tail
and +z <-z and >+z <-z or >+z and +z <-z and >+z <-z or >+z
0.000 0.000 1.000 0.500 0.000 0.000 1.000 0.500
0.050 0.040 0.960 0.480 0.050 0.040 0.960 0.480
0.100 0.080 0.920 0.460 0.100 0.080 0.920 0.460
0.150 0.119 0.881 0.440 0.150 0.119 0.881 0.440
… … … …

Z score -z 0 +z

21 22

Areas under the Standard Normal curve Areas under the Standard Normal curve

z Area between –z Area in two tails Area in one tail z Area between –z Area in two tails Area in one tail
and +z <-z and >+z <-z or >+z and +z <-z and >+z <-z or >+z
0.000 0.000 1.000 0.500 0.000 0.000 1.000 0.500
0.050 0.040 0.960 0.480 0.050 0.040 0.960 0.480
0.100 0.080 0.920 0.460 0.100 0.080 0.920 0.460
0.150 0.119 0.881 0.440 0.150 0.119 0.881 0.440

Z score -z 0 +z Z score -z 0 +z

23 24

4
 26/02/2020

The normal curve The normal curve

m = 27.2 kg/m2 What proportion of m = 27.2 kg/m2 What proportion of

s = 3.5 kg/m2 Melbourne men, aged s = 3.5 kg/m2 Melbourne men, aged
40-69 years, are obese 40-69 years, are obese
(BMI≥30)? (BMI≥30)?

z-score
= (30-27.2)/3.5
Z score 0.8 = 0.8

25 26

The normal curve The normal curve

m = 27.2 kg/m2 Proportion (percentage) m = 27.2 kg/m2 What proportion of

s = 3.5 kg/m2 of Melbourne men, s = 3.5 kg/m2 Melbourne men, aged
aged 40-69 years, that 40-69 years, are
are obese is 0.21 (21%) overweight (BMI≥25)?

0.21

27 28

The normal curve The normal curve

m = 27.2 kg/m2 What proportion of m = 27.2 kg/m2 What proportion of

s = 3.5 kg/m2 Melbourne men, aged s = 3.5 kg/m2 Melbourne men, aged
40-69 years, are 40-69 years, are
overweight (BMI≥25)? overweight (BMI≥25)?

z-score z-score
= (25-27.2)/3.5 = (25-27.2)/3.5
= -0.63 = -0.63
Z score -0.63 Z score -0.63

29 30

5
 26/02/2020

The normal curve The normal curve

m ~ 27.2 kg/m2 What proportion of m = 27.2 kg/m2 1 - 0.258 Proportion (percentage)

s ~ 3.5 kg/m2 Melbourne men, aged s = 3.5 kg/m2 = 0.742 of Melbourne men,
40-69 years, are aged 40-69 years, that
overweight (BMI≥25)? are overweight is 0.742
(74%)
0.258 z-score 0.258
z-score
= (25-27.2)/3.5 = (25-27.2)/3.5
= -0.63 = -0.63
Z score -0.63 Z score -0.63

31 32

The normal curve The normal curve

m = 27.2 kg/m2 What proportion of m = 27.2 kg/m2 What proportion of

s = 3.5 kg/m2 Melbourne men, aged s = 3.5 kg/m2 Melbourne men, aged
40-69 years have BMI 40-69 years have BMI
between 20 and 35? between 20 and 35?

z-score
= (35-27.2)/3.5
= 2.23
z-score
-2.06 2.23
= (20-27.2)/3.5
= -2.06

33 34

The normal curve Question - 90% reference range

m ~ 27.2 kg/m2 1 – 0.02 – 0.012 What proportion of

s ~ 3.5 kg/m2 = 0.968 Melbourne men, aged • Determine the range of BMI where 90% of Melbourne
40-69 years have BMI men lie within?
between 20 and 35?

0.02 0.012
-2.06 2.23

35 36

6
 26/02/2020

Question - 90% reference range Question - 90% reference range

m ~ 27.2 kg/m2
• Determine the range of BMI where 90% of Melbourne m = 27.2 kg/m2 and s = 3.5 kg/m2 s ~ 3.5 kg/m2
men lie within? = m – (1.645×s)
m ~ 27.2 kg/m2 Lower limit 0.90
s ~ 3.5 kg/m2 = 27.2 – (1.645 × 3.5)
= 21.4 kg/m 2
Lower limit = m – (z×s) 0.90
Upper limit = m + (z×s) Upper limit = m + (1.645×s) Z score -1.645 0 +1.645
= 27.2 + (1.645 × 3.5)
= 33.0 kg/m 2
Z score -z 0 +z
The 90% reference range for BMI of Melbourne men (age 40-69 yrs) is 21.4 kg/m 2
up to 33.0 kg/m 2.

37 38

Question - 95% reference range Question

m ~ 27.2 kg/m2 m = 171.5 cm What proportion of

m = 27.2 kg/m2 and s = 3.5 kg/m2 s ~ 3.5 kg/m2 s = 6.5 cm Melbourne men, aged
Lower limit = m – (1.96×s) 0.95 40-69 years, are shorter
= 27.2 – (1.96 × 3.5) than 175cm?
= 20.34 kg/m 2

Upper limit = m + (1.96×s) Z score -1.96 0 +1.96

= 27.2 + (1.96 × 3.5)
= 34.06 kg/m 2

The 95% reference range for BMI of Melbourne men (age 40-69 yrs) is 20.34 kg/m 2
up to 34.06 kg/m 2.

39 40

Question Question

m = 171.5 cm What proportion of m = 171.5 cm What proportion of

s = 6.5 cm Melbourne men, aged s = 6.5 cm Melbourne men, aged
40-69 years, are shorter 40-69 years, are shorter
than 175cm? than 175cm?
1 - 0.291 = 1 - 0.291 =
0.709 0.291 0.709 0.291 z-score
= (175-171.5)/6.5
= 0.54

0.54

41 42

7
 26/02/2020

Summary

• Normal distribution
– Standard normal curve
– Using z-scores & statistical
tables to calculate
probabilities associated with
any value of a normally
distributed variable.

• Reference range

43