Introduction to PROBABILITY

Biostatistics Course 2021-2022 / Block 3

Ali Lateef Jasim

MBChB.
Learning objectives

❑ Define the probability.

❑ Explain the applications of probability in medical sciences.
❑ Describe types of probability.
 Introduction
❖ Science is uncertain. Scientists are sometimes wrong.
❖ Many studies are inconclusive.
Why is that?
❖ Nature is complex and full of unexplained biological
variability.
❖ Almost all methods of observation and experiment are
imperfect.
❖ Science and scientists cope with uncertainty by
calculating probabilities, they are able to describe what
has happened and predict what should happen in
future under similar conditions.
 Why to study probability in medicine?
❖ Medicine is an inexact science, therefore Physicians can
rarely predict an outcome with absolute certainty.
❖ Results of available diagnostic tests are not necessarily
absolutely accurate, but it definitely affect the
probability of presence or absence of disease.
❖ Probability theory allows clinicians to draw conclusions
about a population of patients based on known
information about a sample drawn from that
population.
❖ Stochastic (definitive) Model Vs probabilistic Model
 Probability
❖ The theory of probability provides the foundation of
statistical inference.
❖ The understanding of probability is essential for
understanding p value and confidence interval.
 Probability
❖ Definition: It is the likelihood of occurrence of a certain
event compared to the total events.

No. of times E occur

P (E) =
No. of times E can occur
❖ P (E) probability of occurrence of event E

❖ The value of probability = 0 – 1

❖ Probability (E) = 0 means event is impossible.
❖ Probability (E) = 1 means event is sure.
❖ No negative value in probability.
 Probability & relative frequency

Probability ≃ percentage (%)

❖ If we keep taking random selections (repeated
sampling), the accumulated long – term relative
frequency with which the event occurs (characteristic
observed) is equal the proportion of the subpopulation
with that characteristic.
❖ So sometimes proportion and probability are used
interchangeably.
 Probability & relative frequency

Probability ≃ percentage (%)

Example: the probability of serum cholesterol level
between 180 and 210 (mg/dl) is the proportion of people
in a certain target population having their cholesterol
levels falling between 180 and 210 (mg/dl).

❖ The sum of the probabilities (or relative frequencies) of

all events that can occur in the sample must be 1 (or
100%).
Types of Probability
 Marginal probability

❖ Is the probability of an event irrespective of the

outcome of another variable.
❖ Marginal Probability = Event total / Grand Total
✓ Event total: the total frequency of certain event.
✓ Grand total: the total number of the sample.
 Find the Marginal probability
Example: This data from cancer screening test.

Event Total (at the margin)

Disease Disease
Total
+ve -ve

Test +ve 9 5 14

Test -ve 6 80 86

Total 15 85 100

Event Total (at the margin) Grand Total

 1. Marginal probability

Example: Solution
✓ P (Disease +ve) = 15 / 100 = 0.15 (15%)
✓ P (Disease -ve) = 85 / 100 = 0.85 (85%)
✓ P (Test +ve) = 14 / 100 = 0.14 (14%)
✓ P (Test -ve) = 86/ 100 = 0.86 (86%)
 Another example
In a sample of 50 people, 21 had blood group O, 22 had
blood group A, 5 had type B, and 2 had blood group AB,
Calculate the marginal probability for the occurrence of
the different blood groups:
P (O) = 21/50 = 0.42 P (B) = 5/50 = 0.1
P (A) = 22/50 = 0.44 P (AB) = 2/50 = 0.04
P (neither A nor O) < We should calculate the probability
of A and O and sum them, then to calculate the
remaining probability we should subtract the sum from 1.
So, P (neither A nor O) = 1 - (P (O) + P (A))
= 1 – (0.42+0.44) = 0. 14
Continue the solution!

Calculate the probability for:

1. P (not AB)
2. P (neither B nor AB)
You Continue the solution!

The results should be:

1. P (not AB) = 0.96
2. P (neither B nor AB) = 0.86
(the opposite of first neither example)
 2. Joint Probability
❖ Is a statistical measure that calculates the likelihood of
two events occurring together and at the same point in
time.
❖ These are the probabilities for two events or more (such
as having the disease and having a positive test result )
occurring simultaneously.

The frequency of the two events

occurring at the same time
Joint probability =
The Grand total
 For the same example
Example: This data from cancer screening test.

Disease Disease
Total
+ve -ve

Test +ve 9 5 14

Test -ve 6 80 86

Total 15 85 100

These are the frequencies of two

events occurring simultaneously Grand Total
 Joint probability

Example: Solution
✓ P (Dis. +ve and test +ve)= 9/100 = 0.09 (9%)
✓ P (Dis. +ve and test –ve)= 6 /100 = 0.06 = (6%)
✓ P (Dis. –ve and test +ve)= 5 / 100 = 0.05 = (5%)
✓ P (Dis. –ve and test –ve)= 80/ 100 = 0.80 = (80%)
 3. Conditional Probability
❖ The probability of occurrence of an event given that
another event had already occurred.
❖ For the same above example: calculate
This symbol means conditional

1. P (disease +ve | test +ve) = probability

When we want to calculate the conditional P. then we

mean that the probability of finding the disease
(the first event written in the question) among those
who have positive test (The second event written in
the questions)
 Conditional Probability
❖ So, the formula will be as follows

The frequency of the two events

occurring at the same time
Conditional probability =
The total of the second event in
the question
 Conditional Probability
Disease Disease
Total
+ve -ve
Test +ve 9 5 14
Test -ve 6 80 86
Total 15 85 100
Red is the frequency of the two events, and as the second
event is the (test +ve) the, Green represent the second
event total.
So, 1. P (disease +ve | test +ve) = 9/14 = 0.64 (64%).
2. P (disease –ve | test –ve) = 80/ 86 = 0.93 (93%)
Rules of Probability
 Rules of probability

1- Multiplication rule (and, ∩ ,both)

✓ Independent
✓ Non independent (dependent)
2- Addition rule (or, ∪ , either)
✓ Mutually exclusive
✓ Non mutually exclusive
 Multiplication rule

❖The multiplication rule is a way to find the probability

of two events happening at the same time.
 Multiplication rule

A. Independent event
P (E1 ∩ E2) = P (E1 and E2) = P (E1) x P (E2)
Ex: the probability that an individual belonging to blood
group A is 0.42, and the individual being a football player
is 0.50. what is the probability of the individual both
belonging to blood group A and being football player?
Since the events are independent
P (E1 ∩ E2) = P E1 x P E2 = 0.42 x 0.50 = 0.21
 Multiplication rule

B. Non independent (dependent)

If the two events are not independent, they have a
statistical relationship or we say that they are statistically
associated.
For the same cancer screening test example:
What is the probability of selecting an individual who is
disease +ve and test –ve
 Multiplication rule

P (dis +ve and test –ve) = P (dis +ve | test –ve) * p test –ve
Let’s assume that the event disease +ve is A, and the event
test +ve is B ,so to calculate the probability of having both
events is as follows:
P (A and B) = P (A | B) * P (B)
So that, we need to calculate the conditional probability
of (A | B) (the probability of A given B has occurred) and
multiply it by the probability of the second event (B)
P (A and B) = 6 / 86 x 86/100 = 6/100 = 6%
 Multiplication rule

What if we reverse the events in the equation?

P (A and B) = P (B | A) * P (A)
✓ P (B | A) = the conditional probability of B given A has
occurred = 6/15
✓ P (A) = 15/100
So, P (A and B) if we reverse the events = 6/15 * 15/100
= 6/100 = 6%
SO, changing the order of the event will not change the
results ( BUT we need to calculate them right)
 Addition rule

A. Mutually exclusive This means the events can not

occur together
Example: the probability that an individual has a blood
group A is 0.4 and the probability that another individual
has a blood group B is 0.3.
What is the probability of the individual belonging to
blood group A or B ?
P (Blood Group A (A) or Blood Group B (B) =
= Probability A + Probability B = 0.4 + 0.3 = 0.7
 Addition rule

B. Non mutually exclusive:

Given two events A & B, the probability that event A, or
event B occur <<< the probability that event A occurs, plus
the probability that event B occurs, minus the probability
that the events occur simultaneously.
P (A or B) = P (A) + P (B) – P (A and B)
Example:
What is the probability of having disease –ve or test –ve ?
 Addition rule

P ( dis -ve or test -ve) =

P (dis -ve) + P (test -ve) – P (dis -ve and test -ve)=
85/100 + 86/100 - 80/100 = 91/100 = 0.91 (91%)
 Addition rule

Why do we subtract the joint probability of the two

events?

If we calculate P(A) and P(B)

without subtracting P(A&B)
the we are calculating the joint
part twice . .
 Addition rule

✓ If we have 100 patients, 85 have event A, 86 have

event B, and 80 have A and B at the same time . .
✓ Thenn those 80 patients are part of the 85 patient with
event A and are also part of the 86 patient with the
event B . .
✓ So, we calculating the probability of (A or B) and we
did not subtract 80 from the summation the we are
calculating those 80 (the joint part) twice.
 Summary of Rules
Marginal probability
𝑇𝑜𝑡𝑎𝑙 𝑜𝑐𝑐𝑢𝑟𝑒𝑛𝑐𝑒𝑠 𝑜𝑓 𝐴
•P A =
𝑆𝑢𝑚 𝑡𝑜𝑡𝑎𝑙 𝑜𝑓 𝑎𝑙𝑙 𝑒𝑣𝑒𝑛𝑡𝑠

Joint probability
𝑂𝑐𝑐𝑢𝑟𝑒𝑛𝑐𝑒 𝑜𝑓 𝐴 𝑎𝑛𝑑 𝐵
• P A, B =
𝑆𝑢𝑚 𝑡𝑜𝑡𝑎𝑙 𝑜𝑓 𝑎𝑙𝑙 𝑒𝑣𝑒𝑛𝑡𝑠

Conditional probability
𝑂𝑐𝑐𝑢𝑟𝑒𝑛𝑐𝑒 𝑜𝑓 𝐴 𝑎𝑛𝑑 𝐵
• P A|B = OR P A|B =
𝑇𝑜𝑡𝑎𝑙 𝑜𝑓 𝐵
𝑃(𝐴,𝐵)
𝑃(𝐵)
Thank You
Ali Lateef Jasim
MBChB.