FACULTY OF MEDICINE

Universitas Syiah Kuala

SAMPLE SIZE ESTIMATION

A practical guide for public health and clinical research

Rovy Pratama, MD, MBA

Department of Public Health and Community Medicine
School of Medicine, Universitas Syiah Kuala
Banda Aceh - Indonesia www.fk.usk.ac.id
 Outline
01 Principle of sample size estimation

02 Descriptive sample size calculation

03 Analytical study concept

04 Sample size estimation: Difference between 2 proportions

Faculty of Medicine, Universitas Syiah Kuala

05 Sample size estimation: Difference between 2 means

06 Sample size estimation: Correlation

07 Sample size estimation in Finite Population

2
Slide
 Population & Sample
Target Population (Domain)
Demographic & Clinical

Accessible Population
Time, Place

Intended Sample
Study criteria (Inclusion & Exclusion)
Faculty of Medicine, Universitas Syiah Kuala

Sampling Inference

Actual Study Subject/Samples

Non-response, drop out, loss to follow-up

3
Slide
 Population & Sample
Population

YES NO

True Positive False Negative

YES (Power) 𝜶 (Type 1 Error)
Sample
Faculty of Medicine, Universitas Syiah Kuala

False Negative True Negative

NO 𝜷 (Type 2 Error) (None)

4
Slide
 Descriptive Categorical

! Research question example

Zα × P × (1 − P)
N= • What is the quality of life profile among
d! healthcare workers in Banda Aceh?

Zα = 1,96 (Confidence interval 95%)

Frequency (n) Percentage (%)
d = Absolut error (5%, 10%, 20%)
Quality of life
Faculty of Medicine, Universitas Syiah Kuala

P = Proportion (reference)
Good
Bad

5
Slide
 Descriptive Numerical

!
Zα × SD Research question example

N= • What is the average of quality of life score among

d healthcare workers in Banda Aceh?

Zα = 1,96 (Confidence interval 95%) Mean ± SD

Faculty of Medicine, Universitas Syiah Kuala

d = Absolut error (5%, 10%, 20%) Quality of life

score
SD = Standard deviation (reference)

6
Slide
 Analytical Study Concept
Determining Parameters

1. Study type à (Comparative or Correlative)

2. Data Scale à (Numerical or Categorical) Statistic Diagnose
3. Data Type à (Paired or Independent)
Faculty of Medicine, Universitas Syiah Kuala

Numerical Categorical
Paired Data
Mean Proportion 1. Same Body
2. Same Variable
Ratio Interval Nominal Ordinal 3. Two times measurement

7
Slide
 Different between 2 Proportion (Paired)

(Zα + Zβ)" 𝜋 Research question example

N! = N" = • What is the difference in the quality of life
(P! −P" )"
before and after treatment?

π = 𝑃! 𝑄" + 𝑃" 𝑄! DRUG B

Success Failure
Faculty of Medicine, Universitas Syiah Kuala

Zα = 1,96 (Confidence interval 95%)

Zβ = 0,84 (Type 2 error 80%)
𝜋 = Discordant Proportion Success a b
P1 = Proportion of group A (Intervention) DRUG A
Q1 = 1 – P1 Failure c d
P2 = Proportion of group B (Control)
Q2 = 1 – P2
P1-P2 = Significant proportion different (Estimation/reference)

8
Slide
 Different between 2 Proportion (Independent)

"
Zα 2PQ + Zβ P! Q! + P" Q "
N! = N"
P! − P"

Research question example

Zα = 1,96 (Confidence interval 95%)
Zβ = 0,84 (Type 2 error 80%) • What is the difference in the quality of life
Faculty of Medicine, Universitas Syiah Kuala

P1 = Proportion of group A (Intervention)

Q1 = 1 – P1 between drugs A and B?
P2 = Proportion of group B (Control)
Q2 = 1 – P2
P1-P2 = Significant proportion different (Estimation/reference)
P = (P1 + P2)/2
Q = (Q1 + Q2)/2

9
Slide
 Different between 2 mean (Paired)
"
Zα + Zβ × Sd Research question example
N! = N" = • What is the difference in the quality of life
X! − X "
scores before and after treatment?

𝑆!" 𝑛! − 1 + 𝑆"" 𝑛" − 1

Sd =
𝑛! + 𝑛" − 2
Faculty of Medicine, Universitas Syiah Kuala

Zα = 1,96 (Confidence interval 95%)

Zβ = 0,84 (Type 2 error 80%)
Sd = Not SD, Standard deviation of mean difference (Reference)
S1 = Standard deviation group 1 (reference)
n1 = Sample size group 1 (reference)
S2 = Standard deviation group 1 (reference)
n2 = Sample size group 1 (reference)
X1 – X2 = Minimal clinically important difference (Estimation/reference)
10
Slide
 Different between 2 mean (Independent)
" Research question example
Zα + Zβ × Sd
N! = N" = 2 • What is the difference in the quality of life
X! − X " scores between drugs A and B?

𝑆!" 𝑛! − 1 + 𝑆"" 𝑛" − 1

Sd =
𝑛! + 𝑛" − 2
Faculty of Medicine, Universitas Syiah Kuala

Zα = 1,96 (Confidence interval 95%)

Zβ = 0,84 (Type 2 error 80%)
Sd = Not SD, Standard deviation of mean difference (Reference)
S1 = Standard deviation group 1 (reference)
n1 = Sample size group 1 (reference)
S2 = Standard deviation group 1 (reference)
n2 = Sample size group 1 (reference)
X1 – X2 = Minimal clinically important difference (Estimation/reference)
11
Slide
 Association between 2 mean (Correlation)
" Research question example
Zα + Zβ
N= +3 • What is the association between quality of life
1+𝑟
0,5𝐼𝑛 1 − 𝑟 scores and Cortisol serum level?

Zα = 1,96 (Confidence interval 95%)

Zβ = 0,84 (Type 2 error 80%)
r = Correlation coefficient (Judgment/reference)
Faculty of Medicine, Universitas Syiah Kuala

Correlation Coefficient Correlation Level

0,00 – 0,199 Very low
0,20 – 0,399 Low
0,40 – 0,599 Middle
0,60 – 0,799 Strong
0,80 – 1,000 Very Strong 12
Slide
 Sample Size Estimation in Finite Population
𝑛
N= Slovin Formula (1960)
1 + 𝑛𝑒 "
𝑛 = Population number
𝑒 = error tolerance (5%)
N’ = Sample size conversion

𝑁
Faculty of Medicine, Universitas Syiah Kuala

N′ =
𝑁−1
1+ 𝑛
Sample Size Conversion to Finite Population

Krejcie & Morgan Table for Sample Size (1970)

13
Slide
FACULTY OF MEDICINE
Universitas Syiah Kuala

TERIMONG
GEUNASE

”
Successful people do ordinary things
with extraordinary commitment,
consistency and focus

www.fk.usk.ac.id
Banda Aceh - Indonesia