Professional Documents
Culture Documents
Dr Lohith D
1st year MDS
Department of orthodontics
V S dental college.Bengaluru
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CONTENTS
• Introduction
• History
• Applications
• Measures of central tendency
• Measures of dispersion
• Steps in statistical methods
• Methods of presentation of data
• Types of studies
• Sampling
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• Null hypothesis
• Parametric and non –parametric tests
• Softwares-Statistical packages
• Conclusion
• References
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INTRODUCTION
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BIOSTATISTICS
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HISTORY OF STATISTICS
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HISTORY OF STATISTICS..
John graunt(1620-1674)
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LIMITATIONS
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SUBDIVISIONS OF STATISTICS
categories:
1. Descriptive statistics
2. Inferential statistics
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MEASURES OF CENTRAL
TENDENCY
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MEAN
• The arithmetic mean is widely used in statistical
calculation. It is sometimes simply called Mean.
• To obtain the mean, the individual observations are first
added together, and then divided by the number of
observations.
• The operation of adding together is called 'summation'
and is denoted by the sign or S. The individual
observation is denoted by the sign and the mean is
denoted by the sign (called "X bar").
• = Sum of observations
No of observations
• = X1+X2+X3……………..+Xn
n 14
• The mean (x) is calculated thus : the age of 10
orthodontic patients was 15, 14, 16, 12, 18, 16, 17, 19,
21,23. The total was 171. The mean is 171 divided by 10
which is 17.1.
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MEDIAN
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DISPERSION
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MEASURES OF DISPERSION
• There must be individual variations. If we examine the
data of blood pressure or heights or weights of a large
group of individuals, we will find that the values vary
from person to person. Even within the same subject,
there may be variation from time. The questions that
arise are : What is normal variation ? And how to
measure the variation ?
• There are several measures of variation (or "dispersion”
as it is technically called) of which the following are
widely known:
(a) The Range
(b) The Mean or Average Deviation
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The Standard Deviation
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• When the sample size is more than 30, the above basic
formula may be used without modification. For smaller
samples, the above formula tends to underestimate the
standard deviation, and therefore needs correction, which
is done by substituting the denominator ( -1) for . The
modified formula is as follows :
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• The steps involved in calculating the standard deviation
are as follows :
(a) First of all, take the deviation of each value from the
arithmetic mean, (x- )
(b) Then, square each deviation - ·(x- )2
(c) Add up the squared deviations- (x- )2
(d) Divide the result by the number of observations
[or] ( -1) in case the sample size is less than 30]
(e) Then take the square root, which gives the standard
deviation.
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Example : The diastolic
blood pressure of 10
individuals was as
follows : 83, 75, 81,
79, 71, 95, 75, 77, 84,
90.
Calculate the
standard deviation.
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STEPS IN STATISTICAL METHODS
1. Collection of data
2. Classification
3. Tabulation
4. Presentation by graphs
5. Descriptive statistics
6. Establishment of relationship
7. Interpretation
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DATA
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VARIABLE
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TYPES OF DATA
1. Qualitative
2. Quantitative
a)Discrete
b)continuous
3. Grouped / ungrouped
4. Primary / secondary
5. Nominal / ordinal
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TYPES OF CLINICAL DATA THAT CAN BE
SUPPORTED BY STATISTICS
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NEED FOR ORGANISING THE DATA
•Tabulation
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TABLES
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GUIDELINES FOR PRESENTATION OF
TABLES
1. The tables should be numbered e.g., Table 1, Table 2,
etc.
2. A title must be given to each table. The title must be
brief and self explanatory.
3. The headings of columns or rows should be clear and
concise.
4. The data must be presented according to size or
importance; chronologically, alphabetically or
geographically.
5. If percentages or averages are to be compared, they
should be placed as close as possible.
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6. No table should be too large.
7. Most people find a vertical arrangement better than
a horizontal one because, it is easier to scan the data
from top to bottom than from left to right.
8. Foot notes may be given, where necessary.
9. providing explanatory notes or additional information
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TYPES OF TABLES
• Simple table:
they are one way tables which supply answer to
questions about one characteristic of data only.
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FREQUENCY DISTRIBUTION TABLE
• In a frequency distribution table, the data is first split up
into convenient groups (class intervals) and the number
of items (frequency) which occur in each group is
shown in the adjacent column.
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CHARTS AND DIAGRAMS
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BAR CHARTS
• Bar charts are merely a
way of presenting a set of
numbers by the length of a
bar. The length of the bar
is proportional to the
magnitude to be
represented.
• Bar charts are a popular
media of presenting
statistical data because
they are easy to prepare,
and enable values to be
compared visually.
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HISTOGRAM
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FREQUENCY POLYGON
• A frequency distribution
may also be represented
diagrammatically by the
frequency polygon. It is
obtained by joining the
mid-points of the
histogram blocks.
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LINE DIAGRAM
• This diagram is useful to
study the changes of
valuables in the variable
over the time and is
simplest of the diagram.
• On the x axis the time such
as hours, days, weeks,
months or years are
represented and the value
of any quantity pertaining
to this is represented along
the y axis.
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Pie charts
• These are so called because
the entire graph looks like a
pie and its components
represent slices cut from a
pie.
• The total angle at the the
centre of the circle is equal to
360 degree and it represents
the total frequency.
• It is divided into different
sectors corresponding to the
frequencies of variables in
the distribution.
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PICTOGRAM
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STATISTICAL MAPS
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COHORT STUDY
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INTERVENTIONAL STUDIES
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SAMPLING
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SAMPLE SELECTION-GUIDELINES
I. EFFICIENCY
II. REPRESENTATIVENESS
III. MEASURABILITY
IV. SIZE
V. COVERAGE
VI. GOAL ORIENTATION
VII. FEASIBILITY
VIII.ECONOMY AND COST EFFICIENCY
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DIFFERENT SAMPLING DESIGNS
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DETERMINATION OF SAMPLE SIZE
Quantitative data
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PRECISION
standarad deviation
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EXPERIMENTAL VARIABILITY
ERROR/ DIFFERENCE / VARIATION
2. Instrumental
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BIAS IN THE SAMPLE
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BIAS IN THE SAMPLE..
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DISTRIBUTION-TYPES
1. Normal or gaussian
2. Binomial
3. Poisson
4. Rectangular or uniform
5. Skewed
6. Log normal
7. Geometric
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NORMAL OR GAUSSIAN
DISTRIBUTION
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In a normal curve
• (a). the area between one
standard deviation on either side
of the mean ( x ± 1 ) will
include approximately 68 per
cent of the values in the
distribution
• (b) the area between two
standard deviations on either
side of the mean( x ± 2 ) will
cover most of the values, i.e.,
approximately 95 per cent of the
values.
• (c) the area between ( x ± 3
) will include 99. 7 per cent of
the values. These limits on either
side of the mean are called
"confidence limits" 67
STANDARD NORMAL CURVE
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BINOMIAL DISTRIBUTION
The binomial distribution is used for describing discrete not
the continuous data. These values are as a result of an
experiment known as bernoulli’s process.They are used to
describe
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THE POISSON DISTRIBUTION
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CRITICAL RATIO, Z SCORE
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NULL HYPOTHESIS…..
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Paired “t” test
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ANALYSIS OF VARIANCE
(ANOVA)
when 3 more or more groups of individuals with the
objective of determining whether any true differences
in mean performance exist among the conditions under
the study.
Ex: comparing the curve of spee, curve of Wilson, curve
of monsoon in 3 different groups.
1st group: control.
2nd group: serial extraction.
3rd group: late premolar extraction.
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CHI- SQUARE(ᵡ2) TEST
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• When the data is measured in terms of attributes or
qualities, and it is intended to test whether the
difference in the distribution of attributes in different
groups is due to sampling variation or not, the chi
square test is applied.
• It is used to test the significance of difference
between two proportions and can be used when
there are more than two groups to be compared.
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• For example , if there are group Occurrence
two groups, one which of new
cavities
has received oral hygiene
Present Absent total
instructions and other has
No. who 10 40 50
not received any received
instructions and if it is instruction
desired to test if the s
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COMPARABLE PARAMETRIC and
NON PARAMETRIC TESTS
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Miscellaneous :-
Fisher’s exact test :
A test for the presence of an association between
categorical variables.
Friedman’s test :
A non- parametric equivalent of the analysis of
variance.
Mc Nemar’s test :
A variant of a chi squared test, used when the data is paired.
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MANN –WHITNEY TEST
• It is non parametric test equivalent to ‘t’ test.
• Used to compare the medians of 2 independent
sampling.
ex: comparison of cervical vertebral maturation index at
the pre and post treatment stages of 2 different groups.
pre treatment.
Group 1 Group 2
Fixed functional Premolar extraction
appliance
1 2 2
2 1 1
3 14 8
4 5 13
5 1 1
90
6 0 0
Post treatment
Group 1 Group 2
Fixed functional Premolar extraction
appliance
1 1 1
2 0 0
3 2 0
4 11 10
5 4 9
6 5 5
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DISCRIMINANT FUNCTION ANALYSIS
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META ANALYSIS
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AIMS OF META ANALYSIS
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Systematic reviews
• Systematic review methodology is at the heart of meta-
analysis. This stresses the need to take great care to find
all the relevant studies (published and unpublished), and
to assess the methodological quality of the design and
execution of each study.
• The objective of systematic reviews is to present a
balanced and impartial summary of the existing research,
enabling decisions on effectiveness to be based on all
relevant studies of adequate quality.
• Frequently, such systematic reviews provide a quantitative
(statistical) estimate of net benefit aggregated over all the
included studies.
• Such an approach is termed a meta-analysis. 95
BENEFITS OF META-ANALYSES
Overcoming bias: The danger of unsystematic (or narrative)
reviews, with only a portion of relevant studies included, is that
they could introduce bias.
Meta-analysis carried out on a rigorous systematic review can
overcome these dangers – offering an unbiased synthesis of the
empirical data.
Precision: The precision with which the size of any effect can be
estimated depends to a large extent on the number of patients
studied.
• Meta-analyses, which combine the results from many trials, have
more power to detect small but clinically significant effects.
• Furthermore, they give more precise estimates of the size of any
effects uncovered.
• This may be especially important when an investigator is looking
for beneficial (or deleterious) effects in specific subgroups of 96
patients.
TRANSPARENCY: good meta-analyses should allow readers to
determine for themselves the reasonableness of the decisions taken
and their likely impact on the final estimate of effect SIZE.
REQUIREMENTS FOR META-ANALYSIS:The main requirement
for a worthwhile meta-analysis is a wellexecuted systematic
review.
• However competent the meta-analysis, if the original review was
partial, flawed or otherwise unsystematic, then the metaanalysis may
provide a precise quantitative estimate that is simply wrong.
• The main requirement of systematic review is easier to state than to
execute: a complete, unbiased collection of all the original studies of
acceptable quality that examine the same therapeutic question.
• There are many checklists for the assessment of the quality of
systematic reviews;however, the QUOROM statement (quality of
reporting of meta-analyses) is particularly recommended.
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CONDUCTING META-ANALYSES
• Location of studies
• Quality assessment
• Calculating effect sizes
• Checking for publication bias
• Sensitivity analyses
• Presenting the findings
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HETEROGENEITY
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LIMITATIONS
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YANCEY’S 10 RULES
-Evaluating Scientific literature
1. Be skeptical
AJODO-1996 559-563
YANCEY’S 10 RULES
-Evaluating Scientific literature
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AJODO-1996 559-563
SOFTWARES-STATISTICAL PACKAGES
SPSS(Statistical package for the social sciences)
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EPIINFO-Statistical software for epidemiology developed by
Centers for disease control and prevention in Atlanta.
-It is used worldwide for the rapid assessment of disease and
helps in public health education
MICROSOFT EXCEL-It is similar to SPSS but provides an
extensive range of statistical functions,that perform
calculations from basic mean,median,mode to the more
complex stastistical distributions and probability tests.
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Conclusion
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REFERENCES
• Park K, Park’s text book of preventive and social medicine,
23rd edition.
• Soben Peter S, essential of public health dentistry, 4th
edition.
• Basic epidemiology 2nd edition R Bonita, R Beaglehole, T
Kjellstrom.
• Mahajan BK, methods in biostatistics. 6th edition
• Rao K Visweswara, Biostatistics – A manual of statistical
methods for use in health, nutrition & anthropology. 2nd
edition.2007
• Determination of sample size-Journal of orthodontics
Vol 31:2004,107-114
• Ten rules for reading clinical research reports. John M
. Yancey AJODO may 1996. vol 109.
• Selection of Statistical Software for Solving Big Data
Problems: A Guide for Businesses, Students, and
Universities. Ceyhun osgur, Michelle kleckner, Yang Li.
SAGE OPEN. May 12, 2015.
• What is meta-analysis? Iain K Crombie PhD
FFPHM Professor of Public Health, University of
Dundee. Huw TO Davies PhD Professor of Health
Care Policy and Management, University of St
Andrews. 107
THANK YOU
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