Medical statistics

VASYLYEV
(ВАСИЛЬЕВ)
Yuriy
Konstantinowich

Lecture No 1
 Statistics is social
science, which study
quantitative structure of
mass phenomena in
indissoluble connection
with their qualitative
characteristics
 P.-C.-A. Louis is often
referred to as the  «father of 
clinical statistics».
In 1837 he wrote  "I
conceive that without the aid of
statistics nothing like real
medical science is possible".
In perhaps his most
famous study, Louis evaluated
bloodletting as a treatment for
pneumonia.
It should be noted that
bloodletting was an extremely
popular form of therapy at the
time.
• Two forms of
bloodletting were
practiced: by lancet
(cutting a vein) and
by placement of
leeches on specific
parts of the body.
• (In 1833, France had
imported more than
42 million leeches for
this purpose.)
 Louis called into
question the
effectiveness of
bloodletting
by carefully
monitoring and Pierre-Charles-
recording outcomes Alexandre
Louis
in various treatment
groups.
In one analysis, he
compared patients who
received early bloodletting
treatment (within the first 4
days of symptoms) and
those who received late
treatment, finding that 18 of
41 patients in the early
treatment group died, while
9 of 36 patients bled later in
the course of their illness
died.
 statistical
totality -

is a group, which consists of relatively

homogeneous units of observation,
which were taken in certain borders of

time and space.

 Unit of observation - it is
component of statistical totality,
which is carrier of taken into
accountable characteristics.
 There are seven units of
observation in this statistical
totality (n=7)
 Accountable characteristics are
characteristics of units of observation
which are taken info account registered
during the statistic research.
 Accountable
characteristics in this
example are the
following:

- Sex
- Age
- Place of residence
- Disease
 Accountable
Statistica characteristics
l totality Unit of
observation
 Accountable characteristics
• attributive accountable characteristics
–
are characteristics which are expressed
verbally, namely sex, place of
residence, profession, etc.
• quantitative accountable
characteristics – are characteristics
which have numerical value.
Example: age, height, body mass, etc.
 Statistical totality
• General statistical totality is
totality which includes all units
representative studying
phenomenon.
• Selective statistical totality is
part of general totality selected by
special method and intended to
characterize general totality.
The organization of the
statistic investigation
• In the activity of a doctor the
ability of the independent
conducting of research work and
knowledge of bases of its
organization is an inalienable
element.
• To that end it is necessary to know
the stages of statistical research,
seize the method of drafting of the
program and plan of study of the
phenomenon (statistical totality).
 The stages of statistical
research
• l stage - composition of the
program and plan of investigation
• 2 stage - collection of material
• 3 stage - working up of material
• 4 stage - analysis of material,
conclusions, proposals, putting
into practice.
The program of statistical research

shows the basic directions of

research and information, which
it is necessary to collect.
The programs are
* official ones (medical Statistical
forms of document) and
* special ones (which are
compiled by a researcher).
 The program of statistic
investigation consists of the
following:

• 1/ program of material collection,

• 2/ elaboration program and
• 3/ program of analysis.
 The collection program
• is the program of statistic observation, the
form with the list of signs, that have to be
registered (registration' signs) with an
indication on whom it will be filled in, that is
with a determination of the unit of
observation.
• There are the official programs of material
collection to study health of population and
activity of medical establishments, as well as
special ones, composed by the investigator.
The material elaboration program is
the composition of models of tables.

There are three types of tables:

• 1) Simple
• 2) Group
• 3) Combination
 Simple table
• Simple table is Number of suicides by gender.
Ukraine, 2004.
a table in which
distribution of Number
statistical Sex of
totality is made suicides
by one
characteristic. Males 9394
Females 1865
Total 11259
 Group table

Group table is a table in which

distribution of statistic totality is made
by two interconnected characteristics.
 Combination table
• C.T. is table in which distribution
of statistic totality by three and
more taken info account
characteristics which correlate
between themselves is present.
Distribution of patients by character of the
disease,
place of residence and sex

Di- Town Country

sea- All
se Ma- Fe- Ma- Fe-
les ma- les ma-
les les
……. …. ….. ….. …… ……
Total …… ….. …… ….. …….
 The plan of statistic investigation
foresees organizational elements of work.

It consists of:
• 1) determination of the object of
investigation;
• 2) the place of investigation;
• 3) the time of investigation;
• 4) the volume of investigation;
• 5) the method of material
elaboration (manual, with the help
of computer);
• 6) the terms of the carrying out of
the work;
• 7) executors;
• 8) composition of the instructions
of the methods of work;
• 9) carrying out of the seminar for
the executors.
The ways of formation of the object
of investigation:
• by the time of observation
-continuous or one-moment;
• by the way of observation
statistic investigation is
subdivided into direct
observation, information copying,
questionnaire survey.
Medic-statistical research can be
complete or selective.
• Complete research covers all
observation units.
• Selective research covers a
representative part of observation
units, which enables to evaluate
phenomenon completely.
 Graphic
representations
in statistics
 Types of graphic
representation of indexes:

• 1) Diagrams
• 2) Cartograms
• 3) Cartodiagrams
 Types of diagrams
1) Linear
2) Column
3) Radial
4) Sector (circular, intracolumn)
5) Figured graphic
 Linear diagrams
are used to illustrate
frequency of the
phenomenon changing
in time.
 Column diagrams
are used to illustrate
homogenous intensive
indexes which are not
connected between
themselves
 Retail sales of oral antibiotics in
Australia and six major developed
countries, 1985-1994 (data from
Intercontinental Medical Statistics).    
Georgia
• Radial diagrams are used if it is
necessary to represent
graphically.
• The dynamics of the phenomenon
in the closed circle of time (days,
week, year).
Seasonal
(on the month
of year)
variations of
death rate of
population.
Sector (circular) diagrams

are used to illustrate

structure of the
phenomenon
Sector (circular) diagrams
 Figured graphic
In the example
at right, the
image
demonstrated to
a lay jury how
community
residents of all
ages showed
similar elevated
concentrations
of industrial
pollutants.
 Cartograms

• The cartogram shows

distribution of one
characteristic amongst the
objects of the map.
Infection rates range from less than 0.1% in the tan
areas to 15%-34% in the dark red areas.
 Prevalence
estimates of
diabetes, 2005

Diabetes currently affects 246 million people

globally and the number of people afflicted
with the disease has been rising at a rate of 7
million per year. Some 380 million people are
expected to suffer from the disease by 2025,
with cases being found increasingly in
developing countries.
Estimated Adult Obesity-Attributable
Medical Expenditures (2003 dollars)
 Cartodiagrams

One can estimate ratio of

some characteristics for
every one of the objects in
the map according to the
cartograms.
 Population size in the regions, for
instance, is represented through the
cartogram, but nationality share,
inhabiting every one of the regions, is
represented as sector diagrams.
World population
Сезонные (по
месяцам года)
колебания
уровней
транспортного
травматизма
 Розничная продажа устных антибиотиков в Австралии и шести главных развитых странах,
1985-1994 (данные от Межконтинентальной Медицинской Статистики).
Retail sales of oral antibiotics in Australia and six major developed countries, 1985-1994 (data
from Intercontinental Medical Statistics).  

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 Physicians' Use of Electronic Medical Records
Использование Врачей Электронных Медицинских Отчетов

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Классиф
икация
учитывае
мых
признако
в
Типы распределения статистической совокупности
Программа и
план
исследования
• Рассчитываем стандартное
отклонение (среднее
квадратическое отклонение)
Этапы статистического исследования