INTRODUCTION TO

BIOSTATISTICS

BY
HARI RAJAN.G 1
 Definition of Statistics
• Different authors have defined statistics differently. The best definition of
statistics is given by Croxton and Cowden according to whom statistics
may be defined as the science, which deals with
collection, presentation, analysis and
interpretation of numerical data.
• The science and art of dealing with variation in data through collection,
classification, and analysis in such a way as to obtain reliable results. —
(John M. Last, A Dictionary of Epidemiology )
• Branch of mathematics that deals with the collection, organization, and
analysis of numerical data and with such problems as experiment
design and decision making. —(Microsoft Encarta Premium
2009)

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 Definition of Biostatistics= Medical
statistics
• Biostatistics may be defined as application of
statistical methods to medical, biological and
public health related problems.
• It is the scientific treatment given to the medical data
derived from group of individuals or patients
 Collection of data.
 Presentation of the collected data.
 Analysis and interpretation of the results.
 Making decisions on the basis of such analysis
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 Role of Statistics in physiotherapy
The main theory of statistics lies in the term variability.
There is No two individuals are same. For example, blood pressure of
person may vary from time to time as well as from person to person.
We can also have instrumental variability as well as
observers variability.
Methods of statistical inference provide largely objective means for
drawing conclusions from the data about the issue under study.
Medical science is full of uncertainties and statistics deals with
uncertainties. Statistical methods try to quantify the uncertainties
present in medical science.
It helps the researcher to arrive at a scientific judgment about
a hypothesis. It has been argued that decision making is an
integral part of a physiotherapist’s work.
Frequently, decision making is probability based.
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 Role of Statistics in
Public Health and Community Medicine

Statistics finds an extensive use in Public Health and Community Medicine.

Statistical methods are foundations for public health administrators to understand
what is happening to the population under their care at community level as well as
individual level. If reliable information regarding the disease is available, the public
health administrator is in a position to:
●● Assess community needs
●● Understand socio-economic determinants of health
●● Plan experiment in health research
●● Analyze their results
●● Study diagnosis and prognosis of the disease for taking
effective action
●● Scientifically test the efficacy of new medicines and
methods of treatment.

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Why we need to study Medical Statistics?
Three reasons:
(1) Basic requirement of medical research.

(2) Update your medical knowledge.

(3) Data management and treatment.

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 Role of statisticians
 To guide the design of an experiment or survey prior to
data collection

 To analyze data using proper statistical procedures and

techniques

 To present and interpret the results to researchers and

other decision makers

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 I. Basic concepts
• Homogeneity: All individuals have similar values or
belong to same category.
Example:
Example all individuals are Chinese, women, middle age (30~40
years old), work in a computer factory ---- homogeneity in nationality,
gender, age and occupation.
• Variation: the differences in feature, voice…
• Throw a coin: The mark face may be up or down ---- variation!
• Treat the patients suffering from pneumonia with same antibiotics: A
part of them recovered and others didn’t ---- variation!
• If there is no variation, there is no need for statistics.
• Many examples of variation in medical field: height, weight, pulse,
blood pressure, … …
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 2. Population and Sample

• Population: The whole collection of individuals that

one intends to study.
• Sample: A representative part of the population.

• Randomization: An important way to make the

sample representative.

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 limited population and limitless population

• All the cases with hepatitis B collected in a hospital

in salem . (limited)
• All the deaths found from the permanent residents
in a city. (limited)
• All the rats for testing the toxicity of a medicine.
(limitless) 
• All the patients for testing the effect of a medicine.
(limitless)  hypertensive, diabetic, …
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 Random
By chance!
• Random event: the event may occur or may not
occur in one experiment.
Before one experiment, nobody is sure whether
the event occurs or not.
Example:
Example weather, traffic accident, …
There must be some regulation in a large number
of experiments.
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 3. Probability
• Measure the possibility of occurrence of a random
event.
• A : random event
• P(A) : Probability of the random event A
P(A)=1, if an event always occurs.
P(A)=0, if an event never occurs.

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Estimation of Probability----Frequency

• Number of observations: n (large enough)

Number of occurrences of random event A: m
f(A)  m/n
(Frequency or Relative frequency)
Example:
Example Throw a coin event:
n=100, m (Times of the mark face occurred)=46
m/n=46%, this is the frequency; P(A)=1/2=50%,
this is the Probability.
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 4. Parameter and Statistic
• Parameter : A measure of population or
A measure of the distribution of population.
Parameter is usually presented by Greek letter.
such as μ,π,σ.
-- Parameters are unknown usually
To know the parameter of a population, we need a sample
• Statistic: A measure of sample or A measure of the distribution of sample.
Statistic is usually presented by Latin letter
such as s , p, t.

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 5. Sampling Error
error :The difference between observed value and
true value.

Three kinds of error:

(1)   Systematic error (fixed)
(2)   Measurement error (random) (Observational error)
(3) Sampling error (random)

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 Sampling error
• The statistics of different samples from same
population: different each other!
• The statistics: different from the parameter!

The sampling error exists in any sampling

research.
It can not be avoided but may be estimated.

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 II. Types of data
1. Numerical Data ( Quantitative Data )

• The variable describe the characteristic of individuals

quantitatively
-- Numerical Data

• The data of numerical variable

-- Quantitative Data

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 2. Categorical Data ( Enumeration Data )

• The variable describe the category of individuals according to a

characteristic of individuals
-- Categorical Data
• The number of individuals in each category

-- Enumeration Data

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 Special case of categorical data :
Ordinal Data ( rank data )
• There exists order among all possible categories. ( level of
measurement)

-- Ordinal Data
• The data of ordinal variable, which represent the order of
individuals only

-- Rank data

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 Examples
Which type of data they belong to?
• RBC (4.58 106/mcL)
• Diastolic/systolic blood pressure
(8/12 kPa) or ( 80/100 mmHg)
• Percentage of individuals with blood type A (20%)
(A, B, AB, O)
• Protein in urine (++) ( － , ±, +, ++, +++)
• Incidence rate of breast cancer ( 35/100,000)

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III. The Basic Steps of Statistical Work
1. Design of study
• Professional design:
Research aim
Subjects,
Measures, etc.

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• Statistical design:

Sampling or allocation method,

Sample size,
Randomization,
Data processing, etc.

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 2. Collection of data
• Source of data
Government report system such as: cholera,
plague (black death) …
Registration system such as: birth/death
certificate …
Routine records such as: patient case report …
Ad hoc survey such as: influenza A (H1N1) …

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• Data collection – Accuracy, complete,
in time

Protocol: Place, subjects, timing; training; pilot;

questionnaire; instruments; sampling method and
sample size; budget…
Procedure: observation, interview, filling
form, letter, telephone, web.

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 3. Data Sorting
• Checking
Hand, computer software
• Amend
• Missing data?
• Grouping
According to categorical variables (sex, occupation, disease…)
According to numerical variables (age, income, blood pressure …)

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 4. Data Analysis
• Descriptive statistics (show the sample)
mean, incidence rate …
-- Table and plot
• Inferential statistics (towards the population)
-- Estimation
-- Hypothesis testing (comparison)

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 About Teaching and Learning
• Aim:
Training statistical thinking
Skill of dealing with medical data.
• Emphasize:
Essential concepts and statistical thinking
-- lectures and practice session
Skill of computer and statistical software
-- practice session ( Excel and SPSS )

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 Sources of
data

Records Surveys Experiments

Comprehensive Sample

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 Types of data

Constant
Variables

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 Types of variables

Quantitative variables Qualitative variables

Quantitative Qualitative
continuous nominal

Quantitative Qualitative
descrete ordinal

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 Methods of presentation of data

Numerical presentation
Graphical presentation
Mathematical presentation

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 1- Numerical presentation
Tabular presentation (simple – complex)
Simple frequency distribution Table (S.F.D.T.)
Title
Name of variable
Frequency %
(Units of variable)
-
- Categories
-

Total
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 Table (I): Distribution of 50 patients at the surgical
department of AAAAA hospital in May 2008 according
to their ABO blood groups

Blood group Frequency %

A 12 24
B 18 36
AB 5 10
O 15 30
Total 50 100

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 Table (II): Distribution of 50 patients at the surgical
department of AAAAA hospital in May 2008 according to
their age

Age Frequency %
(years)
20-<30 12 24
30- 18 36
40- 5 10
50+ 15 30
Total 50 100

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 Complex frequency distribution Table
Table (III): Distribution of 20 lung cancer patients at the chest department of
AAAAA hospital and 40 controls in May 2008 according to smoking

Lung cancer
Total
Smoking Cases Control
No. % No. % No. %
Smoker 15 75% 8 20% 23 38.33
Non
smoker 5 25% 32 80% 37 61.67

Total 20 100 40 100 60 100

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 Complex frequency distribution Table

Table (IV): Distribution of 60 patients at the chest department of

AAAAA hospital in May 2008 according to smoking & lung cancer

Lung cancer
Total
Smoking positive negative
No. % No. % No. %
Smoker 15 65.2 8 34.8 23 100
Non
smoker 5 13.5 32 86.5 37 100

Total 20 33.3 40 66.7 60 100

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 Line Graph

MMR/1000
Year MMR
60
50
1960 50
40 1970 45
30 1980 26
20
10 1990 15
0 2000 12
Year
1960 1970 1980 1990 2000

Figure (1): Maternal mortality rate of (country),

1960-2000
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 Frequency polygon

Age Sex Mid-point of interval

(years) Males Females

20 - 3 (12%) 2 (10%) (20+30) / 2 = 25

30 - 9 (36%) 6 (30%) (30+40) / 2 = 35
40- 7 (8%) 5 (25%) (40+50) / 2 = 45
50 - 4 (16%) 3 (15%) (50+60) / 2 = 55
60 - 70 2 (8%) 4 (20%) (60+70) / 2 = 65
Total 25(100%) 20(100%)

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 Sex
Age M-P
Frequency polygon M F
20- (12%) (10%) 25
Males Females 30- (36%) (30%) 35
%
40 40- (8%) (25%) 45
50- (16%) (15%) 55
35
30 60-70 (8%) (20%) 65

25
20
15
10
5
0
Age
25 35 45 55 65

Figure (2): Distribution of 45 patients at (place) , in (time)

by age and sex 40
 Frequency curve

8 Female

7 Male

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Frequency

5
4

0
20- 30- 40- 50- 60-69
Age in years

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 Histogram

% 35
30
25
20
15
10
5
0
0 25 30 40 45 60 65
Age (years)
Figure (2): Distribution of 100 cholera patients at (place) , in (time)
by age 42
 Bar chart
%
45
40
35
30
25
20
15
10
5
0
Single Married Divorced Widowed

MaritalMarital
Status status

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 Bar chart
%
50
Male
40 Female

30
20
10
0
Single Married Divorced Widowed
Marital status
Marital Status

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 Pie chart
Deletion
Inversion
3%
18%

Translocation
79%

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Doughnut chart

Hospital B

DM
Hospital A IHD
Renal

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 3-Mathematical presentation
Summery statistics

Measures of location
1- Measures of central tendency
2- Measures of non central locations
(Quartiles, Percentiles )
Measures of dispersion

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Summery statistics

1- Measures of central tendency (averages)

Midrange
Smallest observation + Largest observation
2
Mode
the value which occurs with the greatest
frequency i.e. the most common value

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Summery statistics
1- Measures of central tendency (cont.)

Median
the observation which lies in the middle of the
ordered observation.

Arithmetic mean (mean)

Sum of all observations
Number of observations

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 Measures of dispersion
Range
Variance
Standard déviation
Semi-interquartile range
Coefficient of variation

“Standard error”

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 Standard déviation SD
7 8
7 7
7 77
7 77
6 3 2
7
7 8 13
Mean = 7 9
Mean = 7 SD=0.63
SD=0
Mean = 7
SD=4.04
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 Standard error of mean SE
A measure of variability among means of samples
selected from certain population

S
SE (Mean) = n

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