introduction to biostatistics

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Introduction to biostatistics lecture by Prof. Faisal Farahat, as part of the 5th Research Summer School - Jeddah held by KAIMRC - WR

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Page 1: Introduction to biostatistics

1

June 22, 2013 Dr Fayssal Farahat, MD 1

Dr. Fayssal M Farahat, MBBCh, MSc, PhD

Consultant Public Health

Infection Prevention and Control

King AbdulAziz Medical City–Jeddah

National Guard Health Affairs

Descriptive Statistics

June 22, 2013 Dr Fayssal Farahat, MD 2

“Whatever you can not measure, you can not

manage”

June 22, 2013 Dr Fayssal Farahat, MD 3

Statistics business education psychology

Biology and Medicine

Biostatistics

Page 2: Introduction to biostatistics

2

June 22, 2013 Dr Fayssal Farahat, MD 4

Statistics

Collection Presentation Analysis

Draw inferences

June 22, 2013 Dr Fayssal Farahat, MD 5

Data = numbers

Measurement Counting

A nurse takes a

patient’s

temperature

A hospital

administrator counts

number of discharged

patients on a given

day.

June 22, 2013 Dr Fayssal Farahat, MD 6

Data

Data

Data

Data

Decision

The procedure by

which we reach a

conclusion about a

population on the

basis of information

contained in a sample

drawn from this

population

Page 3: Introduction to biostatistics

3

June 22, 2013 Dr Fayssal Farahat, MD 7

Students’ scores:

75, 95, 60, 93, 85, 84, 76, 92, 62, 83,

80, 90, 64, 75,79, 32, 78, 64, 98,

73,88, 61, 82, 86, 79, 78, 80, 55

How useful would that list of number be to you?

How to get information out of data …

FIRST STEP, the data have to be organized and Summarized.

Data INFO

June 22, 2013 Dr Fayssal Farahat, MD 8

Sources of Data

Primary Data Collection & Analysis

Secondary Data Collection & Analysis

Client satisfaction & Identification Surveys

Lifestyle and health behavior surveys

Focus Group discussions

Hospital Records

inpatients outpatients Birth Death

External sources (published reports)

June 22, 2013 Dr Fayssal Farahat, MD 9

Measurement

Page 4: Introduction to biostatistics

4

June 22, 2013 Dr Fayssal Farahat, MD 10

Variable

=

Characteristic not the same when observed in different possessors.

June 22, 2013 Dr Fayssal Farahat, MD 11

VARIABLES

June 22, 2013 Dr Fayssal Farahat, MD 12

Quantitative

Discrete

منفصلة

No fractions

ال كسور عشرية

Continuous

متصلة

Fractions

كسور عشرية

Page 5: Introduction to biostatistics

5

June 22, 2013 Dr Fayssal Farahat, MD 13

Qualitative

Ordinal

ترتيبية

Nominal

اسمية

June 22, 2013 Dr Fayssal Farahat, MD 14

Discrete

منفصلة

• Number of pregnancies • Number of children • Family size • Heart rate • Respiratory rate • Number of cigarettes

June 22, 2013 Dr Fayssal Farahat, MD 15

Continuous

متصلة• WEIGHT

• HIGHT

• AGE

• TEPERATURE

• BLOOD PRESSURE

• RBS

• AMOUNT OF URINE

• BODY SURFACE AREA

Page 6: Introduction to biostatistics

6

June 22, 2013 Dr Fayssal Farahat, MD 16

Nominal

- Gender : " Male – female . "

- Marital status: married, single, widow, divorced

(1) (2)

(1) (2) (3) (4)

June 22, 2013 Dr Fayssal Farahat, MD 17

Ordinal

- grade : " A+ A B+ B C+ C D+ D "

.

- Educational level: 1ry, 2ry, university

- Income: < 5000, 5000-10.000, >10.000

(1) (2) (3) (4) (5) (6) (7)

(1) (2) (3)

(1) (2) (3)

June 22, 2013 Dr Fayssal Farahat, MD 18

Quantitative

Qualitative

High systole

Qualitative

x

Quantitative

200 x

Page 7: Introduction to biostatistics

7

June 22, 2013 Dr Fayssal Farahat, MD 19

Measurement Scales

Nominal

Ordinal

Interval

Ratio

June 22, 2013 Dr Fayssal Farahat, MD 20

Temperature

True

zero

Weight

June 22, 2013 Dr Fayssal Farahat, MD 21

The distinction is not about

the value, but the association,

causality each variable

occupies in the equation.

Page 8: Introduction to biostatistics

8

June 22, 2013 Dr Fayssal Farahat, MD 22

Frequency table

الجدول التكراري

Interval

الفترة

Frequency

التكرار

Valid %

النسبة المئوية

Cumulative %

النسبة التراكمية<20

20-29

30-39

40-49

50-59

60-69

70-79

80-89

≥90

Total

46

70

108

106

74

72

42

29

33

580

7.9

12.1

18.6

18.3

12.8

12.4

7.2

5.0

5.7

100.0

7.9

20.0

38.6

56.9

69.7

82.1

89.3

94.3

100

Few

6-14

Overlap 40-49, 49-50

Equal width

Avoid

open-ended Cumulative %=

Obs % + all lower %

<60

June 22, 2013 Dr Fayssal Farahat, MD 23

City Male smokers المدخنون

Taif

Riyadh

Jeddah

TOTAL

Table (1). Number and percent of male smokers

less and more than 18 ys old in different cities

< 18 years > 18 years n % n %

80

90

150

320

TOTAL

n %

40

30

30

32

120

210

350

680

60

70

70

68

200 100

300

500

1000

100

100

100

Tables

June 22, 2013 Dr Fayssal Farahat, MD 24

Tables

City Male smokers

Taif

Riyadh

Jeddah

TOTAL

Table (1). Number and percent of male smokers

less and more than 18 ys old in different cities

< 18 years > 18 years

n % n %

80

90

150

320

TOTAL

n %

25

28

47

100

120

210

350

680

18

31

51

100

200 20

300

500

1000

30

50

100

Page 9: Introduction to biostatistics

9

June 22, 2013 Dr Fayssal Farahat, MD 25

2 x 2

Exposure

Smoker

Non-smoker

Cancer Lung Positive

N (%)

Negative

N (%)

June 22, 2013 Dr Fayssal Farahat, MD 26

Graphs

Line graph

Frequency Histogram

Frequency polygon

Bar chart

Pie chart

Pictogram

June 22, 2013 Dr Fayssal Farahat, MD 27

Time

Positive

No relation

Negative

Vari

ab

le

X

Y

+

-

0

Page 10: Introduction to biostatistics

10

June 22, 2013 Dr Fayssal Farahat, MD 28

X

Y

Equal width

June 22, 2013 Dr Fayssal Farahat, MD 29

Frequency Polygone

المنحنى التكراري

June 22, 2013 Dr Fayssal Farahat, MD 30

heal thy disease

group

2

4

6

8

10

Coun

t

Healthy Diseased

Co

un

t

Page 11: Introduction to biostatistics

11

June 22, 2013 Dr Fayssal Farahat, MD 31

39.7

58.8

gp 1

gp 2

Age

June 22, 2013 Dr Fayssal Farahat, MD 32

Sex distribution in different studied groups

0

10

20

30

40

50

60

70

80

Control Asthmatic COPD

%

Male

Female

June 22, 2013 Dr Fayssal Farahat, MD 33

healthydisease

group

Pies show countsPie

44.44%8.055.56%

10.0

Pie Chart

Page 12: Introduction to biostatistics

12

June 22, 2013 Dr Fayssal Farahat, MD 34

Pictogram

1970 1980 1990 2000

June 22, 2013 Dr Fayssal Farahat, MD 35

0

2

4

6

8

10

12

14

Y1950 Y1960 Y1970 Y1980 Y1990 Y2000

Year

Mo

rta

lity

(p

er 1

00

0)

2

4

6

8

10

12

14

0

1

2

3

4

1970y 1980y 1990y 2000y

June 22, 2013 Dr Fayssal Farahat, MD 36

Summarizing qualitative data

Proportion

a / a + b (part / whole)

Percentage Proportion X 100%

Ratio

a / b (part / another part)

Rate a / a + b X base (1000, 10,000,100,000) + In a specific time (20 per 10,000 per year)

Page 13: Introduction to biostatistics

13

June 22, 2013 Dr Fayssal Farahat, MD 37

Arithmetic Mean

Extremes HR

variation

1

2

3

4

5

6

7

8

9

10

19.2

51.9

33.1

86.7

29.1

45.3

16.4

85.7

18.9

42.6

42.9

32.1

Consider each variable

X

June 22, 2013 Dr Fayssal Farahat, MD 38

Weighted Mean

Interval Frequency Valid % Cumulative %

2-20

21-30

31-40

41-50

51-60

61-70

71-80

81-90

>90

Total

46

70

108

106

74

72

42

29

33

580

7.9

12.1

18.6

18.3

12.8

12.4

7.2

5.0

5.7

100.0

7.9

20.0

38.6

56.9

69.7

82.1

89.3

94.3

100

[(11 x 46) + (25 x 70) + ….+ (85 x 29) + (100 x 33)] / 580 = 49.1

X

?

June 22, 2013 Dr Fayssal Farahat, MD 39

Median Middle observation

Odd Even

Extremes Consider each variable

Ordinal data

Page 14: Introduction to biostatistics

14

June 22, 2013 Dr Fayssal Farahat, MD 40

Mode

Most frequent value

Uni-modal Bi-modal

Most frequent interval

Most frequent diagnosis

June 22, 2013 Dr Fayssal Farahat, MD 41

Measures of Spread

مقاييس التشتت

Range SD CV

Percentiles Interquartile

Range

المدى االنحراف المعياري

معامل التغير

Percentiles

المدى الربعي

June 22, 2013 Dr Fayssal Farahat, MD 42

The Range

The largest – the smallest

Page 15: Introduction to biostatistics

15

June 22, 2013 Dr Fayssal Farahat, MD 43

June 22, 2013 Dr Fayssal Farahat, MD 44

Coefficient of Variation

معامل التغير

Measure 1 70 (31)

Measure 2 105 (48)

Can

we

Compare

2 different scales

2 different investigators

CV = (SD / Mean) x 100

44.3 % 45.7 %

Quality

Control

June 22, 2013 Dr Fayssal Farahat, MD 45

Page 16: Introduction to biostatistics

16

June 22, 2013 Dr Fayssal Farahat, MD 46

Interquartile Range

المدى الربعي

= the difference between the 25th and 75th percentiles

25th 75th

Central 50%

6.5 kg 7.5 kg

1st 3rd

June 22, 2013 Dr Fayssal Farahat, MD 47

STEM

الساق

LEAF

الورقة

2

3

4

5

6

5689

0011369

0269

03

027

30.00

33.00

31.00

29.00

30.00

31.00

26.00

28.00

36.00

39.00

40.00

49.00

50.00

60.00

67.00

46.00

42.00

25.00

62.00

53.00

Stem and Leaf Plot

June 22, 2013 Dr Fayssal Farahat, MD 48

Box – and whisker plot

Page 17: Introduction to biostatistics

17

June 22, 2013 Dr Fayssal Farahat, MD 49

Normal Distribution Curve

Gaussian Distribution Curve

June 22, 2013 Dr Fayssal Farahat, MD 50

Mean

Median

Mode

Bell Shape

68%

Symmetric

June 22, 2013 Dr Fayssal Farahat, MD 51

Mean

Median

Mode

Bell Shape

95%

Symmetric

Page 18: Introduction to biostatistics

18

Normal curves

(μ=0, σ2=1) and (μ=5, σ 2=1)

-2 0 2 4 6 8

x

0.0

0.1

0.2

0.3

0.4

fx1

Normal curves (μ=0, σ2=1) and (μ=0, σ2=2)

-3 -2 -1 0 1 2 3

x

0.0

0.1

0.2

0.3

0.4

y

Normal curves (μ=0, σ2=1) and (μ=2, σ2=0.25)

-2 0 2 4 6 8

x

0.0

0.2

0.4

0.6

0.8

1.0

fx1

Page 19: Introduction to biostatistics

19

June 22, 2013 Dr Fayssal Farahat, MD 55

80 90 100 110 120 130 140 150 160

0

5

10

15

20

25

P e r c e n t

POUNDS

120 130 110

68% of 100 = .68 x 100 = ~ 68 students

80 90 100 110 120 130 140 150 160

0

5

10

15

20

25

P e r c e n t

POUNDS

120 100

95% of 100 = .95 x 120 = ~ 95 students

140 130 110

Page 20: Introduction to biostatistics

20

80 90 100 110 120 130 140 150 160

0

5

10

15

20

25

P e r c e n t

POUNDS

120 100 140 130 110

0 +1 +2 -1 -2

X

Z

130 – 120

10

x – μ

σ

80 90 100 110 120 130 140 150 160

0

5

10

15

20

25

P e r c e n t

POUNDS

120 100 140 130 110

126

0 +1 +2 -1 -2

x – μ

σ

Looking up probabilities in the

standard normal table

Z=0.60

Z=0.00

Page 21: Introduction to biostatistics

21

What is the area to the left of Z=1.51 in a standard normal curve?

Z=1.51

Z=1.51

Area is 93.45%