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Organization of statistical research
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The role of Biostatisticians
Biostatisticians play essential roles in designing studies, analyzing data and creating methods to attack research problems as diverse as
determination of major risk factors for heart disease, lung disease and cancer
testing of new drugs to combat AIDS evaluation of potential environmental factors
harmful to human health, such as tobacco smoke, asbestos or pollutants
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Applications of Biostatistics
Public health, including epidemiology, health services research, nutrition, and environmental health
Design and analysis of clinical trials in medicine Genomics, population genetics, and statistical genetics in
populations in order to link variation in genotype with a variation in phenotype. This has been used in agriculture to improve crops and farm animals. In biomedical research, this work can assist in finding candidates for gene alleles that can cause or influence predisposition to disease in human genetics
Ecology Biological sequence analysis
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Applications of Biostatistics
Statistical methods are beginning to be integrated into
medical informatics public health informatics bioinformatics
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Types of Data
Categorical data: values belong to categories- Nominal data: there is no natural order to the
categories e.g. blood groups- Ordinal data: there is natural order e.g. Adverse
Events (Mild/Moderate/Severe/Life Threatening)- Binary data: there are only two possible categories
e.g. alive/dead Numerical data: the value is a number
(either measured or counted)- Continuous data: measurement is on a continuum
e.g. height, age, haemoglobin- Discrete data: a “count” of events e.g. number of
pregnancies
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Measures of Frequency of Events
Incidence- The number of new events (e.g. death or a particular
disease) that occur during a specified period of time in a population at risk for developing the events.
Incidence Rate- A term related to incidence that reports the number of
new events that occur over the sum of time individuals in the population were at risk for having the event (e.g. events/person-years).
Prevalence- The number of persons in the population affected by a
disease at a specific time divided by the number of persons in the population at the time.
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Measures of Association
Relative risk and cohort studies- The relative risk (or risk ratio) is defined as the
ratio of the incidence of disease in the exposed group divided by the corresponding incidence of disease in the unexposed group.
Odds ratio and case-control studies- The odds ratio is defined as the odds of
exposure in the group with disease divided by the odds of exposure in the control group.
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Measures of Association
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Measures of Association Absolute risk
- The relative risk and odds ratio provide a measure of risk compared with a standard.
Attributable risk or Risk difference is a measure of absolute risk. It represents the excess risk of disease in those exposed taking into account the background rate of disease. The attributable risk is defined as the difference between the incidence rates in the exposed and non-exposed groups.
Population Attributable Risk is used to describe the excess rate of disease in the total study population of exposed and non-exposed individuals that is attributable to the exposure.
Number needed to treat (NNT)- The number of patients who would need to be treated to
prevent one adverse outcome is often used to present the results of randomized trials.
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Terms Used To Describe The Quality Of Measurements
Reliability is variability between subjects divided by inter-subject variability plus measurement error.
Validity refers to the extent to which a test or surrogate is measuring what we think it is measuring.
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Measures Of Diagnostic Test Accuracy
Sensitivity is defined as the ability of the test to identify correctly those who have the disease.
Specificity is defined as the ability of the test to identify correctly those who do not have the disease.
Predictive values are important for assessing how useful a test will be in the clinical setting at the individual patient level. The positive predictive value is the probability of disease in a patient with a positive test. Conversely, the negative predictive value is the probability that the patient does not have disease if he has a negative test result.
Likelihood ratio indicates how much a given diagnostic test result will raise or lower the odds of having a disease relative to the prior probability of disease.
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Measures Of Diagnostic Test Accuracy
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Expressions Used When Making Inferences About Data
Confidence Intervals- The results of any study sample are an estimate of the true value
in the entire population. The true value may actually be greater or less than what is observed.
Type I error (alpha) is the probability of incorrectly concluding there is a statistically significant difference in the population when none exists.
Type II error (beta) is the probability of incorrectly concluding that there is no statistically significant difference in a population when one exists.
Power is a measure of the ability of a study to detect a true difference.
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Kaplan-Meier Survival Curves
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Why Use Statistics?
Cardiovascular Mortality in Males
0
0,2
0,4
0,6
0,8
1
1,2
'35-'44 '45-'54 '55-'64 '65-'74 '75-'84
SMR Bangor
Roseto
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Percentage of Specimens Testing Positive for RSV (respiratory syncytial virus)
Jul Aug Sep Oct Nov Dec Jan Feb Mar Apr May Jun
South 2 2 5 7 20 30 15 20 15 8 4 3
North-east
2 3 5 3 12 28 22 28 22 20 10 9
West 2 2 3 3 5 8 25 27 25 22 15 12
Mid-west
2 2 3 2 4 12 12 12 10 19 15 8
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Descriptive Statistics
Percentage of Specimens Testing Postive for RSV 1998-99
05
101520253035
South
Northeast
West
Midwest
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Distribution of Course Grades
0
2
4
6
8
10
12
14
Number of Students
A A- B+ B B- C+ C C- D+ D D- F
Grade
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The Normal Distribution
Mean = median = mode
Skew is zero 68% of values fall
between 1 SD 95% of values fall
between 2 SDs
.
Me
an
, Med
ian
, Mo
de
1
2
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Hypertension Trial
DRUG Baseline mean SBP F/u mean SBP
A 150 130
B 150 125
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30 Day % Mortality
Study IC STK Control p N
Khaja 5.0 10.0 0.55 40
Anderson 4.2 15.4 0.19 50
Kennedy 3.7 11.2 0.02 250
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95% Confidence Intervals
-,40 -,35 -,30 -,25 -,20 -,15 -,10 -,05 ,00 ,05 ,10 ,15 ,20
Khaja(n=40)
Anderson(n=50)
Kennedy(n=250)
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Types of Errors
Nodifference
Difference
Nodifference
TYPE IIERROR ()
Difference TYPE IERROR ()
Truth
Conclusion
Power = 1-
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Suppose we made three more series of draws, and the results were + 16%, + 0%, and + 12%. The random sampling errors of the four simulations would then average out to:
ERROR ANALYSIS
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Note that the cancellation of the positive and negative random errors results in a small average. Actually with more trials, the average of the random sampling errors tends to zero.
ERROR ANALYSIS
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So in order to measure a “typical size” of a random sampling error, we have to ignore the signs. We could just take the mean of the absolute values (MA) of the random sampling errors. For the four random sampling errors above, the MA turns out to be
ERROR ANALYSIS
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The MA is difficult to deal with theoretically because the absolute value function is not differentiable at 0. So in statistics, and error analysis in general, the root mean square (RMS) of the random sampling errors is generally used. For the four random sampling errors above, the RMS is
ERROR ANALYSIS
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The RMS is a more conservative measure of the typical size of the
random sampling errors in the sense that MA ≤ RMS.
ERROR ANALYSIS
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For a given experiment the RMS of all possible random sampling errors is called the standard error (SE). For example, whenever we use a random sample of size n and its percentages p to estimate the population percentage π, we have
ERROR ANALYSIS