EELO UNIVERSITY

Lecturer : Mr. Abdilahi Mohamed Bade

Master of Public Health (MPH)

Master of Education (MED)

Bachelor of Science (BSc)

Classes: Nursing and Nutrition

Course: Biostatistics

Phone Number: 063-4451542

Email address : ambade [email protected]

Mr. Abdilahi M. Bade

Feb, 2022
 CHAPTER 1
INTRODUCTION TO BIOSTATISTICS

Mr. Abdilahi M. Bade

Feb, 2022
 Learning objectives
At the end of this chapter, students will be able to:
• Origins and history of Statistics.
• Define statistics & Biostatistics.
• Differentiate the two types of statistics.
• Explain the roles of statistics in public health, Medicine and
research.
• Describe the types of data and scales of measurement.
• Identify different methods of data collection.

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 Origins

• Statistics arose from the need of states to collect data on

their people and economies, in order to administer
them. Its meaning broadened in the early 19th
century to include the collection and analysis of data in
general. Today statistics is widely employed in
government, business, in the natural and social sciences.

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 History of Statistics

The word ‘statistics’ have been derived from Latin word ‘status’ or
the Italian word ‘statista’, meaning of these words is ‘political
state’ or a government.
In the past, statistics was used by rulers. The application of statistics
was very limited, but rulers and kings needed information about
lands, agriculture, commerce, population of their states to assess
their military potential, their wealth, taxation and other aspects of
government.

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 Definition of Statistics

• Statistics is the science of collecting, summarizing,

presenting, interpreting data, and of using them to test
hypotheses.
• Statistics is the science of dealing with numbers.
• Statistics is the science of collecting, organizing,
analyzing, and interpreting data in order to make
decisions.

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 Definition of Biostatistics
• The tools of statistics are employed in many fields—
business, education, psychology, agriculture, and
economics, to mention only a few. When the data
analyzed are derived from the biological sciences and
medicine, we use the term biostatistics to distinguish this
particular application of statistical tools and concepts.
• Biostatistics is statistics applied to biological and health
problems.

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 Definitions of Biostatistics
• Biostatistics is a growing field with applications in many
areas of biology including epidemiology, medical sciences,
health sciences, educational research and environmental
sciences.
• Biostatistics is the branch of statistics that deals with data
relating to living organisms.
• Biostatistics is the application of statistical principles to
questions and problems in medicine, public health or
biology.
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 Variable

A variable is a characteristic that takes on different values

in different persons, places, or things.
For example:
 Heart rate.
 The heights of adult males.
 The weights of preschool children.

 The ages of patients seen in a dental clinic.

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 What are statistical data?

• The raw material of statistics is data. For our purposes we

may define data as numbers. The two kinds of numbers that
we use in statistics are numbers that result from the taking in
the usual sense of the term of a measurement, and those that
result from the process of counting.
• For example, when a nurse weighs a patient or takes a
patient’s temperature, a measurement, consisting of a
number such as 150 pounds or 100 degrees Fahrenheit, is
obtained.
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• Quite a different type of number is obtained when a
hospital administrator counts the number of patients—
perhaps 20—discharged from the hospital on a given
day. Each of the three numbers is a datum, and the
three taken together are data.
• Statistical data: raw material or facts of any statistical
observation arising when ever measurements are made
or observations are classified.

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 Types of statistics
• Descriptive Statistics
– Collection,
– organization,
– summarization, and
– presentation of data.
• Inferential Statistics
– Generalizing from samples to populations using probabilities.
– Performing hypothesis testing.

– Determining relationships between variables.

– Making predictions. Mr. Abdilahi M. Bade

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 Descriptive Statistics
• Descriptive statistics are methods for organizing and
summarizing data.
• For example, tables or graphs are used to organize data,
and descriptive values such as the average score are
used to summarize data.
• A descriptive value for a population is called a parameter
and a descriptive value for a sample is called a statistic.

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 Inferential Statistics
• Inferential statistics are methods for using sample data
to make general conclusions about populations.
• Because a sample is typically only a part of the whole
population, sample data provide only limited information
about the population. As a result, sample statistics are
generally imperfect representatives of the corresponding
population parameters.

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Mr. Abdilahi M. Bade
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 Functions and Uses of Statistics
Medical services and health care delivery systems require use
of statistics in a variety of ways, such as:
1. Collection of information in the best possible way.
2. Simplification of huge and complex sets of data.
3. Formulation of hypothesis.

4. Community health diagnosis—identification and

definition of health problems, health resources and
health services utilization.
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5. Analyzing and interpreting data.
6. Making generations about populations based on studies of
samples.
7. Measurement of association between two or more variables.
8. Prediction and forecasting—done through regression analysis
techniques.
9. Designing experimental study.
10. Providing information that support in planning management,
monitoring and evaluation of health services programmes.

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 Uses of Statistics in Nursing
i. Importance of statistical literacy .
ii. Nurses need to understand statistics.
iii. Enhance patient care.

iv. Statistics help nurses to understand their patients.

v. Statistics help nurses to develop their profession.
vi. Educate trainee nurses.

vii. Statistics help nurses to compare options for practice.

viii. Statistics teach nurses to be cautious .

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 Application and Uses of Biostatistics

1. In Community Medicine and Public Health

(i) To test usefulness of sera and vaccines in the community
by control studies.
(ii) In epidemiological studies the role of causative factors is
statistically tested. For example, deficiency of iodine as an
important cause of goiter in a community is confirmed
only after comparing the incidence of goiter cases before
and after giving iodized salt.
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(iii) To study the correlation or association between two or more
attributes in the same population.

2. In Medicine
(i) To compare the efficacy of a particular drug. For this, the
percentage of cured, relieved or died in the experiment and
control groups is compared by applying statistical
techniques.
(ii) To find an association between two attributes such as cancer
and smoking or filariasis and social class.
(iii) To identify the signs-symptoms of a disease or syndrome.
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 Classification of data

Data can be classified into two broad classes:

i. Qualitative

ii. Quantitative

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Qualitative data: which relate to attributes or categories
into which things, animals, people are classified such as
sex, race, occupation, immune status of the body, access
to safe water etc; where we can record yes or no.
Quantitative data: which result from measurement such as
height, weight, serum levels, family size, pulse rate etc.

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Quantitative data may be continuous and discrete.
The continuous quantitative data have an infinite number
of possible values in any given interval. For example
height in meter, weight in kilogram etc.
A discrete quantitative data have only a finite number of
value in any given interval. For examples, family size,
pulse rate etc.

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Mr. Abdilahi M. Bade
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Data can also be classified into primary, secondary and tertiary
on the basis of source.
Primary data: which are obtained directly from an individual.
The primary data give the desired precise information.

Example—data collected by a researcher from the respondents.

Secondary data: which are obtained from outside sources
such as hospital records, census report etc.
Tertiary data: which are collected from text books.

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Data can also be classified on the basis of processing into
grouped and ungrouped.
 Grouped data: when data are processed as groups after
collection. For example— height on ten boys in feet are 4
x 4 boys, 4.5 x 4 boys, 5 x 2 boys.
 Ungrouped data: when data processed on individual
basis after collection. For example— weight of four boys
in kg are 20, 22, 18 and 16.

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 Types of data
Based on source, data can be classified as:
– Primary & secondary data

1. Primary data
• Data collected by the investigator for the purpose of specific
study.
• Original in character.
• Mostly generated by surveys.
• Complete, reliable and more accurate.
• Expensive ( money & time).
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 Examples of Primary Data

• Surveys
• Focus groups
• Questionnaires
• Personal interviews
• Experiments and field study

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2. Secondary data
• When the investigator uses data which have been
collected by others for other purpose.
• Obtained from Journals, reports, Gov’t publications etc.

• Less expensive (less money & time).

• May be incomplete, less quality, less valid.

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 Sources of Secondary Data
• District health departments.
• Vital Statistics – birth, death certificates.
• Hospital, clinic, school nurse records.
• Private and foundation databases.
• Federal and State governments.
• Surveillance data from state government programs.
• Federal agency statistics.
• Department of Environment.
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 Scales of measurement

Variable is any aspect of an individual or thing that is

measured and can take any value for different

individuals or cases.

Divided in to two:
1. Qualitative (categorical) variables.
2. Quantitative (numerical) variables.

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 Qualitative (categorical) variable
• A variable which can not be measure in quantitative
(numerical) form but can only be identified by names.
• Qualitative variables—which take non-numeric narrative
values, e.g. Sex, colour, etc.
• It has two forms based on scales of measurement:
– Nominal
– Ordinal

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 Nominal data
• Represent categories or names.
• There is no orders in the categories.
• It has two forms:

– Dichotomous- has 2 value categories.

• E.g. Sex : Male or Female

» Immunization: yes or No
» Diseases outcome : Died or survived

– Multichotomous: > more than two categories.

– Blood group: A, B, AB or O.
– Marital status: single, married, divorced or widowed.
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 Ordinal data
• Have order in the response categories.
• But, the distance or interval between categories are not
necessarily equal.
For example:
• Immunization status:
» Not immunized,
» Partially immunized
» Fully immunized
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 Disease state:
 Mild
 Moderate

 Severe

 Agreement questions:
 Strongly agree
 Agree
 Not comment

 Disagree
 Strongly disagree Mr. Abdilahi M. Bade
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 Sources of Data

 Census reports

 Annual vital statistics reports

 Hospital records
 Disease notification
 Disease register
 Medical records

 Sample survey reports

 Medical text books and journals

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 Data collection
• The process of obtaining statistical data, before any statistical
work can be done data must be collected.
• Collecting Primary data
– Observation
– Interview
– Questionnaire

• Collecting secondary data

– Use of documentary sources

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 Obtrusive vs. Unobtrusive Methods

Obtrusive: data collection methods that directly obtain

information from those being evaluated e.g. interviews,
surveys, focus groups.

Unobtrusive: data collection methods that do not collect

information directly from evaluees. e.g., document

analysis.

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 OBSERVATION METHOD
Observation method is a method under which data from the field
is collected with the help of observation by the observer.
 Observation: is the process of looking and noticing as a means
of gathering information.
 The observer: is the person doing the observation.
 The observant: is the person who is being observed.
 Observation checklist: summary of items that form the content
of observation.

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 TYPES OF OBSERVATION

When observation is done by characterizing style of recording

the observed information, standardized conditions of
observation, then it is Structured Observation.
When observation is done without thought before observation,
then it is Unstructured Observation.
When the observer is a member of the group which he is
observing, then it is Participant Observation.
When observer is observing people without giving any
information to them, then it is Non-participant Observation.
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When the observation takes place in natural condition, it is
uncontrolled observation. It is done to get spontaneous
picture of life and persons.
When observation takes place according to definite pre-
arranged plans, with experimental procedure, then it is
Controlled observation. It is generally done in laboratory
under controlled condition.

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 INTERVIEW METHOD
An interview is a person to person oral conversation in
which one part asks the other questions intended to
produce information.
Interview method is oral-verbal communication where
interviewer asks questions, which are aimed to get
information required for study to respondent.

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 Types of Interviews
 Personal interviews: the interviewer asks questions in a
face to face contact to the other person or persons.
 Telephonic interviews: contacting samples on telephone.
Uncommon method, may be used in developed regions.
 Structured interviews: in this case, a set of pre-decided
questions are there.
 Unstructured interviews: in this case, we don’t follow a
system of pre-determined questions.
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 Focused interviews: attention is focused on the given
experience of the respondent and its possible effects.
 Group interviews: a group of 6-8 individuals is
interviewed.
 Individual interviews: interviewer meets a single person
and interviews him/her.
 Selection interviews: done for the selection of people for
certain jobs.

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 QUESTIONNAIRE METHOD

In this method, questions are asked the respondents in

writing and the respondents also respond in writing.

There are three main formats of a questionnaire:

i. Structured questionnaire
ii. Unstructured questionnaire

iii. Semi-structured questionnaire

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Questionnaire is a set of items in which the respondents
answer by writing. E.g. Gender or Describe performance
of Eelo University students.
Male: Female:

Structured Questionnaire
Structured questionnaire is a quantitative method of
research, which was advocated by Emile Durkheim (1858
– 1917). It includes the low level of involvement of the
researcher and high number of respondents ( individuals
who answer the questions).
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 Unstructured Questionnaire

Unstructured questionnaire is an instrument used by an

interviewer who asks questions about a particular topic
or issue.

This is formed exclusively from open-ended items. It is

similar to a written interview.

E.g. describe performance of junior nursing students.

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 Semi-structured Questionnaire

Semi-structured questionnaire is a mix of unstructured and

structured questionnaire. It contains a mixture of close-
ended and open-ended items.

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 Use of documentary sources
• These include
– Clinical & other personal records

– Vital statistics
– Census data

• Sources
– Publications of MOH & other ministries .
– News papers & journals.
– International publications (WHO, UNICEF, etc).

– Health facilities’ records.

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 Choosing method of data collection

• Choosing which method(s) of data collection depends

on:
– Type of data we need.
– Resources (time, personnel & facility).

– Accuracy & strength of the method.

– Acceptability of the method by the subjects.
– Back ground of study subjects.
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