Mettu University

College of Health science

Department of Public Health
Biostatistics
for
Health Science Students

By: Gebisa Roba (BSc/PH, MPH/Biostatistics)

1 01/10/24
 Course Outline
Chapters Contents
1) Introduction  Definition of statistics and Biostatistics
to Biostatistics  Rationale of studying statistics
 Limitation of statistics
 Uses of biostatistics
 Data and its classification
 Variables and Measurement of scale
2) Method of Method of data collection
data collection, Distinguish different methods of data collection
Problems in collecting data
organization
Questions and its Types
and presentation
Requirements of questions
Method of data organization and presentation
Frequency Distributions
Graphical and diagrammatic presentations
2 01/10/24
 Course Outline

Chapters Contents
3) Methods of data  Measures of central tendency
summarization  Measures of variation
4) Probability and  Introduction to probability
probability  Categories of probability
 Basic probability rules
distribution  Types of random variables
 probability distribution and its
classification

3 01/10/24
 Course Outline
Chapters Contents
5) Sampling and  Concepts of sampling methods
sample size  Error during sampling
determination  Types of sampling methods/techniques
 Approach of sample size determination
6) Statistical  Introduction to statistical estimation
Estimation  Point estimation Classification of
 Interval estimation SE
 CI for single population
 CI for double population
7) Hypothesis testing  Concepts of hypothesis testing
 Types of hypothesis testing
 Steps in hypothesis testing
 χ2-distribution
4 01/10/24
 Teaching methods
 Interactive Lecture

 Case studies

 Presentation

 Seminar

 Reading assignments

5 01/10/24
 Assessment Method

Assessment Point (%) Schedule

Quiz-I 5 randomly
Quiz-II 5 randomly
Individual Assignment 10
Group Assignment 10
Mid Exam 20 At the end of chapter
three
Final Exam 50 At the end of the class
Total 100

6 01/10/24
 Chapter: One

Introduction
To
Biostatistics
7 01/10/24
 Contents of this chapter
 Basic statistical concepts

 Limitation of statistics

 Classification of statistics

 Application of statistics

 Variables and measurement scale

8 01/10/24
 Objectives
After completing this chapter, the student will be able to:
Define Statistics and Biostatistics

Enumerate the importance and limitations of statistics

Define and Identify the different types of data

Identify the different types of variables

Identify the different types of measurement scale

9 01/10/24
 Introduction
Definition
The term statistics is used to mean either statistical data or
statistical methods.
Statistical data: refers to numerical descriptions of things.
 These descriptions may take the form of counts or
measurements.

NB: Even though statistical data always denote figures

(numerical descriptions) it must be remembered that all
'numerical descriptions' are not statistical data.

10 01/10/24
 Characteristics of statistical data
In order that numerical descriptions may be called statistics they
must possess the following characteristics:
1. They must be in aggregates
This means that statistics are 'number of facts.' A single fact, even
though numerically stated, cannot be called statistics.
2. They must be affected to a marked extent by a multiplicity of
causes. This means that statistics are aggregates of such facts
only as grow out of a 'variety of circumstances'.
Thus the explosion of outbreak is attributable to a number of
factors, Viz., Human factors, parasite factors, mosquito and
environmental factors.
All these factors acting jointly determine the severity of the
outbreak and it is very difficult to assess the individual contribution
11
of any one of these factors. 01/10/24
 3. They must be enumerated or estimated
according to a reasonable standard of accuracy.
This means that if aggregates of numerical
facts are to be called 'statistics' they must be
reasonably accurate.
This is necessary because statistical data are to
serve as a basis for statistical investigations.
If the basis happens to be incorrect the results
are bound to be misleading.

12 01/10/24
 4. They must be collected in a systematic manner for
a predetermined purpose.
 Facts collected in an unsystematic manner and without
a complete awareness of the object, will be confusing
and cannot be made the basis of valid conclusions.
5. They must be placed in relation to each other.
That is, they must be comparable.
 Numerical facts may be placed in relation to each
other either in point of time, space or condition.
The phrase, ‘placed in relation to each other' suggests
that the facts should be comparable.
13 01/10/24
 Statistical methods: refers to a body of methods that are used
for:
collecting,
organizing, analyzing and
interpreting numerical data for understanding a
phenomenon or making wise decisions.
 In this sense it is a branch of scientific method and

 It helps us to know in a better way the object under study.

 The branch of modern statistics that is most relevant to

public health and clinical medicine is statistical inference.
14 01/10/24
 Rationale of studying statistics
 Statistics pervades a way of organizing information on
a wider and more formal basis than relying on the
exchange of outlines and personal experience

 More and more things are now measured quantitatively

in medicine and public health.

 There is a great deal of intrinsic (inherent) variation in

most biological processes.

15 01/10/24
  The planning, conduct, and interpretation of much
of medical research are becoming increasingly
reliant on statistical technology.

 Statistics provides the medical literature.

 "It is the interpretation of data in the presence of

such variability that lays at the heart of statistics."

16 01/10/24
 Limitations of statistics
 It deals with only those subjects of inquiry that are
capable of being quantitatively measured and
numerically expressed.

 It deals on aggregates of facts and no importance is

attached to individual items–suited only if their group
characteristics are desired to be studied.

 Statistical data are only approximately and not

mathematically correct.
17 01/10/24
 Definition of Some Basic terms

 Census: a complete enumeration of the population.

But in most real problems it cannot be realized, hence
we take sample.

 Sampling: The process or method of sample selection

from the population.

 Sample size: The number of elements or observation

to be investigated

18 01/10/24
 Definition of Some Basic terms....
Population and Sample
Population:
Refers to any collection of objects
Target population:
A collection of items that have something in common
for which we wish to draw conclusions at a particular
time.
E.g., All hospitals in Ethiopia
The whole group of interest

19 01/10/24
 Population and Sample…
Study (Sampled) Population:
The subset of the target population that has at least some
chance of being sampled

The specific population group from which samples are

drawn and data are collected

20 01/10/24
 Population and Sample…
Sample:
A subset of a study population, about which information
is actually obtained.

The individuals who are actually measured and comprise

the actual data.

21 01/10/24
 Definition of Some Basic terms....
Generalizability
Is a two-stage procedure:
We need to be able to generalize from: the sample to
the study population, &
 then from the study population to the target population

If the sample is not representative of the population,

the conclusions are restricted to the sample & don’t have
general applicability.

22 01/10/24
 Role of statistics
Population in using information
from a sample to
make inferences
about the population

Information

Sample

23 01/10/24
 E.g.: In a study of the prevalence
of HIV among adolescents in
IAB Zone, a random sample of
adolescents in Mettu town were
included.

Sample Target Population: All

adolescents in IAB
Study Population Study population: All
adolescents in Mettu town
Target Population
Sample: Adolescents in Mettu
town who were included in the
study

24 01/10/24
 Definition of Some Basic terms....
Parameter and Statistic
 Parameter: A descriptive measure computed from
the data of a population.
E.g., the mean (µ) age of the target population

Statistic: A descriptive measure computed from the

data of a sample.
E.g., sample mean age ( )

25 01/10/24
 Stages in statistical investigation

There are five stages or steps in any statistical

investigation.
1. Collection of data
The process of obtaining measurements or counts.
2. Organization of data
Includes editing, classifying, and tabulating the data.
3. Presentation of data:
Overall view of what the data actually looks like.
Facilitate further statistical analysis.

26 01/10/24
 Stages in statistical investigation...
4. Analysis of data
 Analysis is the major part of learning about biostatistics
To dig out useful information for decision making
It involves extracting relevant information from the
data(like mean, median, mode, range, variance…),
5. Interpretation of data
 Concerned with drawing conclusions from the data
collected and analyzed
Giving meaning to analysis results.
A difficult task and requires a high degree of skill and
experience.

27 01/10/24
 Biostatistics:
The application of statistical methods to the fields of
biological and medical sciences.
Concerned with interpretation of biological data & the
communication of information derived from these data
Has central role in medical investigations
The numbers must be presented in such a way that valid
interpretations are possible

Statistics are everywhere – just look at any newspaper

or the current medical and public health literature.
28 01/10/24
 Uses of biostatistics
 Provide methods of organizing information

 Assessment of health status

 Health program evaluation

 Resource allocation

 To assess magnitude of association

Strong vs weak association between exposure and
outcome

29 01/10/24
 Uses of biostatistics…
Evaluation of a new vaccine or drug
What can be concluded if the proportion of people
free from the disease is greater among the vaccinated
than the unvaccinated?
How effective is the vaccine (drug)?
Is the effect due to chance or some bias?
Drawing of inferences
Information from sample to population

30 01/10/24
 Classification of Biostatistics

1. Descriptive statistics:
Ways of organizing and summarizing data
Helps to identify the general features and trends in
a set of data and extracting useful information
Also very important in conveying the final results
of a study
Example: tables, graphs, numerical summary
measures

31 01/10/24
 Types of Statistics…

2. Inferential statistics:
Methods used for drawing conclusions about a
population based on the information obtained from a
sample of observations drawn from that population

Example: estimation, hypothesis testing, correlation,

regression analysis etc.

32 01/10/24
 Data
Data are numbers which can be measurements or can be
obtained by counting

Refers to a collection of facts, values, observations, or

measurements that the variables can assume.

The raw material for statistics

33 01/10/24
 Types of Data
1.Primary data: collected from the items or individual
respondents directly by the researcher for the purpose
of a study.
 Are those data, which are collected by the
investigator himself for the purpose of a specific
inquiry or study.

 Such data are original in character and are mostly

generated by surveys conducted by individuals or
research institutions.

34 01/10/24
 .
2. Secondary data: which had been collected by
certain people or organization, & statistically treated
and the information contained in it is used for other
purpose by other people
When an investigator uses data, which have
already been collected by others
The secondary data can be obtained from journals,
reports, government publications, publications of
professionals and research organizations

35 01/10/24
 Variables
Variable: A characteristic which takes different
values in different persons, places, or things.

 Any aspect of an individual or object that is

measured (e.g., BP) or recorded (e.g., age, sex) and
takes any value.

There may be one variable in a study or many.

E.g., A study of treatment outcome of TB

36 01/10/24
 Types of Variables....
Categorical variable:
A variable or characteristic which can not be measured
in quantitative form but can only be sorted by name or
categories

Not able to be measured as we measure height or

weight

The notion of magnitude is absent or implicit.

37 01/10/24
 Types of Variables....
Quantitative variable: A variable that can be
measured (or counted) and expressed numerically.

Height, wt., # of children, etc.

Has the notion of magnitude.

38 01/10/24
 Types of Variables....
Quantitative variable is divided into two:
1. Discrete: It can only have a limited number of
discrete values (usually whole numbers).
E.g., the number of episodes of diarrhoea a child has
had in a year. You can’t have 12.5 episodes of diarrhoea
Characterized by gaps or interruptions in the
values (integers).
Both the order and magnitude of the values matter.
The values aren’t just labels, but are actual
measurable quantities.
39 01/10/24
 Types of Variables....
2. Continuous variable:

 It can have an infinite number of possible values in

any given interval.

 Both the magnitude and the order of the values matter

 Does not possess the gaps or interruptions
Weight is continuous since it can take on any number of
values (e.g., 34.575 Kg).

40 01/10/24
 Types of variables SUMMARY

Variables
.

Qualitative Quantitative
or categorical measurement

Nominal Ordinal Discrete Continuous

(not ordered) (ordered) (count data) (real-valued)
e.g. ethnic e.g. response e.g. # of e.g. height
group to treatment admissions

41 Measurement scales 01/10/24

 Scale of Measurements
To collect data, we need to have something to
measure
Measurement is the process of assigning numbers
or other symbols to characteristics or attributes of
the objects or people of interest according to
certain prespecified rules.
The rules for assigning numbers should be
standardized and applied uniformly.
They must not change over objects or time.

42 01/10/24
 Scale of Measurements...
1. Nominal scale:
 Data that represent categories or names.
 There is no implied order to the categories of nominal data.
 The simplest type of data, in which the values fall into
unordered categories or classes
 Consists of “naming” observations or classifying them into
various mutually exclusive and collectively exhaustive
categories
 Uses names, labels, or symbols to assign each
measurement.
 Each item must fit into exactly one category.
 Examples: Blood type, sex, race, marital status, etc.
01/10/24 43
 Example of nominal Scale:

Race/Ethnicity:
1. Black
• The numbers have NO
2. White
meaning
3. Latino • They are labels only
4. Other

01/10/24 44
• If nominal data can take on only two possible
values, they are called dichotomous or binary.

• So sex is not just nominal, it is dichotomous

(male or female).

• Yes/no questions
– E.g., cured from TB at 6 months of Rx

01/10/24 45
 Scale of Measurements...
Ordinal scale:
• Assigns each measurement to one of a limited number
of categories that are ranked in terms of order.
• The spaces or intervals between the categories are not
necessarily equal.
• Although non-numerical, can be considered to have a
natural ordering
– Examples: Patient status, cancer stages,
social class, etc.
01/10/24 46
 Example of ordinal scale:

• Pain level:
The numbers have LIMITED
1. None
meaning
2. Mild
3. Moderate 4>3>2>1 is all we know
4. Severe apart from their utility as
labels

01/10/24 47
 Scale of Measurements...
Interval scale:
- In interval data the intervals between values are the same.
- Measured on a continuum and differences between any two
numbers on a scale of known size.
Example: Temp. in oF on 4 consecutive days
Days: A B C D
Temp. oF: 50 55 60 65
For these data, not only is day A with 50o cooler than day D
with 65o, but is 15o cooler.
- It has no true zero point. “0” is arbitrarily chosen and doesn’t
reflect the absence of temp.

01/10/24 48
 Scale of Measurements...
Ratio scale:
- Measurement begins at a true zero point and
the scale has equal space.
- Examples: Height, age, weight, BP, etc.

Note on meaningfulness of “ratio”-

– Someone who weighs 80 kg is two times as heavy
as someone else who weighs 40 kg.
– This is true even if weight had been measured in
other measurements.

01/10/24 49
 Degree of precision in measuring

Nominal

Ordinal

Interval

Ratio

01/10/24 50
 .

01/10/24 51