Debre Birhan University

School of Public Health

Biostatistics for Public Health Students

By: Zenebe A.(BSc in PH, MPH in Biostatistics )

Email: [email protected]

October, 2024
Debre Birhan, Ethiopia
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 Course Description
• This course is designed to equip the undergraduate Public Health learner with

a basic working knowledge and skill of statistics as it applies to the fields of

medicine and public health.

• The course will introduce the learner to the definition of (bio)statistics and the

importance of statistics in the broad field of health sciences.

• This course will equip the student with a basic know-how of managing health

and health related data in research and in the delivery of health services.

• Health service of any kind is delivered based on concrete and proven

evidences—not based on intuitions, anecdotes and preferences.

• This course is the tool that furnishes the learner with the capability of

generating credible and dependable evidence to guide health sector activities.

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 Course learning outcome
1: Discuss the role of statistics in health sciences and explain the
main uses of statistical methods in the broad field of health
care.
2: Differentiate the various forms of data and variables.
3: Describe and use methods of data collection, data organization
and presentation, and data summarization.
4: Recognize the relative merits and demerits of the different ways
of data presentation.
5: Calculate and interpret various measures of central tendency
and dispersion.
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 Course learning outcome …
6: Identify and make use of data from existing health records.
7: Differentiate the different sources of demographic information.
8: Apply different techniques of sampling.
9: Carryout statistical estimation and sample size estimation.
10: Determine and explain confidence intervals.
11: Carryout hypothesis testing and explain the meaning of
statistical significance.
12: Describe the basic concept of statistical software and its
application

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 Contents
Chapter One : Introduction to Bio(statistics)
• Introduction

• Rationale of studying Statistics

• Scales of measurement

Chapter Two: Methods of Data collection, Organization and

presentation
• Introduction

• Data collection methods

• Choosing a method of data collection

• Types of questions

• Steps in designing a questionnaire

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Methods of data organization and presentation 5
 Contents…
Chapter Three : Summarizing data
• Measures of Central Tendency
• Measures of Variation

Chapter Four : Demographic Methods and Health Services Statistics

• Sources of demographic data
• Stages in demographic transition
• Vital Statistics
• Measures of Fertility
• Measures of Mortality
• Population growth and Projection
• Health services statistics

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 Contents …

Chapter Five : Elementary Probability and probability

distribution

• Mutually exclusive events and the additive law

• Conditional Probability and the multiplicative law

• Random variables and probability distributions

Chapter Six : Sampling methods

• Common terms used in sampling

• Sampling methods

• Errors in Sampling
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 Contents…
Chapter seven : Estimation
• Point estimation.
• Interval estimation
• Sampling distribution of means and proportion
• Sample size estimation for cross-sectional data

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 Contents …
Chapter Eight : Hypothesis Testing

• The Null and Alternative Hypotheses

• Tests of significance on means and proportions on one and two

tailed test

• Test a hypothesis for single population mean and proportion

• Test a hypothesis for difference between two population means

and proportions

• Comparing the means of small samples

• Test of significance using the Chi-square and Fisher’s exact tests

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 Contents …
Chapter Nine: Correlation and Regression
• Correlation analysis
• Regression analysis

Chapter 10: introduction to statistical software's

• Kobo-collect
• Epi-data
• STATA

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 Teaching Methods
• Interactive lecture
• Small group discussion
• Large group discussion
• Seminar presentation
• Project presentation

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 Assessment methods

Formative assessment (50%)

•Individual project with presentation 15%
•Group project with presentation 20%
•Quiz (10%)
•Test (15%)

Summative assessment (40%)

•Final exam(40%)

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• Chapter one : Introduction to Biostatistics

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 Objectives:
At the end of this section the student should be able to:-
• Define statistics and biostatistics
• Discuss the role of statistics in health sciences
• Explain types of statistics
• Describe common terms in biostatistics
• Describe the importance of statistics in health sciences
• Define and identify the different types of data

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 Brain storming
 what is statistics?

 Is it important to all professionals?

 Have you heared about vital statistics?

 Is a statistics a tool or science or art?

 What is biostatistics?

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 Definition of statistics
 It is a methodology that scientists and mathematicians
have developed for collecting, analyzing, interpreting data
and drawing conclusions from information

 Statistics is a way of thinking about numbers (collection,

analysis, and presentation) with emphasis on relating their
interpretation and meaning to the manner in which they are
collected

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 Cont’d…
 The term statistics is used to mean either statistical data
or statistical methods.
 Statistical data: numerical descriptions of things.

– These descriptions may take 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.
 In order say numerical descriptions called statistics they
must possess the following characteristics:
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 Characteristics of statistical data

i. Must be in aggregates
ii. Must be affected to a marked extent by a multiplicity of
causes.
iii. They must be enumerated or estimated according to a
reasonable standard of accuracy.
 If the basis happens to be incorrect the results are bound
to be misleading.
iv. They must have been collected in a systematic manner
v. They must be placed in relation to each other

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 Statistical Methods

It refers to a body of methods that are used for

collecting, organising, analysing and interpreting
numerical data for understanding a phenomenon or
making wise decisions.

 It is a branch of scientific method and helps us to know in

a better way the object under study.

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 Statistical cycle

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 Biostatistics
• When the data analyzed are derived from the biological
sciences and health science,
• We use the term biostatistics to distinguish this particular
application of statistical tools and concepts.
• Biostatistics is a branch of applied statistics concerned
with the application of statistical methods to medical and
biological problem.

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 Rationale of Biostatistics
Statistical method is used to explain and predict some of the
health outcomes and the direction of epidemics and pandemics
It definitely influences decision-makers in public health.
Biostatistics is a critical and invaluable tool in developing public
health policy and initiatives
Scientific community rely on accurate and timely data to deal
with outbreaks of infectious diseases, such as Cholera, and
COVID-19.

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 Limitation 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 approximate and not
mathematically correct
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 Types of applied statistics
Depending on how data are used, statistics divided into two
1. Descriptive statistics

2. Inferential statistics

1. Descriptive statistics
 All about a set of information that has been collected only
 Consists of the collection, organization, summarization, and
presentation of data.
 Focus on just mere descriptive, do not involve generalizing
beyond the data at hand.
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 Types of statistics…
2. Inferential statistics.
 Generalizing from our data to another set of cases or from
samples to populations
 Determining relationships among variables, and making
predictions
 Uses probability, i.e., the chance of an event occurring

It has two main uses:

 Making estimates about populations
 Testing hypotheses to draw conclusions about populations

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 Definition of common statistical terms
Data : Numbers or non-numbers (i.e. qualities or attributes of
something) which contain information
 The raw material of statistics
 Derived/resulted from either measurement or count
 Thus the purpose of statistics is to investigate and evaluate
the nature and meaning of these data

Information: Is data that have been processed, organized

and has meaning to the user

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 Definition of common…
Population & Sample
Target population: A collection of items that have something
in common for which we wish to draw conclusions at a
particular time.
Study Population: Part of source population in which the
sample is drawn(has a chance of being included in the
actual sample)
Sample: A subset of a study population, about which
information is actually obtained

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 E.g.: In a study of the prevalence
of depression among adolescents
in Ethiopia, a random sample of
adolescents in Tebase Kifle
Ketema of Debre Birhan
Town were included.
Sample Target Population: All
adolescents in Ethiopia
Study Population
Study population: All adolescents
in Debre Birhan
Target Population
Sample: Adolescents in Tebase
Ketema who were included in the
study

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 Definition of common …
Parameter: It is numerical expression of population measurements
Example
 Population mean (µ),
 Population variance ,
 Population standard deviation, etc.

Statistic: It is numerical expression of sample measurements.

Example:
 Sample mean,
 Sample variance (s2 ) and
 Standard deviation (s).

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 Definition of common …
 Variable: a characteristic that takes different values in different
persons, places, or things /not the same when observed in different
possessors
 E.g. Blood pressure, Heart rate, Height, Weights, Ages, Sex,
Temperature, etc.
 Can be classified as

– Categorical (Qualitative ) and

– Numeric variables (Quantitative)
 Quantitative Variables - is a quantifiable characteristic whose
values are numbers

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 Definition of common…
 Numeric variables may be either continuous or discrete.

– E.g. heights, weights, and body temperatures etc.

 Discrete variables
– Can be assigned values such as 0, 1, 2, 3 and are said to
be countable.

 Continuous variables
– Assume an infinite number of values in an interval
between any two specific values.
– Obtained by measuring
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– Often include fractions and decimals
 Definition of common…
• Categorical variables
– Characteristic that can’t be quantifiable.
– Variables that can be placed into distinct categories
– Can be either nominal or ordinal.
– E.g. gender (male or female), religion, residence etc.

• Random variables: variables whose values are determined

by chance

• Data set: a collection of data values

• Data value or a datum - each value in the data set

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 Definition of common…
Independent variable: a variable that you believe might
influence your outcome measure.
 An independent variable is a hypothesized cause or
influence on a dependent variable
Dependent variable: in a research study , the variable that
you believe might be influenced or modified by some
treatment or exposure.
 It may also represent the variable you are trying to predict.

 Some times called as outcome variable

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 Measurement/observations
 Assignment of numbers to objects or events according to a set

of rules
 Variables can be classified in to four basic scales of

measurement)under these broader nonmetric & metric

measurements
 Nominal Scale

 Ordinal scale

 Interval scale

 Ratio scale

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Nominal and ordinal scales are nonmetric measurement scales.
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 Measurement Scale….

Nominal scale: Categorical data and numbers that are

simply used as identifiers or names represent a
nominal scale of measurement this consists of two or
more categories/classes that are mutually exclusive.
• Nominal measurements have no meaningful rank
order among values.
e.g. sex, marital status, blood type, ethnicity, religion,
eye color
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 Measurement Scale….
Ordinal scale: putting variables in graded order
You can rank ordinal data but you cannot
quantify differences between two ordinal values
This has additional quality that the categories
are ranked.
e.g. social class, income status, patient status,
level of education, smoking status ,cancer
stage
We try to rank from the lowest to the highest
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 Measurement Scale….

Interval scale: assigns each measurement to unlimited

categories that are equally spaced
 In addition zero does not represent the absolute lower
value
e.g. temperature
 Not that zero degree Celsius is arbitrary, so it does not
make sence to say that 20 degree Celsius is twice hot as
10 degree Celsius

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 Measurement Scale….

Ratio scale: measurements where both a zero value and

distances between different measurements are defined ,
provide the greatest flexibility in statistical methods that
can be used for analyzing data.
 In this case zero shows the absence of quantity
measured(true zero point).
e.g. height, weight, length etc

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 Exercise
 Identify the type of data represented by each of the following
variables and confirm your answer by giving your own
explanation?
 Blood group, temperature, number of heart attacks, diagnosis
of disease, IQ, number of cases of each reportable disease
reported by health officer e.g. polio, stage of cancer, the
weight of one year old dog(with special diet supplement)was
950gm last month, number of accidents in three year period

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 Reading Assignment
• History of statistics and Biostatistics

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 Thank you !!

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