Dilla University

College of Medicine and Health Science

Biostatistics
Lecture Note
By: Gizaw S. (MSc. In Biostatistics)
 Contents
Chapter One: Introduction to Biostatistics
 Definition and use of Biostatistics
 Classification of Bio/statistics
 Basic terms of Biostatistics
 Types of Variable
 Scales of measurement
Chapter Two: Methods of Data Collection
 Types of Data source
 Methods of Data Collection
 Types of questionnaire
Chapter Three: Methods of Data Presenting and summarizing
 Tabular methods and
 Graphical methods
Chapter Four: Methods of Data Summarization
 Measures of central tendency
 Measures of dispersion.
 Contents Cont …

Chapter Seven: Elementary Probability

 Probability theory and probability rules
 Probability distributions
Chapter Eight: Sampling And Sampling Distribution
 Definition
 Basic terms of sampling
 Types sampling method
 Errors in sampling
 Sample size determination
Chapter Nine : Statistical Estimation
 Point estimation and
 Interval estimation, and sample size determination.
Chapter Ten: Hypothesis Testing:
 Z-test, T-test, Χ-test
 References
1. Degu G. and Tessema F. Biostatistics for health science students, Lecture Note
series Universty of Gondar. 2005.
2. Astatkie A and Muktar E. A brief lecture note on biostatistics for medicine and
health science students. Hawassa University. December 2009.
3. Knapp RG & Miller MC III. Clinical Epidemiology and Biostatistics.
Williams and Wilkins, Baltimore , Maryland. 1992.
4. Wencheko E. Introduction to statistics. Addis AbabaUniversity. April 2000.
5. Training module on Health Research Methods, module II. Ethiopian Science
and Technology commission in collaboration with Regional Health Bureaus
and EPHA. Nov. 2004.
6. Daniel WW. Biostatistics: A foundation for analysis in the health sciences.
John Wiley & Sons, Inc.1999.
7. Bland M. An introduction to medical statistics. Oxford University Press.
2000.
8. Bernard Rosner. Fundamentals of Biostatistics, seventh edition, Harvard
University, 2010.
9. CHAP T.LE. Introductory Biostatistics, Minnisotta university, 2003.
 Introduction to Biostatistics
At the end of the Session you will be able to:
 Describe Statistics /Biostatistics.
 Explain the main uses of statistical methods in the broader field
of health care.
 Describe the classification of Biostatistics.
 Identify the type of a variable and scale of measurements.
 1.1 Introduction
What is Statistics/ Biostatistics?
 Statistics is a field of study concerned with the collection,
organization, summarization and presentation of data, and
drawing of inferences about a body of data when only part of the
data is observed.
 When the data being analysed are derived from the biological
sciences and medicine, we use the term biostatistics to distinguish
this particular application of statistical tools and concepts.
 Concerned with interpretation of biological data & the
communication of information derived from these data.
 Has central role in medical investigations.
 1.2 Uses of Biostatistics
 Provide methods of organizing information →condenses and
summarizes complex data.
 Assessment of health status.
 Health program evaluation.
 Resource allocation.
 Facilitates comparison of data.
 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?
 Uses of Biostatistics Cont…
 Drawing of inferences: Information from sample to population.
 Assessing risk factors:
– Use sampling and estimation methods to study the factors
related to compliance and outcome.
– Cause & effect relationship
 Magnitude of association
– Strong vs weak association between exposure and outcome.
 Statistics helps in predicting future trends: statistics is
extremely useful for analyzing the past and present data and
predicting some future trends.
 Essential for understanding, appraisal and critique of scientific
medical literature.
 1.3 Classification of Statistics
 Descriptive Statistics: Is the methodology of collecting,
organizing, summarizing and presenting of mass of numerical data
in to a meaning full form using different statistical technique
(tables, graphs, numerical summary measures).
 Inferential Statistics: Methods used for drawing conclusions
about a population based on the information obtained from a
sample of observations drawn from that population.
 Includes:
- Inductive Statistics: The process of drawing conclusion about
unknown characteristics of a population, based on sample
based study.
- Predictive Statistics: The process of predicting future based
on historical data.
 1.4 Limitations of Statistics

 It does not study qualitative characteristics directly.

 It doesn’t deals with a single individuals but deals with
aggregate of facts.
 Statistical findings are approximate.
 It is sensitive to misuse.
 Analysis is done based on multiple assumptions.
 1.4 Stages in Statistical Investigation
• Stage 1. Data Collection: The process of measuring, gathering,
assembling the raw data up on which the statistical investigation is
to be based.
• Stage 2. Organization of Data: If an investigator has collected
data through a survey, it is necessary to edit these data in order to
correct any apparent inconsistencies, ambiguities, and recording
errors.
• Stage 3. Presentation of Data: The organized data can now be
presented in the form of tables or diagrams or graphs.
• Stage 4. Data Analysis: The basic purpose of data analysis is to
make it useful for certain conclusions.
• Stage 5. Interpretation of the Result: Interpretation means
drawing conclusions from the data which form the basis of
decision making.
 1.5 Definition of Some Basic Terms

 Data: Collection of information, comprised either individual or group.

►sets of values or observations resulting from the process of counting or
from taking a measurement.
 Population: Is consists of the set of all measurements/elements under
study.
 Sample: Is a subset of the measurements selected from the population.
 Census : Is a complete enumeration of every item in a population.
 Sampling: Is the process of taking a sample form a population.
 Parameter: Is a statistical measure obtained from a population data.
 Statistic: Is a statistical measure obtained from a sample data.
 Variable: Is a characteristics under study that assumes different values for
different elements.
 1.6 Types of Variables

 A variable : is any characteristic of a study unit that is measureable or

classifiable, and can take any value for different units.
Eg age , gender, religion, height, weight, SBP, students grade…
 Depending on their quantifiably can be classified as Qualitative and
Quantitative variables.
1. Qualitative (Categorical) Variable: is a characteristic which can not be
measured in quantitative form but can be identified by names or
categories. For example religion, ethnicity, illness status (well or ill),
treatment outcome (improved or not improved), Stage of breast cancer (I,
II, III, IV) etc.
 Types of Variables Cont…
2. Quantitative Variable: is a characteristic that can be measured
and expressed numerically.
This can be of two types:
 Discrete Quantitative Variable:
– Can only take on a finite number of values.
- can not be expressed in fraction.
– Eg : number of children, number of episode of illness.
 Continuous Quantitative Variable:
– Measured on continuous scale.
– It can assume infinite number of values between two
given values.
– Example: height, weight, age, blood sugar level.
 Scale of Measurement
 In clinical medicine and public health as in many other areas of science,
we typically assign numbers to various attributes of people, objects, or
concepts, and the process is known as measurement.
 The way that the numbers are assigned determines the scale of
measurement.
 There are four types of scales of measurement.
1. Nominal Scale:
 Is the lowest scale of measurement.
 Numbers are assigned to categories as "names“ arbitrarily.
 Therefore, the only number property of the nominal scale
of measurement is “identity”.
 For example classifying people according to gender is a
common application of a nominal scale.
 The only mathematical operation we can perform with nominal data is to
count.
 Scale of Measurement Cont…
2. Ordinal Scale:
 Ordinal scale has the property of some magnitude.
 It assigns each measurement to one of a limited number of
categories that are ranked in terms of graded order.
 However the interval between the categories is not necessarily
equal.
 Example: Cancer stage, Economic status (poor, medium,
higher).
 Scale of Measurement Cont…
3. Interval Scale:
 Interval scale has property of equal interval b/n values.
 It doesn’t have a true zero point; the number "0" is arbitrary.
 Similarly the ratio between two values on interval scale doesn’t have
meaningful interpretation.
 Eg: in measuring temperature using °C scale, we can always be
confident that the distance between 25°C and 35°C is the same as
the distance b/n 65°C and 75°C.
 However, 0°C doesn’t mean there is no temperature. Similar, it
would be inappropriate to say that 60°C degrees is twice as hot as
30°C degrees.
 Scale of Measurement Cont…

4. Ratio Scale:
 Ratio scale of measurement has the property of equal interval
between values and absolute/true zero.
 These properties allow us to apply all mathematical operations
(addition, subtraction, multiplication, and division) in data
analysis.
 The absolute/true zero allows us to know how many times
greater one case is than another.
Example :Weight, Height, Number of students / items ,Age,
Salary
Exercise
For each of the following variables indicate whether it is
quantitative or qualitative and specify the measurement scale that is
employed when taking measurements on each:
– Marital status of (married, single, widow, divorce)
– Intelligent quotient/IQ
– Age
– Salary
– Volume
– Regional differentiation of Ethiopia.
– Students grade (A,B,C,D)
– Eye color (e.g. brown, blue)
– religion (Muslim, protestant, orthodox),
– place of residence (urban, rural)
 Exercise-2

Give the correct scales of measurement for each variable

1. Blood group
2. Temperature (Celsius)
3. Hair colour
4. Job satisfaction index (1-5)
5. Number of heart attacks
6. Calendar year
7. Serum uric acid (mg/100ml)
8. Number of accidents in a 3 - year period
9. Number of cases of each reportable disease
reported by a health worker
10. The average weight gain of 6 1-year old dogs with
a special diet supplement was 950 grams last

Gizaw S. 20