Mathematics and Biostatistics

First stage
2021/ 2022

Lecture three
By

Dr. Ghasaq Ali

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 Biostatistics with clinical application
Basic concept in biostatistics with clinical application:
What is statistics and biostatistics?
Statistics: the science that dealing with variation in data through collection, classification,
and analysis in such a way as to obtain reliable result.
Biostatistics: refers to the application of statistics in medicine
Note: Epidemiology is the study of the development, frequency ,distribution ,determinants
,and consequences of disease in human population.
The use of statistics for a researcher:
To plan and implement a research work
To understand the epidemiological issues
To assess the validity of information from the pharmaceutical industry
To understand diagnostic tests
To critically assess research protocols and the validity of scientific articles

Levels of measurement:
There are 4 levels of measurement Nominal, ordinal, interval, and ratio.

1.Nominal:
Data are coded by a number , name or letter that is assigned to a category or group.
Examples. Gender (e.g,male, female)
Treatment preference (e.g., manipulation , mobilization , massage ).

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2.Ordinal:
Is similar to nominal because the measurements involve categories
However, the categories are ordered by rank
Examples. Pain level (e.g., mild, moderate, severe)
Military rank (e.g., lieutenant, caption, major, colonel, general)
Ordinal values only describe order, not quantity
Yhus, severe pain is not the same as 2 times mild pain
The only mathematical operations allowed for nominal and ordinal data are counting of
categories
e.g.,25 males and 30 females

3.Interval
Measurements are ordered (like ordinal data)
Have equal intervals
Does not have a true zero
Examples
The Fahrenheit scale, where 0° does not correspond to an absence of heat (no true zero)
In contrast to Kelvin, which dose have true zero .

4.Ratio:
Measurements have equal intervals There is true zero .
Ratio is the most advanced level of measurement, which can handle most types of
mathematical operations .

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Ratio examples
-Range of motion
No movement correspond to zero degrees
The interval between 10 and 20 degrees is the same as between 40 and 50 degrees
-Lifting capacity
A person who is unable to lift scores zero
A person who lifts 30 kg can lift twice as much as who lifts 15 kg.

Common statistical terms:

Data: Measurements or observations of a variable.
Variable: A characteristic the is observed or manipulated can take on different values.

Independent variables: Precede dependent variables in time. Are often manipulated by the
researcher The treatment or intervention that is used in a study.
Dependent variables : What is measured an outcome in study ? Values depend on the
independent variable.

Parameters: Summary data from population .

Statistics :Summary data from a sample .

A population is the group form which a sample is drawn e.g., headache patients in a
chiropractic office ; automobile crash victims in an emergency room in research, it is not
practical to include all members of population.
Thus, a sample (a subset of population) is taken .

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Classification of statistics :-
1. Descriptive statistics:
Descriptive statistics is statistics used to organize and describe the characteristics of a
collection of data . Descriptive statistics has no hypothesis and dose not analyze data.
Descriptive statistic measures:
Central tendency :Mean, median, and mode
Range: Minimal and maximal values
Dispersion: Standard deviation , Standard error, variance, coefficient of variation , range ,
skewness,

2.Inferential statistics:
Inferential statistics is statistics used to infer the results based on sample to a population .
Inferential statistics always compares groups and deals with analysis which means it strives
to find out whether there is a significant difference between means of groups

Examples: It is desired to know whether the body weight of newborns in rural areas differs
significantly from those born in large cities.

Sample size estimation

In both inferential and descriptive statistics, sample size should be determined before the
study begins because:

In descriptive statistics: too small a sample size → distortion of the true value.
Meanwhile too large sample size → wasting of time and fund

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 In inferential statistics: too small a sample size → false negative result.
Meanwhile too large sample size → wasting of time, funds , false positive results, and
causing ethical problems.

Describing the Data with Numbers:

Measures of Central Tendency (location):
MEAN -- average
MEDIAN -- middle value
MODE – most frequently observed value.
1.Arithmetic Mean:
The mean of the sample is the arithmetic average of the sample values. It
represents the center of data according to the size of the values
To calculate the mean . Add all values of a series of numbers and then divided by the total
number of elements.
Ʃ
Formula to calculate the mean: X=

Ʃ
-Mean of population: μ=

Where: X is command that adds all of the X values.

n is the total number of values in the series of a sample and N is the for a population .

Ex1: suppose the degree of student in exams was :

77,50,65,70,83,55,90

X= = 70

The mean can also be calculated for grouped data:

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1. The data are assumed to be evenly distributed within each class interval.
2. The values in each interval are best represented by mid point.
The formula for the weighted mean ( Xw ) is :

𝒙𝒋 𝒇𝒋
Xw= ∑𝒌𝒋 𝟏 𝒏

Where:
Xj: midpoint of class interval. K: No. of class intervals.
Fj: frequency of class interval. n: total No . of values = = ∑𝒌𝒋 𝟏 𝒇𝒋

Ex2: Work table calculating weighted mean of 40 patients with pulmonary tuberculosis by
age group in Washington, D.C, find the arithmetic mean (weight mean) of the age of these
patients
Class interval j Class midpoint Xj Class frequency f j Xj f j

25-29.9 27.5 4 110

30-34.9 32.5 5 162.5
35-39.9 37.5 12 450
40-44.9 42.5 9 382.5
45-49.9 47.5 5 237.5
50-54.9 52.5 4 210
55-59.9 57.5 1 57.5
Sum=40 Sum=1610
Ʃ
Xw= = 1610/ 40= 40 years.

2.Median: The value that divides a series of values in half when they are all listed in order
. or . The middle value from a set of observation that has been ranked.

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 When there are an odd number of values. The median is the middle value.
When there are an even number of . Count from each end of the series toward the middle
and then average the 2 middle values.

Ex3; Find the median from the set of No .

4,6,9,10,15,20,23 (odd No. & ranked) → median=10.

5,8,12,20,25,27,33,44 (even No . & ranked) → median= 22.5

3.Mode: The most frequently occurring value in a series. The modal value is the highest
bar in a Histogram.
We have Three common measures of central tendency (mean, median, and mod ). There is
another tow types:

-Geometric mean.
-Harmonic mean.

The normal Distribution:

The area under a normal curve has a normal distribution (Gaussian distribution ).
Properties of a normal distribution:
- It is symmetric about its mean.
- The highest point is at its mean.
- The height of the curve decreases as one moves away from the mean in direction ,
approaching, but never reaching zero.

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 Skewed distributions:
The data are not distributed symmetrically in skewed distributions
Consequently , the mean , median ,and mod are not equal and are in different positions.
Scores are clustered at one end of the distribution . A small number of extreme values are
located in the limits of opposite end .

Skew is always toward the direction of the longer tail:

- Positive if skewed to the right.
- Negative if to the left.

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Because the mean is shifted so much, it is not the best estimate of the average score for
skewed distribution.
The median is better estimate of the center of skewed distributions.

Dispersion and variability:

The simplest measure of variability is the range ( difference between the largest and the
smallest values in intervals set of data)
Deviation: the difference between each value and the mean is calculated.
(dj)= (xi – x- )
Where d is deviation of value i from the mean
Xj value of observation i
x- mean of the variable x

Ʃ‫׀‬ ^‫׀‬
the mean deviation: m= where m is mean deviation and n id sample number.

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Standard deviation and variance:
a- the formula of standard deviation of the sample S:

Ʃ 𝒙 𝒙 𝟐
S= where Ʃ is sum and x= score for each point in data, x^ = mean od scores
𝒏 𝟏
and n is sample size.

b- the formula of standard deviation of the population:

Ʃ 𝒙 𝝁 𝟐
σ= where N is degree of freedom.
𝑵

Variance: the square of standard deviation.

Ʃ 𝒙 𝒙^ 𝟐
a- simple variance S2 =
𝒏 𝟏
2 Ʃ 𝒙 𝝁 𝟐
b- population variance σ =
𝑵

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Ex / work table for computing the mean from group data:

Class interval Class mid point Class frequency mifi

mi
10-19 14.5 5 72.5
20-29 24.5 19 465.5
30-39 34.5 10 345
40-49 44.5 13 578.5
50-59 54.5 4 218
60-69 64.5 4 258
70-79 74.5 2 149
Total 57 2086.5

.
X^= = 36.6
To compute the variance and standard deviation from grouped data of table1:
(mi-x) (mi-x)2 (mi-x)2fi (mi)2 (mi2fi)
-22.1 488.41 2442.05 210.25 1051.25
-12.1 146.41 2781.79 600.25 11404.75
-2.1 4.41 44.10 1190.25 11902.50
7.9 62.41 811.33 1980.25 2543.25
17.9 320.41 1281.64 2970.25 11881
27.9 778.41 3113.64 4160.25 16641
37.9 1436.41 2872.82 5550.25 11100.5
3236.87 13347.37 89724.25

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 .
S2 = = 238.345
The standard deviation is: s= √238.345 = 15.44

Ex / calculate the standard deviation of the number shown in table:

76 84 69 92 58
89 73 97 85 77

X^=
=
=80
⋯………….
S= ‫ﺍﻻﻗﻮﺍﺱ ﺟﻤﻴﻌﻬﺎ ﺗﺮﺑﻴﻊ ﻓﻲ ﺍﻟﺒﺴﻂ‬
S=11.70

Ex / calculate the standard deviation of the following set of number

82,93,98,89,88

X^ = sum/n
= 85+93+98+89+88/ 5
=450/5
=90

Ʃ 𝒙 𝒙 𝟐
S= = ‫ﺍﻻﻗﻮﺍﺱ ﺟﻤﻴﻌﻬﺎ ﺗﺮﺑﻴﻊ ﻓﻲ ﺍﻟﺒﺴﻂ‬
𝒏 𝟏

S=5.9

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Uses of statistics in health sciences:
1- interpret research studies.
2- evaluate statistics used every day
3- presentation of data to audiences
4- illustrate central tendency and variability
5- formulate and test hypotheses

What do statistician do?

1- guide design of an experiment, clinical trial
2- formulate statistical hypotheses and determine appropriate methodology
3-analyze data
4- present and interpret results

Sources of health data:

1- archival and vital statistics records
2- experiments
3- medical research studies
4- descriptive surveys
5- clinical trials.

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