“What we observe is not nature itself, but nature exposed to our method of

questioning.”

Werner Heisenberg
 Sample

Nitesh Kumar Roy

JR – I
Department of Periodontology and Oral Implantology, BPKIHS, Dharan, Nepal
 Scientific Foundations of Research
• Order
• Inference and Chance
• Deductive and Inductive Reasoning
• Evaluation of Probability
• Hypothesis

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 Mill’s Canons of Inductive Reasoning
• Method of Difference
• Method of Agreement
• Method of Concomitant Variation
• Method of Analogy
• Method of Residue

2. Mill J. S. (1886). A system of logic ratiocinative and inductive : being a connected view of the principles of evidence and the methods of scientific investigation (People's).
Longmans Green.
 What is sample?
A sample is a group of people, objects, or items that are taken from a
larger population for measurement. The sample should be representative
of the population to ensure that we can generalize the findings from the
research sample to the population as a whole.

3. Sampling in Research: https://www.thh.nhs.uk/documents/_Departments/Research/InfoSheets/16_sampling_research.pdf

 What is sampling? And, why?
• Sampling is a process of choosing a section of the population for
observation and study. There are several reasons why samples are
chosen for study, rather than the entire population. First and foremost,
a researcher wants to minimize the costs (financial and otherwise) of
collecting the information, processing this information and reporting
on the results.

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 How to delineate a sampling frame?
• Population should be clearly defined.
• A list of exclusion and inclusion criteria should be specified.

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 How to select a unit from the sampling frame?
• To select individual units, we have to first know how large a sample
should be.

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 How large should a sample be?
• Two methods
• Empirical
The empirical approach involves using sample sizes that have been used in similar studies. This has
no scientific basis, and will only be satisfactory if the previous studies had acceptable limits on the errors
of
generalization, and the current study is very similar in its scope (objectives, design, study population, etc.).
This method is not recommended and will not be discussed further.

• Analytical
Depends on the assessment of errors of inference, and a desire to minimize ‘sampling error’.

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 Analytical (Scientific) Method of Determining
Sample Size
• Sample size for descriptive studies
• What is the measure of interest?
The identification of the characteristic of primary importance determines the next steps in the process
of defining the sample size. For example, if a prevalence rate in the population is to be estimated by
observing a sample from the population, the measure is the proportion of people in the sample with
the disease.

• What is the underlying probability distribution of the characteristic of interest?

Binominal Distribution – fixed proportion π with the proportion p
Normal Distribution – average of population μ with average of sample x

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 • What is the sampling distribution of the measure?
It depends on the type of study design and on how the samples were obtained. In calculating sample
sizes, it is often assumed that the sampling involves simple random sampling. Sometimes the
sampling design is much more complicated (e.g. multistage cluster sampling techniques) and more
complicated formulae will have to be used to calculate sample sizes appropriately.

• How accurate do you want the results to be?

The accuracy of the estimate depends on two quantities: how narrow the interval is (width of the
interval) and how confident we are (e.g. 95%).

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 • Estimating a Population Proportion
n = (z(1-a) /d )2 p(1- p)
or,

• Estimating a Population Average

Various computer programs are available to calculate the appropriate sample sizes.

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 • Sample size for analytical studies
• Testing equality of two proportions

• Comparison of two population means

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
4. Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Indian J Psychol Med 2013;35:121-6.
 Examples
• An epidemiologist wants to know percentage of children who are
hypertensive in a population, what should be the sample size?
We know that .

According to previously published studies actual number of hypertensives may not

be more than 15%. The researcher wants to calculate this sample size with the
precision/absolute error of 5% and at type 1 error of 5%.

4. Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Indian J Psychol Med 2013;35:121-6.
 • A researcher is interested in knowing average systolic blood pressure
of children of Dharan, what should be the sample size?
We know,

At 5% of type of 1 error and precision of 5 mm of Hg of either side (more or less than

mean systolic BP) and standard deviation, based on previously done studies, is 25 mm
of Hg then,

4. Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Indian J Psychol Med 2013;35:121-6.
 • A researcher wants to see the link between childhood sexual abuses
with psychiatric disorder in adulthood, what should be the sample size?

She wants to fix power of study at 80% and assuming expected proportions in case
group and control group are 0.35 and 0.20 respectively, and she wants to have equal
number cases and control; then,

4. Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Indian J Psychol Med 2013;35:121-6.
 • A researcher wants to compare the clinical outcomes of diode laser as an
adjunct to scaling and root surface debridement in periodontitis patients.
What should be the sample size?

Probing depth (clinical outcome) among the case group and control group are 2.8 ±
0.20 mm and 3.10 ± 0.60 mm respectively, and he wants to have equal number of cases
and controls; then,

= 27.81

5. Rosner B. Chapter 7: Hypothesis Testing: Categorical Data/Estimation of Sample Size and Power for Comparing Two Binomial Proportions. Fundamentals of Biostatistics. 7th
ed. Boston: Brooks/Cole; 2011.
 • A researcher wants to examine the agreement in gingival thickness
measurement by periodontal probe transparency versus direct
measurement techniques.
2 ^ ^) 2 ^ ^)
𝑍 𝛼 𝑆𝑒 ( 1− 𝑆𝑒 𝑍 𝛼 𝑆𝑝 ( 1− 𝑆𝑝
2 2
𝑛𝑆𝑒 = 𝑛𝑆𝑝 =
𝑑2 𝑥 𝑝 𝑑 2 𝑥 ( 1 −𝑝 )

She considered 95% confidence interval and 80% power to estimate the sample size.
According to Kan et al. (2010), the value of sensitivity is 70%, specificity is 83%,
prevalence is 70%, precision is 0.20. For α = 0.05, Zα/2 = 1.96.

Thus, becomes 29 and becomes 46. Since, the larger sample size is that of , the
sample size becomes 46.

6. Hajian-Tilaki, K. (2014). Sample size estimation in diagnostic test studies of biomedical informatics. Journal of Biomedical Informatics, 48, 193–204.
https://doi.org/10.1016/J.JBI.2014.02.013
 • A researcher wants to examine the correlation between width of
attached gingiva and recessions in lingual mandibular region.

[ ] [ ]
2
( 𝑍𝛼 + 𝑍 𝛽 ) 1 +𝑟
𝑛= +3 , where c =0.5 x ln
𝑐 1 −𝑟

He considered 95% confidence interval and 80% power to estimate the sample size. The
standard mean deviate for α, Zα = 1.9600 and for β, Zβ= 0.8416.

Since there is no study correlating the gingival recessions and width of attached gingiva in
lingual mandibular region, according to literature review, the correlation between
keratinized gingiva and gingival recessions is taken which was found to be 0.314
Sample Size =

Adding 10%, Sample size = 85.

7. Hulley S, Cummings S, Browner W, Grady D, Newman T. Designing clinical research : an epidemiologic approach. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins;
2013. 79 p.
 How to select a unit from the sampling
frame?
Probability Sampling Techniques
• Simple random sampling

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
• Stratified sampling
• Cluster sampling
• Multi-stage sampling
Non-probability Sampling Techniques
• Convenience sampling
• Judgmental/ purposive sampling
• Quota Sampling
• Snowball sampling
 Bias
• Selection bias
• Prevalence-incidence bias
• Admission rate (Berkson’s) bias
• Non-response bias
• Ascertainment or information bias
• Diagnostic bias
• Recall bias
• Confounding

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 How to control confounding?
• Restriction by study design
• Matching
• Stratification in the analysis without matching
• Mathematical modelling in the analysis

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
 How to minimize bias?
• Cases should be limited to incident cases, and should be chosen as homogeneous entities or as
random samples of all cases.
• Definitions, ascertainments and exclusions must always be made explicit, and this should be done
in advance.
• At least two control groups should be chosen:
• a hospital-based group, preferably from among patients who have undergone the same
diagnostic procedures as the cases; controls may either be matched to the cases, preferably on
a stratified basis, or chosen as a random sample of potential controls;
• a community-based control group.
• Analysis should be complete. All known potential confounders, if not already considered in the
matching process, should be the subject of analysis by stratification or multivariate techniques.

1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a guide for training in research methods. 2nd ed.. WHO Regional
Office for the Western Pacific.
Conclusion
• Sample should represent population to effectively implement inductive
reasoning.
References
1. World Health Organization. Regional Office for the Western Pacific. (2001). Health research methodology : a
guide for training in research methods. 2nd ed.. WHO Regional Office for the Western Pacific.
2. Mill J. S. (1886). A system of logic ratiocinative and inductive : being a connected view of the principles of
evidence and the methods of scientific investigation (People's). Longmans Green.
3. Sampling in Research: https://www.thh.nhs.uk/documents/_Departments/Research/InfoSheets/
16_sampling_research.pdf
4. Charan J, Biswas T. How to calculate sample size for different study designs in medical research?. Indian J
Psychol Med 2013;35:121-6.
5. Rosner B. Chapter 7: Hypothesis Testing: Categorical Data/Estimation of Sample Size and Power for
Comparing Two Binomial Proportions. Fundamentals of Biostatistics. 7th ed. Boston: Brooks/Cole; 2011.
6. Hajian-Tilaki, K. (2014). Sample size estimation in diagnostic test studies of biomedical informatics. Journal
of Biomedical Informatics, 48, 193–204.
7. Hulley S, Cummings S, Browner W, Grady D, Newman T. Designing clinical research : an epidemiologic
approach. 4th ed. Philadelphia, PA: Lippincott Williams & Wilkins; 2013. 79 p.
Thank You!