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Interpreting Basic Statistics

Beginners’ statistics for assessing the


effectiveness of an intervention

UH Bristol library service


Aim
To give you a greater understanding of how
to interpret basic medical statistics.

Session outline:
• Statistics which compare risks
• Statistics which test confidence
• Forest Plots
Objectives
• Use raw data to calculate simple statistics to
compare risk
• Interpret p-values and confidence intervals
within the context of a study
• Pick out key information from a forest plot
• Understand the values and issues of using
different statistical measures
Statistics Which Compare Risk
Randomised Control Trial
Experiment Event Group

Control Event Group


Control Event Rate (CER) Control Event Group

= Risk of outcome event in


control group

Experimental Event Rate (EER)


= Risk of outcome event in Experiment Event Group

experimental group
Example 1
Randomised Control Trial of a new drug tested on a
population at risk of a heart attack.
 90/100 of those not receiving the drug (control group)
will have a heart attack.

 60/100 of those receiving the drug (experimental


group) will have a heart attack.
Risk
Control event rate (CER) Control Event Group

number in the control group with event 90


total number in the control group 100

Risk in the control group is: 0.9 = 90% risk of event

Experimental event rate (EER) Experiment Event


Group
number in the experimental group with event 60
total number in the experimental group 100

Risk in experiment group is: 0.6 = 60% risk of event


Relative Risk (RR)
Compares the risk of having an event between two
groups
RR = EER /CER =

÷
0.6 0.9 0.67
Relative Risk
Example 2
2 RCTs of a new drug tested on two populations at risk of a
heart attack over 10 years.

RCT1: High risk group (n=200)


 90/100 of those not receiving the drug (control group) will have a heart
attack.
 60/100 of those receiving the drug (experimental group) will have a heart
attack.

RCT 2: Low risk group (n=200)


 3/100 of those not receiving the drug (control group) will have a heart
attack.
 2/100 of those receiving the drug (experimental group) will have a heart
attack.
High Risk Group
Control Event Rate (CER)=
number in the control group with event 90
Control Event Group
total number in the control group 100
Risk in the control group is: 0.9 = 90% risk of event

Experimental Event Rate (EER)=


number in the experimental group with event 60
total number in the experimental group 100

Risk in experiment group is: 0.6 =60% risk of event Experiment Event Group
Low Risk Group
Control Event Rate (CER)=
number in the control group with event 3
Control Event Group
total number in the control group 100

Risk in the control group is: 0.03 = 3% risk of event

Experimental Event Rate (EER)=


number in the experimental group with event 2
total number in the experimental group 100
Experiment Event Group
Risk in experiment group is: 0.02 = 2% risk of event
Relative Risk (RR)

Compares the risk of having an event between two groups

RR = EER/CER =
High Risk 0.6 0.9 0.67

Low Risk 0.02 0.03 0.67


Relative Risk Reduction (RRR)
The reduction in the rate of the event in the
treatment group relative to the control group
RRR = 1 – RR =
High
Risk 1 - 0.67 = 0.33 = 33%

Low
risk 1 - 0.67 = 0.33 = 33%
Absolute Risk Reduction (or Risk Difference)
Compares the risk of having an event between two groups

ARR = CER – EER =

High Risk 0.9 - 0.6 = 0.3 30%


33%
RRR
Low Risk 0.03 - 0.02 = 0.01 1% 33%
Example
If you didn't take aspirin, your risk of having a heart attack was 2% over 5 years.

If you did take aspirin, your risk of having a heart attack was 1% over 5 years.

Relative Risk Reduction would say that aspirin reduces your chance of heart attack by 50%

Absolute Risk Reduction would say that aspirin reduced your chance of heart attack by 1%
Numbers Needed to Treat (NNT)

The number of people who must be treated to result in


benefit in one person. It is the inverse of ARR.

NNT = 1/ARR =
Numbers Needed to Treat (NNT)
CER EER
High Risk 0.9 - 0.6 = 0.3 30%
CER EER
Low Risk 0.03 - 0.02 = 0.01 1%

ARR = CER – EER = NNT = 1/ARR =


Odds Ratio

Expresses the odds of having an event compared with not having an event .
Odds Ratio

2 x 2 table Disease No Disease


Exposure Positive A B
Negative C D

OR = (A / B) ÷ (C / D) = ?

Online Calculator: http://www.hutchon.net/confidor.htm


Odds Ratio

2 x 2 table Disease No Disease


Exposure Positive A B
Negative C D

Odds Ratio = (60/40) ÷ (90/10) = 0.166

Online Calculator: http://www.hutchon.net/confidor.htm


RE-CAP
RR = EER / CER
RRR = 1 – (EER/ CER)

ARR = CER - EER


NNT = 1- ARR
OR = odds of EER / odds of CER
Statistics Which Test Confidence
P-values
• The probability (ranging from zero to one) that the results observed in a study could have
occurred by chance.
• Convention states we accept p-values of p<0.05 to be statistically significant
• The P value is computed from the F ratio which is computed from the ANOVA table.

P value Interpretation
P<0.05 The result is unlikely to be due to chance.
i.e. It s a statistically significant result.

P>0.05 The result is likely to be due to chance,


i.e. It is not a statistically significant result.

P= 0.05 The result is quite likely to be due to chance,


i.e. It is not a statistically significant result.
Confidence Intervals

What is a confidence interval?


• The range within which we can be 95% sure that the
true value for the whole population lies

What can a confidence interval indicate?


• Indication of precision
• Strength of the evidence
• Whether a result is statistically significant
Interpreting CIs

Relative Risk / Odds Ratio RRR, ARR or mean difference


(binary outcome) (continuous outcome)

Measure Measure
of effect of effect

<0

>0

If the CI range crosses 1, then the difference between the If the CI range crosses 0, then the difference between the
two groups is not statistically significant two groups is not statistically significant
Trials to examine the effect of probiotics on the risk
of antibiotic associated diarrhoea

• Which study/studies show a significant result?


• Which study demonstrated the strongest
evidence?
Forest Plots
Forest Plots
“Effect of probiotics on the risk of antibiotic associated diarrhoea”
Exercise
A closer look at Significant Results
Confidence interval graphic

http://sphweb.bumc.bu.edu/otlt/MPH-Modules/EP/EP713_RandomError/EP713_RandomError_print.html
Library outreach service

The library
Level 5,
Education Centre
Upper Maudlin St

Tel. ext. 20105


Email. library@uhbristol.nhs.uk

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