Statistical Methods in Medical Research New Edition PDF
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Foreword
v
Preface
vii
viii Preface
I hope that this book would be liked by teachers and researchers in the field of
Medicine and Basic Medical Sciences, and would lessen their dependency on others
for statistical analysis. Any suggestions for improving this book would be highly
acknowledged and appreciated.
1 Introduction to Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.1 Definitions of Statistics . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.2 Origin and Development of Statistics . . . . . . . . . . . . . . . . . . . 1
1.3 Concept of Probability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 1
1.4 Definition of Probability . . . . . . . . . . . . . . . . . . . . . . . . . . . . 2
1.5 Types of Events . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 3
1.6 Different Theories of Probability . . . . . . . . . . . . . . . . . . . . . . 4
1.6.1 Classical or Priori Probability . . . . . . . . . . . . . . . . . 4
1.6.2 Relative Theory of Probability . . . . . . . . . . . . . . . . . 5
1.6.3 Subjective Approach . . . . . . . . . . . . . . . . . . . . . . . . 5
1.6.4 Axiomatic Theory of Probability . . . . . . . . . . . . . . . 5
1.7 Uses of Probability . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
1.8 Theorems of Probability . . . . . . . . . . . . . . . . . . . . . . . . . . . . 6
2 Collecting Statistical Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.1 Methods of Collection of Data . . . . . . . . . . . . . . . . . . . . . . . . 13
2.1.1 Procedure for Collection of Data . . . . . . . . . . . . . . . 13
2.1.2 Planning the Study . . . . . . . . . . . . . . . . . . . . . . . . . 13
2.1.3 Devising the Questions and Making the Schedule . . . 14
2.1.4 Population and Samples . . . . . . . . . . . . . . . . . . . . . 14
2.1.5 Using Schedules to Obtain the Information . . . . . . . . 15
2.1.6 Editing the Schedules . . . . . . . . . . . . . . . . . . . . . . . 16
2.1.7 Organizing the Data . . . . . . . . . . . . . . . . . . . . . . . . 16
2.1.8 Presentation and Analysis . . . . . . . . . . . . . . . . . . . . 16
3 Tabulated Presentation of Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . 17
3.1 Examples Depicting Tabulated Presentation of Data . . . . . . . . 17
4 Diagrammatic Presentation of Data . . . . . . . . . . . . . . . . . . . . . . . . . 21
4.1 Usefulness . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
4.2 Limitations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 21
4.3 Characteristics of Diagrams and Rules for Drawing These . . . . 21
4.4 Different Types of Diagrams . . . . . . . . . . . . . . . . . . . . . . . . . 22
ix
x Contents
7 Measures of Dispersion . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
7.1 Definition . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
7.2 Various Measures of Dispersion . . . . . . . . . . . . . . . . . . . . . . . 47
7.2.1 Range . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 47
7.2.2 Quartile Deviation . . . . . . . . . . . . . . . . . . . . . . . . . 48
7.2.3 Mean Deviation . . . . . . . . . . . . . . . . . . . . . . . . . . . 49
7.2.4 Standard Deviation . . . . . . . . . . . . . . . . . . . . . . . . . 52
7.3 Symbols Representing the Standard Deviation . . . . . . . . . . . . . 53
7.4 Symbols Used in Statistical Analysis . . . . . . . . . . . . . . . . . . . 53
7.5 Formulae for Calculating Standard Deviation
from Ungrouped Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 54
7.6 Computation of Measures of Dispersion . . . . . . . . . . . . . . . . . 54
7.6.1 From Ungrouped Data . . . . . . . . . . . . . . . . . . . . . . 54
7.7 Formulae for Calculating Standard Deviation
from Grouped Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 56
7.8 Computing Standard Deviation from Classified Data . . . . . . . . 56
7.9 Shortcut Method for Computing “Standard Deviation”
from Classified Data . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 57
7.10 Merits and Demerits of Various Measures of Dispersion . . . . . 59
7.11 When to Use Various Measures of Dispersion? . . . . . . . . . . . . 60
8 Correlation . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 61
8.1 Causation and Correlation . . . . . . . . . . . . . . . . . . . . . . . . . .. 61
8.2 One Variable Being a Cause of Another . . . . . . . . . . . . . . . .. 61
8.2.1 Both Variables Being the Result
of a Common Cause . . . . . . . . . . . . . . . . . . . . . . . . 61
8.2.2 Chance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 62
8.3 Methods of Studying Correlation . . . . . . . . . . . . . . . . . . . . . . 62
8.3.1 The Scatter Diagram . . . . . . . . . . . . . . . . . . . . . . . . 62
8.3.2 Pearson Coefficient of Correlation
for Ungrouped Data . . . . . . . . . . . . . . . . . . . . . . .. 62
8.3.3 Regression Line . . . . . . . . . . . . . . . . . . . . . . . . . .. 67
8.4 Proportions of “r” . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. 68
9 Chi-Square Test (χ 2 – Test) . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
9.1 Degrees of Freedom . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 69
9.2 Levels of Significance . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
9.3 Applications of χ 2 – Test . . . . . . . . . . . . . . . . . . . . . . . . . . . . 70
9.3.1 Double Variable Data . . . . . . . . . . . . . . . . . . . . . . . 70
9.3.2 Goodness of Fit Test . . . . . . . . . . . . . . . . . . . . . . . . 71
9.4 Coefficient of Contingency . . . . . . . . . . . . . . . . . . . . . . . . . . 74
9.5 Yates’ Correction . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 77
9.6 Application of Yates’ Correction to Multivariable Data . . . . . . 78
9.7 Inference . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 79
xii Contents
Appendices . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 149
Bibliography . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . 157
About the Author
Charan Singh Rayat completed his postgraduate studies and Ph.D. in Pathology at
the Postgraduate Institute of Medical Education & Research (PGIMER),
Chandigarh, India. He is a Lecturer in histopathology at PGIMER and has hands
on experience in a variety of diagnostic and research studies in the field of immu-
nology and pathology, along with more than 17 years of experience in ultrastructural
pathology and morphometry. Dr. Rayat has published papers in numerous medical
journals and is a peer reviewer for international journals. The Department of
Immunopathology, PGIMER, Chandigarh, conferred awards on him in recognition
of his diagnostic work in the field of immunopathology and histopathology and his
contributions to patient care and clinical research. On his blogs, he also disseminates
his knowledge for the benefit of medical students and patients.
xv
Introduction to Statistics
1
Erstwhile kings used to collect information regarding population and wealth of their
people. Collected data was analyzed to plan development of the state and to finance
war. Statistics in those days was known as “science of kings.” Later the data of
diverse nature were obtained for general uses of the government. Students of game
of chances also developed certain methods of statistical analysis. Biology and
insurance as well as other natural sciences are bright fields for application of
statistical methods.
The concept of probability is used in day-to-day life which stands for the probability
of occurring or non-occurring of events. The notion of probability is used in social
sciences, statistics, economics, industry, business, and engineering. The probability
The examples cited above are uncertain about the associated events. So, these
statements are just conjectures. The concept of probability was very first used by
Italian mathematician Eardan in his book entitled The Book on Games of Chance in
1963. The foundation of the “mathematical theory” of probability was laid by French
mathematicians Blaise Pascal and Pierre de Fermat. Afterwards the Swiss mathema-
tician James Bernoulli (1654–1705) contributed to the theory of probability; how-
ever, his concepts came to light after his death. Other pioneers associated with the
probability are de Moivre (1667–1754), Thomas Bayes (1702–1761), Markov
(1856–1922), and Kolmogorov.
The probability has a great role in our day-to-day life. Our personal life, social
life, academic life, and even business life are deeply associated with probability.
Managerial decisions in production and business are analyzed in the light of theories
of probability to calculate risks and uncertainties.
pþq¼1
p¼1q
q¼1p
1. Mutually exclusive events: All events, happening independent of the other, are
called “mutually exclusive events.” As in the case of tossing a coin, the head and
tail cannot occur simultaneously. Only head or tail can occur. So, the occurrence
of one event would exclude the occurrence of the other.
2. Equally likely events: Events are said to be “equally likely” if all the cases have an
equal chance to occur. As we draw a playing card from a pack of cards, every card
out of 52 cards will have the equal chance of being getting drawn. Similarly when
a dice is thrown, 1, 2, 3, 4, 5, or 6 equally has a likely chance to occur. So, such
events are called “equally likely events.”
3. Exhaustive events: When all the cases of random experiment are included in the
study, the events are called “exhaustive events.” Possible outcomes in a dice are
1, 2, 3, 4, 5, or 6, and any of these may appear on the top.
4. Simple and compound events: “Simple events” are based on the natural law and
without any calculations. An event may occur or may not occur. In “compound
events” joint possibility of two or more events is considered. For example, if we
have a bag containing five white, six red, and seven green balls, the possibility of
drawing two balls at a time may be both white, both red, and both green.
Possibility would also be of white and red, white and green, or red and green.
5. Independent and dependent events: The event is said to be independent if
happening of this is not under the happening of any other event. For example:
Drawing of a “King” from a pack of cards would always have a probability as 52 4
.
1
A single card seen and put in the packet again would have probability as 52.
If the happening of the second event depends on the happening of the first
event, we call it “dependent event.” For example, if we try to draw a “King” from
4
the pack of cards, its probability will be 52 . If we remove a card from the pack at
random and try to draw a “King” again, its probability will be 51 4
. In the second
case, if the drawn card was a “King” and we keep that aside and try to draw the
second “King,” then the probability of second King will be 51 3
.
6. Complementary events: Events are said to be “complementary events” if one
event complements the other event for the failure or success. For example, in a
throwing of “dice,” if condition is applied that winning player will win if the score
is odd number, it would mean that the player will win only if 1 or 3 or 5 comes at
the top during the toss of dice.
4 1 Introduction to Statistics
The “classical or priori probability” is the earliest approach, and the same was
developed by Laplace who also coined the definition of probability as “the ratio of
the favorable case to the number of equally likely cases.” If random experiment
(A) results in N exclusive and equally likely events, out of which m are the favorable
outcomes, then the probability (P) of occurring of favorable event is given by the
following formula:
m
PðAÞ ¼
N
Example 1 Suppose you throw a dice. The probability of occurring of number “1”
would be denoted as