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BMS1042 Module 1

What is the definition of Biostatistics?


Bio - meaning health of humans and Statistics - meaning to
collect, analyse and record
What is a variable?
Characteristics that vary in people in a group or population
What are the main types of variables?
Discrete variables, Continuous variables, Nominal and Ordinal
What is a discrete variable
Variables that are only whole numbers. e.g: counting the
number of people at the hospital.
What are continuous variables?
Variables that can be calculated using fractions. e.g: cholesterol levels
Time and length of stay (hours) are continuous

What is nominal
variables that can't be ranked only named like nouns . e.g:
smoking status (smoker/ex-smoker/never)
What is ordinal?
Categorical variable that can be ranked or where ranking is important/
intervals. e.g: smoking level (none/mild/medium/heavy)

What is a sample?
A sample describes the participants in a study

What is sampling?
The process whereby a researcher chooses her sample.

What is the process of sampling?


1. Identify the population of interest. - The group of people you want to
make assumptions about.
2. Specify a sampling frame (the group of people you will draw your
sample from)
3. Specify a sampling method
4. Determine sampling size

Types of sampling methods


SRS, cluster, systematic, stratified and judgemental

What is Simple random sampling (SRS)?


1. Each member of the population is equally likely to be chosen.
2. The members of the sample are chosen independently of each other.

Simple random sampling properties:


- The most recommended way to select a simple random sample is to
use a table of random numbers or a computer generated list of random
numbers.

What is a systematic random sample?


1. In a systematic random sample every kth item is selected. k is
determined by dividing the number of items in the sampling frame (group
of people you will draw your sample from) by the sample size (the
amount of people you actually choose to be in your sample).

Example of systematic random sample


A study was recruiting an oral rehydration therapy for diarrhoea, every
alternative child under 5 years of age came to the emergency
department with watery diarrhoea were recruited and later were
randomised in to either oral rehydration therapy or antibiotics.

What is stratified sampling?


A stratified sample is one where:
1. the population is divided into subgroups/strata based on a
characteristic.
2. Each member of the population is in one of the subgroups/strata.
3. Then you draw a simple random sample from each subgroup.

What is a cluster sample?


A sample were cases are randomly selected from a naturally occurring
group or cluster, selected by a random process.

Example of a cluster sample?


A sample of 30 high school juniors out of a class of 390 selected from (3
english classes, or clusters. Then a SRS is completed on each cluster.

What is judgmental sampling?


The type of sample is based on the judgement of who the researcher
thinks will be best for the sample.
Judgemental sampling is the only type of sampling method which is non
probability based the rest of the sampling methods are probability based.

Advantages of SRS

Cheap

Easy

Software friendly
Nothing other than frame is needed

Disadvantages of SRS

Need a list of the entire population which may be difficult or costly to


obtain.

Some groups may be over or under represented due to chance.

May disperse visits across different geographical areas costing time,


money and manpower.

Less efficient in terms of estimation (e.g: estimation of standard error)

Advantages of stratified sampling

Allows a better representation of subgroups compared to SRS.


It allows samples to be selected based on strata/characteristics so that
the population is better represented.
Estimation is efficient (e.g: standard error estimation is more precise
than SRS)

Disadvantages of stratified sampling:

Need a list of the entire population along with stratification characteristics


which is costly and time consuming and sometimes hard to get.
The strata must be carefully designed otherwise the sampling would be
biased.

Advantages of cluster sampling

Easier to conduct than SRS if the subjects are spread over a wide
geographical area.
Reduces time and cost of data collection as it doesn't need a list of the entire
population (instead list of of sampling within the selected clusters are needed).

Disadvantages of cluster sampling

Could be less precise with sampling unit independence (clusters are


independent but within units may not)

Estimation is less efficient than stratified.


Bias in sampling may be caused if the clusters are very different in the
studied trait.

Advantages in judgement sampling

Most efficient when the subjects have a rare condition or trait.

Disadvantages in judgement sampling


Does not allow a representative sample to be selected.

1. Difference between stratified and cluster sampling


The main difference between stratified and cluster sampling is that in
cluster sampling the cluster is treated as the sampling unit, therefore
analysis is done on a population of clusters. While in stratified sampling,
the units (subjects) within the stratum are analysed.

2. Differences between cluster and stratified sampling


Cluster sampling does not require any sampling frame (list of the
subjects) however it needs the list of clusters in the population.
Systematic sampling does require the sampling frame for each stratum.

3. Differences between cluster and stratified sampling


Within cluster the subjects might be heterogeneous but between clusters
they are homogeneous, i.e., clusters are homogeneous. On the other
hand, within stratum the patients are homogeneous and between strata
they are heterogeneous.

What is a Randomised clinical trial?

A randomised clinical trial is a prospective study where participants are


sorted into two groups (treatment with drug or placebo) at the
commencement of the study, and then followed into the future to
compare outcomes.

Example of a randomised clinical trial


An example of a current randomised clinical trial is the ASPREE study
where elderly participants (70 yrs and above) are randomly sorted into
the treatment group (with aspirin) or placebo group. At the conclusion of
the five-year study, outcome data from both groups will be compared to
determine the benefits of aspirin on a number of important health issues.

What is a case controlled study


case-control study is a retrospective study where patients are separated
based on a current outcome (e.g. development of a disease case, or
no disease - control). The past of these two groups are then compared to
see if the case group was significantly more exposed to a risk factor.

Example of a case controlled study


A real life example of this is a study done by Teo, K. K. et al. (2006)
where the relationship between the risk of acute myocardial infarction
and smoking was examined.

What is a cohort study?


Cohort studies are longitudinal studies. In this type of research a group
of patients is followed over time and the incidence of one or more
outcomes is recorded together with exposure to one or more factors.
There are two types prospective and historical.

What is a prospective cohort study?


The researcher selects the population at the beginning of the study. At

baseline, risk factors are measured for the sample and then the groups
are followed on over a period of time for outcomes.

Example of a prospective cohort study


A researcher can select a group of teenagers who lives in Clayton
suburb and classify them as smokers and non-smokers. The researcher
will follow them for certain period and will record an outcome that occurs
in the smokers and non-smoker

What is a historical perspective study?


In historic cohort studies researchers select patients after outcomes
have occurred. Researchers look back to the history or life-style of the
patients and record patients exposure status to suspected risk factors in
relation to the outcomes that are considered at the start of the study.

Example of a historical perspective study


Consider a study where the researcher will investigate the physical and
psychological effect of the Chernobyl disaster victims. The Chernobyl
disaster (also referred as Chernobyl or the Chornobyl accident) was a
catastrophic nuclear accident that occurred on 26 April 1986 at the
Chernobyl Nuclear Power Plant in Ukraine which was under the direct
jurisdiction of the central authorities of the Soviet Union. An explosion
and fire released large quantities of radioactive particles into the
atmosphere, which spread over much of the western USSR and Europe

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