Haramaya University

College of Health and Medical Sciences, School

of Public Health

Biostatistics Lecture
Prepared by
Hirbo Shore (MPH, Assist. Professor)
October 2019

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 Course objectives:
At the end of the course students will able to;

– The role of biostatistics in health sciences and the use of

biostatistical methods in field of health sciences

– Describe methods of data collection, recording, coding and

handling data

– Compute numerical summary measures and present data

– Identify and make use of data from existing health record

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 Course objectives, …
– Apply different techniques of sampling and determine
sample size

– Explain the context and meaning of statistical estimation

and statistical significance

– Measure associations between outcome and exposure

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 Course contents

1. Introduction

2. Measures of central tendency and dispersion

3. Probability and probability distribution

4. Sampling and sampling distribution

5. Basic Concepts of Inference

6. Introduction to correlation and Regressions

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 References
1. M. Pagano & K. Gauvereau: Principles of Biostatistics
2. Daniel W. : Biostatistics: A Foundation for analysis in Health
Sciences
3. Colton T. : Statistics in Medicine
4. Bland M. : An Introduction to Medical Statistics
5. David S. Moor, G.P.McCable: Introduction to the practice of
Statistics
6. Kleinbaum, K.Muller: Applied Regression
7. Analysis and other Multivariate Methods
8. L. D. Fisher & G. Van Belle: Biostatistics

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 References, …
8. Kirkwood B. : Essentials of Medical Statistics
9. A. R. Feinstein: Principles of Medical Statistics
10. R. G. Knapp & M. C. Miler: Clinical epidemiology
and biostatistics
11. D. J. Sheskin: Hand book of Parametric and
Nonparametric Statistical Procedure
12. Armitage P. & Berry G. : Statistical Methods in
Medical Research
13. P. S.R.S. Rao: Sampling methodologies with
application
14. R.N.Forthofer & E. S. Lee: Introduction to
Biostatistics
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 Teaching Methods

Lecture
assignment
Exercise &

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 Chapter 1
Introduction
• Why we need Biostatistics in Public Health?

• What is public health?

– “Public Health is the science and art of preventing disease,

prolonging life and promoting health through the organized
efforts of society.” (WHO)

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 The Functions of Public Health

• Assessment: Identify problems related to the public’s health,

and measure their extent

• Policy Setting: Prioritize problems, find possible solutions, set

regulations to achieve change, and predict effect on the
population
• Assurance: Provide services as determined by policy, and
monitor compliance
• Evaluation: how well are they performed?

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 What is statistics

• A field of study concerned with the collection, organization and

summarization of data, and the drawing of inferences about a
body of data when only part of the data are observed.

• The science of collecting, describing, and interpreting data

• Help scientists to describe our perception of the world

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 What is biostatistics
• The discipline that deals with the collection, organization,
summarization, and analysis of data in the fields of biological,
health, and medical sciences including other life sciences
• An application of statistical method applied to life and health
sciences

• Statistical tools/methods applied to biological phenomenon

characterized by the resultant of interaction between the
genetic architecture and the environmental factors under which
lives exist
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 What is biostatistics,…

• Emerged as one of the most important disciplines in recent

decades

– due to interactive advancements in the fields of statistics,

computer science, and life sciences

• To address new challenges due to new sources of data and

growing demand for biostatisticians with sound background to
face the needs

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 What is biostatistics,…

• Biostatistics deals with designing studies, analyzing data, and

developing new statistical techniques to address the problems
in the fields of life sciences

• It includes statistical analysis with special focus to the needs in

the broad field of life sciences including public health,
biomedical science, medicine, biological science, community
medicine

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 Population & Sample

• The information used to decision about the underlying

problem is to be made on the basis of a relatively small set of
data that can be generalized for the whole population of
interest

• The term population is used with specific meaning and a

defined domain

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 Population
• E.g. 1
 In a study of disease among under five children;

• The population is comprised of every child of under 5

years of age

 In the study substance use among university students

 The study population is students studying in universities

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 Population

• Target population: A collection of items that have something

in common for which we wish to draw conclusions at a
particular time

• E.g.

– Under five children in Harar

– Haramaya University students

– Adults 25 years or older in Dire Dawa

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 Population, …
• Study Population: The specific population from which data
are collected or accessible population
• E.g.

– under five children in Harar in Hakim Woreda

– Haramaya University students in CHMS

– Adults 25 years or older in Kebele 8

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 Sample

• A subset of a study population, about which information is

actually obtained

• In reality, it is difficult to conduct the study on the whole

population due to;

– cost

– Time

– skilled manpower needed to collect quality data

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 Sample,…

• E.g.
– under five children in randomly selected from Hakim
Woreda

– Haramaya University students randomly selected from

Schools and department in CHMS

– Adults 25 years or older in randomly selected from Kebele

8 in Dire Dawa

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Population and sample

Target
population

Study population

Sample

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 Parameters and statistics
• Parameter: A descriptive measure computed from the data of
a population
– E.g
• polation mean (µ)
• Population variance(δ2)
• Population standard deviation (δ), etc
Statistic: A descriptive measure computed from the data of a
sample. E.g.
• Sample mean(𝑥)
• Sample variance (S2)
• Sample standard Deviation (S), ete.

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 Variable
• Characteristic that it takes on different values in different
persons, places, or things

• Some examples of variables include diastolic blood pressure,

heart rate, the heights of adult males, the weights of preschool
children, and the ages of patients seen in a dental clinic

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 Types of variable
• Quantitative Variables
– that can be measured in the usual sense

– Measurements made on quantitative variables convey

information regarding amount

– Example; obtain measurements on the heights of adult

males, the weights of preschool children, and the ages of
patients seen in a dental clinic

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 Quantitative variable
Divided into two;
1. Discrete
• Characterized by presence of gaps between to
subsequent number
• E.g. number of patients admitted, number empty bed
2. Continuous
• Characterized by absence of gaps between two
consecutive number
• E.g. weight, height, bloods pressure, BMI, etc.

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 Qualitative Variables
• Characteristics are not capable of being measured

• Many characteristics can only be categorized only

• Measurements made on qualitative variables convey

information regarding attribute.
• Example: when an ill person is given a medical diagnosis, a
person is designated as belonging to an ethnic group, or a
person, place, or object is said to possess or not to possess
some characteristic of interest

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 Qualitative variable,…
• Divided into two
1. Nominal variable

– Name or symbol assigned to characteristic being measured

– Categories in variable are mutually exclusive

– E.g. sex, cause of disease, caused of death, marital status,

place of residence

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2. Ordinal variable
– Similar to nominal attribute assigned to characteristics

– Categories are not only mutually exclusive, but also have

some order or rank

– E.g. cancer stage, class performance, height as

taller/average/shorter, condition of patients;
unimproved/slightly improved, improved, much improved,
etc.

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 Scale of Measurement
• Clearly not all measurements are the same.

• Measuring an individuals weight is qualitatively different from

measuring their response to some treatment on a three category
of scale, “improved”, “stable”, “not improved”.

• Measuring scales are different according to the degree of

precision involved.

• There are four types of scales of measurement.

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 Scale of measurement,…
1. Nominal scale:

– uses names, labels, or symbols to assign each measurement

to one of a limited number of categories that cannot be
ordered.

– Used only to qualitatively classify or categorize not to

quantify

• Examples: sex, race, marital status, caused diseases,

Blood type, causes death, religions

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 Scale of measurement,…
2. Ordinal scale:

– characterized by the ability to measure a variable in terms

of both identity and magnitude

– Categorize a variable and its relative magnitude in relation

to other variables

– assigns each measurement to one of a limited number of

categories that are ranked in terms of a graded order.

• Examples: Patient status, Cancer stages

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 Scale of measurement,…

3. Interval scale:
– Builds on ordinal measurement by providing information about both
order and distance between values of variables

– assigns each measurement to one of an unlimited number

of categories that are equally spaced. It has no true zero
point.

– The numbers on an interval scale are scaled at equal

distances.

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 Scale of measurement,…
Interval scale,…
– Numbers scaled at equal distances

– No absolute zero point; zero point is arbitrary.

• Example:

– Temperature measured on Celsius or Fahrenheit

– Time of each day in the meaning of a 12-hour clock

– IQ test (intelligence scale)

– Measuring an income as a range

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 Scale of measurement,…
4. Ratio scale:
– measurement begins at a true zero point and the scale has
equal space.

– Allow for the use of sophisticated statistical techniques.

– Examples: Height, weight, Age, budget, number of

students, area

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 The end !

THANK YOU
FOR
THANK YOU
FOR
!!
THANK YOU FOR YOUR ATTENTION!!

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