HARAMAYA UNIVERSITY, CHMS

SCHOOL OF PUBLIC
HEALTH
COURSE: BIOSTATISTICS
FOR PYSCHIATRIC NURSING STUDENTS

BY : ADISU B. (BSC, MPH IN BIOSTATISTICS)

JUNE, 2021
 Evaluation Methods
Course highlight
Module Name : Public Health II Assignment (2)=20%
Course title : Biostatistics Quiz=10%
Course code: COMH4132 Mid exam=20%
Credit Hours: 3, ECTS: 5 Final Exam 50%
Ground Rules
At least 90% Attendance to sit for
final exam
Punctuality
Submit your assignment timely 2
IF THERE IS A WILL THERE IS A WAY!!!

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 COURSE OBJECTIVES
AT THE END OF THE COURSE YOU WILL BE
ABLE TO:
1. Describe the role of statistical method in public health

2. Present results effectively by making appropriate displays, summaries,

and tables of data

3. Select an appropriate statistical method for the analysis of simple data sets

4. Identify the different sampling methods

5. Estimate sample size for cross-sectional study
6. Interpret the statistical findings and present them in a clear, concise and
logical manner.

7. Understand statistical estimation techniques and hypothesis testing

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 REFERENCES
 DANIEL, W.W., 1991. BIOSTATISTICS: A FOUNDATION FOR ANALYSIS IN
HEALTH SCIENCES, 5TH ED. JOHN WILLY & SONS, NEW YORK

 GETU DEGU AND FASIL TESSEMA, 2003. BIOSTATISTICS FOR HEALTH SCIENCE
STUDENTS. LECTURE NOTE SERIES. THE CARTER CENTER

 BETTY R. KIRKWOOD, 1988. ESSENTIALS OF MEDICAL STATISTICS.

BLACKWELL SCIENCE LTD

 WILLIAM G. COCHRAN, 1977. SAMPLING TECHNIQUES. 3RD ED. JOHN WILLY &
SONS INC.

 LWANGA, S.K. AND LEMESHOW, S., 1991. SAMPLE SIZE DETERMINATION IN

HEALTH STUDIES. A PRACTICAL MANUAL. WORLD HEALTH ORGANIZATION,
GENEVA.

 BLUMAN, ALLAN G. ELEMENTARY STATISTICS : A STEP BY STEP APPROACH

ALLAN G. BLUMAN. — 7TH ED. P. CM. 5
 INTRODUCTION TO BIOSTATISTICS
DEFINITION OF STATISTICS

A FIELD OF STUDY CONCERNED WITH:

COLLECTION, ORGANIZATION, ANALYSIS, SUMMARIZATION

AND INTERPRETATION OF NUMERICAL DATA, & THE DRAWING
OF INFERENCES ABOUT A BODY OF DATA WHEN ONLY A SMALL
PART OF THE DATA IS OBSERVED.

THE SCIENCE AND ART OF DEALING WITH VARIATION OF DATA IN

ORDER TO OBTAIN RELIABLE RESULTS AND DRAW CONCLUSIONS
FROM THEM. 6
 DEFINITIONS…
 STATISTICS REFER TO EITHER STATISTICAL DATA OR
STATISTICAL METHOD

A. STATISTICAL DATA: REFERS TO NUMERICAL DESCRIPTIONS OF

THINGS.

 THESE DESCRIPTIONS MAY TAKE THE FORM OF COUNTS OR

MEASUREMENTS.

NB: EVEN THOUGH STATISTICAL DATA ALWAYS DENOTE

FIGURES (NUMERICAL DESCRIPTIONS) ALL 'NUMERICAL
DESCRIPTIONS' ARE NOT STATISTICAL DATA.

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 CHARACTERISTICS OF STATISTICAL DATA
IN ORDER THAT NUMERICAL DESCRIPTIONS MAY BE CALLED STATISTICS
THEY MUST POSSESS THE FOLLOWING CHARACTERISTICS:
i) THEY MUST BE IN AGGREGATES
 THIS MEANS THAT STATISTICS ARE 'NUMBER OF FACTS‘.
 A SINGLE FACT, EVEN THOUGH NUMERICALLY STATED,
CANNOT BE CALLED STATISTICS.
II) THEY MUST BE AFFECTED TO A MARKED EXTENT BY A MULTIPLICITY OF CAUSES.
• THIS MEANS THAT STATISTICS ARE AGGREGATES OF FACTS THAT GROW OUT
UNDER VARIETY OF CIRCUMSTANCES.

FOR EXAMPLE, THE PERFORMANCE OF STUDENTS EXAMINATION DOES NOT

DEPEND ON ANY SINGLE FACTOR BUT COLLECTIVELY ON STANDARD OF
TEACHERS, TEACHING METHODS, TEACHING AIDS, STANDARD OF
QUESTION PAPERS AND AS WELL AS OF EVALUATION.
ALL THESE FACTORS ACTING JOINTLY DETERMINE THE SEVERITY OF THE OVERALL
PERFORMANCE AND IT IS VERY DIFFICULT TO ASSESS THE INDIVIDUAL
CONTRIBUTION OF ANY ONE OF THESE FACTORS.
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III) THEY MUST BE ENUMERATED OR ESTIMATED ACCURATELY

 THIS IS NECESSARY BECAUSE STATISTICAL DATA ARE TO SERVE

AS A BASIS FOR STATISTICAL INVESTIGATIONS.
 IF THE BASIS HAPPENS TO BE INCORRECT THE RESULTS ARE
BOUND TO BE MISLEADING.
 STANDARD OF ACCURACY DEPENDING UPON THE NATURE AND
PURPOSE OF COLLECTION OF DATA.

E.G. WE MAY MEASURE THE HEIGHT OF BUILDINGS IN METERS BUT WE

CANNOT MEASURE THE LENGTH OF SMALL THINGS LIKE BRICKS IN
THE SAME UNIT OF METER.

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IV)THEY MUST HAVE BEEN COLLECTED IN A SYSTEMATIC MANNER
FOR A PREDETERMINED PURPOSE.

 NUMERICAL DATA CAN BE CALLED STATISTICS ONLY IF

THEY HAVE BEEN COMPILED IN A PROPERLY PLANNED
MANNER AND FOR A PURPOSE ABOUT WHICH THE
ENUMERATOR HAD A DEFINITE IDEA.
 FACTS COLLECTED IN AN UNSYSTEMATIC MANNER AND
WITHOUT A COMPLETE AWARENESS OF THE OBJECT, WILL
BE CONFUSING AND CANNOT BE MADE THE BASIS OF
VALID CONCLUSIONS.

V) THEY MUST BE PLACED IN RELATION TO EACH OTHER.

 THEY MUST BE COMPARABLE.

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 NUMERICAL FACTS MAY BE PLACED IN RELATION TO EACH OTHER
EITHER IN POINT OF TIME, SPACE OR CONDITION.
 STATISTICS AS STATISTICAL
METHODS
 REFERS TO A METHODOLOGICAL SCIENCE, A SCIENTIFIC METHOD OR

 A BRANCH OF APPLIED RESEARCH WHICH IS CONCERNED WITH

THE DEVELOPMENT AND APPLICATION OF METHODS AND
TECHNIQUES FOR COLLECTING, ORGANIZING, PRESENTING,
ANALYZING, AND INTERPRETING QUANTITATIVE (NUMERICAL) DATA
FOR UNDERSTANDING A PHENOMENON OR MAKING WISE DECISIONS.

 IN THIS SENSE IT IS A BRANCH OF SCIENTIFIC METHOD AND HELPS US

TO KNOW IN A BETTER WAY THE OBJECT UNDER STUDY.

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BIOSTATISTICS

 THE APPLICATION OF STATISTICAL METHODS TO THE FIELDS OF

BIOLOGICAL AND MEDICAL SCIENCES OR FIELD OF HEALTH IN
GENERAL.

 CONCERNED WITH INTERPRETATION OF BIOLOGICAL DATA & THE

COMMUNICATION OF INFORMATION DERIVED FROM THESE DATA
 IT HAS CENTRAL ROLE IN MEDICAL INVESTIGATIONS

EXAMPLES
• COMPUTING INCIDENCE RATES TO DETERMINE TRENDS OVER TIME
• CALCULATING STATISTICAL MEASURES OF THE RISK OF MVA
• TO COMPARE THE EFFICACY OF A PARTICULAR DRUG
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 APPLICATION OF BIOSTATISTICS IN HEALTH

 PROVIDE METHODS OF SUMMARIZING INFORMATION

 HEALTH PROGRAM EVALUATION

 RESOURCE ALLOCATION

 MAGNITUDE OF ASSOCIATION
 STRONG VS WEAK ASSOCIATION BETWEEN EXPOSURE AND
OUTCOME

 ASSESSING RISK FACTORS

o CAUSE & EFFECT RELATIONSHIP

 EVALUATION OF A NEW VACCINE OR DRUG

 DRAWING OF INFERENCES 13

o INFORMATION FROM SAMPLE TO POPULATION

 LIMITATIONS OF STATISTICS

  IT DEALS WITH ONLY THOSE SUBJECTS OF INQUIRY THAT ARE

CAPABLE OF BEING QUANTITATIVELY MEASURED AND
NUMERICALLY EXPRESSED.

 IT DEALS ON AGGREGATES OF FACTS RATHER THAN

INDIVIDUAL ITEMS AND SUITED ONLY IF THEIR GROUP
CHARACTERISTICS ARE DESIRED TO BE STUDIED.

 STATISTICAL DATA ARE ONLY APPROXIMATELY CORRECT.

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 Scope of Biostatistics
Research Planning
The best way to learn
about biostatistics is to
Design follow the flow of a
Bio statistical thinking
research from inception to
contribute in every step
the final publication
in a research Execution (Data collection)

Data Processing

Data Analysis

Presentation

Interpretation

Publication

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 TYPES OF STATISTICS
1. DESCRIPTIVE STATISTICS:

 WAYS OF ORGANIZING AND SUMMARIZING DATA

 HELPS TO IDENTIFY THE GENERAL FEATURES AND TRENDS IN

A SET OF DATA AND EXTRACTING USEFUL INFORMATION

 ALSO VERY IMPORTANT IN CONVEYING THE FINAL RESULTS

OF A STUDY
EG: TABLES, GRAPHS, NUMERICAL SUMMARY MEASURES

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 TYPES OF STATISTICS
2. INFERENTIAL STATISTICS:

 METHODS USED FOR DRAWING CONCLUSIONS ABOUT A

POPULATION BASED ON THE INFORMATION OBTAINED FROM A
SAMPLE OF OBSERVATIONS DRAWN FROM THAT POPULATION

 EXAMPLE: PRINCIPLES OF PROBABILITY, ESTIMATION,

CONFIDENCE INTERVAL, HYPOTHESIS TESTING, ETC.

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 STATISTICS IS CLASSIFIED IN TO TWO

DESCRIPTIVE BIOSTATISTICS INFERENTIAL BIOSTATISTICS

INCLUDE INCLUDE
 COLLECTION  MAKING INFERENCE
 ORGANIZING  HYPOTHESIS TESTING
 SUMMARIZING  DETERMINE RELATIONSHIP
 PRESENTING DATA  MAKING PREDICTION

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 SOME BASIC CONCEPTS
DATA
 DATA ARE NUMBERS WHICH CAN BE MEASUREMENTS OR CAN BE
OBTAINED BY COUNTING
 THE RAW MATERIAL FOR STATISTICS
SOURCE OF DATA
 ROUTINELY KEPT RECORDS, LITERATURE

 SURVEYS

 COUNTING

 EXPERIMENTS

 REPORTS

 OBSERVATION
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 TYPES OF DATA
1. PRIMARY DATA: COLLECTED FROM THE ITEMS OR INDIVIDUAL
RESPONDENTS DIRECTLY BY THE RESEARCHER FOR THE PURPOSE OF
A STUDY.

2. SECONDARY DATA: WHICH HAD BEEN COLLECTED BY CERTAIN

PEOPLE OR ORGANIZATION, & STATISTICALLY TREATED AND THE
INFORMATION CONTAINED IN IT IS USED FOR OTHER PURPOSE BY
OTHER PEOPLE

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 PRIMARY VS SECONDARY DATA…

Primary Data Secondary Data

 Real time data.  Past data.

 Sure about sources of data.  Not sure about sources of
 Costly and Time consuming process. data.
 Avoid biasness of response data  Cheap and Not time
 More flexible. consuming process.
 Can not know data biasness
or not
 Less Flexible.
 Incompleteness

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 POPULATION AND SAMPLE

POPULATION:

REFERS TO ANY COLLECTION OF OBJECTS, ITEMS OR

PERSON THAT HAVE SOME THING IN COMMON

TARGET POPULATION:

A COLLECTION OF ITEMS THAT HAVE SOMETHING IN

COMMON FOR WHICH WE WISH TO DRAW CONCLUSIONS AT A
PARTICULAR TIME.

THE WHOLE GROUP OF INTEREST

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 POPULATION AND SAMPLE
STUDY (SAMPLED) POPULATION:

 THE SUBSET OF THE TARGET POPULATION THAT HAS AT LEAST SOME CHANCE OF BEING

SAMPLED

 ACTUALLY ACCESSIBLE AND LEGITIMATE FOR DATA COLLECTION

SAMPLE:

 A SUBSET OF A STUDY POPULATION, ABOUT WHICH INFORMATION IS ACTUALLY

OBTAINED.

 THE INDIVIDUALS WHO ARE ACTUALLY MEASURED AND COMPRISE THE ACTUAL DATA.

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 E.g.: In a study of the prevalence of HIV
among adolescents in
Ethiopia, a random sample of adolescents in
Lideta Kifle Ketema of AA were included.

Sample Target Population: All adolescents in

Ethiopia
Study Population Study population: All adolescents in Addis
Ababa
Target Population
Sample: Adolescents in Lideta Kifle Ketema
who were included in the study

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 Population  Role of statistics
in using information
from a sample to make
inferences about the
population

Information

Sample

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 PARAMETER AND STATISTIC

• PARAMETER: DESCRIPTIVE MEASURE COMPUTED FROM THE

DATA OF A POPULATION.
E.G. THE MEAN AGE OF THE TARGET POPULATION

• STATISTIC: DESCRIPTIVE MEASURE COMPUTED FROM THE DATA

OF A SAMPLE.
E.G., THE MEAN AGE OF THE SAMPLE

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 VARIABLE

VARIABLE: A CHARACTERISTIC WHICH TAKES DIFFERENT

VALUES IN DIFFERENT PERSONS, PLACES, OR THINGS.

ANY ASPECT OF AN INDIVIDUAL OR OBJECT THAT IS

MEASURED (E.G., BP) OR RECORDED (E.G., AGE, SEX) AND
TAKES ANY VALUE.

E.G., A STUDY OF TREATMENT OUTCOME OF TB

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 VARIABLES CAN BE BROADLY CLASSIFIED INTO:

CATEGORICAL (OR QUALITATIVE) &

QUANTITATIVE (OR NUMERICAL VARIABLES).

 OTHER CLASSIFICATION:

 DEPENDENT(OUTCOME) VS INDEPENDENT

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CATEGORICAL VARIABLE: A VARIABLE OR CHARACTERISTIC WHICH
CAN NOT BE MEASURED IN QUANTITATIVE FORM BUT CAN ONLY BE
SORTED BY NAME OR CATEGORIES

NOT ABLE TO BE MEASURED AS WE MEASURE HEIGHT OR WEIGHT

THE NOTION OF MAGNITUDE IS ABSENT OR IMPLICIT.

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QUANTITATIVE VARIABLE: A VARIABLE THAT CAN BE
MEASURED (OR COUNTED) AND EXPRESSED
NUMERICALLY.

HEIGHT, WT, # OF CHILDREN, ETC.

HAS THE NOTION OF MAGNITUDE.

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 QUANTITATIVE VARIABLE IS DIVIDED INTO TWO:

1. DISCRETE: IT CAN ONLY HAVE A LIMITED NUMBER OF DISCRETE

VALUES (USUALLY WHOLE NUMBERS).

E.G., THE NUMBER OF EPISODES OF DIARRHOEA A CHILD HAS HAD IN A

YEAR.

YOU CAN’T HAVE 12.5 EPISODES OF DIARRHOEA

 CHARACTERIZED BY GAPS OR INTERRUPTIONS IN THE VALUES

(INTEGERS).

 BOTH THE ORDER AND MAGNITUDE OF THE VALUES MATTER.

 THE VALUES AREN’T JUST LABELS, BUT ARE ACTUAL MEASURABLE

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QUANTITIES.
2. CONTINUOUS VARIABLE: IT CAN HAVE AN INFINITE NUMBER OF
POSSIBLE VALUES IN ANY GIVEN INTERVAL.

 BOTH THE MAGNITUDE AND THE ORDER OF THE VALUES MATTER

 DOES NOT POSSESS THE GAPS OR INTERRUPTIONS

 WEIGHT IS CONTINUOUS SINCE IT CAN TAKE ON ANY NUMBER OF

VALUES (E.G., 34.575 KG).

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 SCALES OF MEASUREMENT
 WAYS IN WHICH VARIABLES/NUMBERS ARE DEFINED AND
CATEGORIZED. 

 ALL MEASUREMENTS ARE NOT THE SAME.

EG. MEASURING WEIGHT = 40KG, MEASURING THE STATUS OF A PATIENT

ON SCALE = “IMPROVED”, “STABLE”, “NOT IMPROVED”.

 SCALE OF MEASUREMENT HAS FOUR PROPERTIES: IDENTITY,

MAGNITUDE, EQUAL INTERVAL AND ABSOLUTE ZERO

 THERE ARE FOUR TYPES OF SCALES OF MEASUREMENT.

1. NOMINAL 2. ORDINAL 3. INTERVAL 4. RATIO

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1. NOMINAL SCALE:

THE SIMPLEST TYPE OF DATA, IN WHICH THE VALUES FALL INTO

UNORDERED CATEGORIES OR CLASSES

CONSISTS OF “NAMING” OBSERVATIONS OR CLASSIFYING THEM INTO

VARIOUS CATEGORIES

USES NAMES, LABELS, OR SYMBOLS TO ASSIGN EACH MEASUREMENT.

EXAMPLES: BLOOD TYPE, SEX, RACE, MARITAL STATUS, ETC.

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 EXAMPLE OF NOMINAL SCALE: 35

RACE/ETHNICITY:
 THE NUMBERS HAVE NO MEANING
1. BLACK
2. WHITE  THEY ARE LABELS ONLY
3. LATINO 
IF NOMINAL DATA CAN TAKE ON ONLY TWO POSSIBLE
4. OTHER
VALUES, THEY ARE CALLED DICHOTOMOUS OR BINARY.

 SO SEX IS NOT JUST NOMINAL, IT IS DICHOTOMOUS

(MALE OR FEMALE).

 YES/NO QUESTIONS

 E.G., CURED FROM TB AT 6 MONTHS OF RX

2. ORDINAL SCALE:

 ASSIGNS EACH MEASUREMENT TO ONE OF A LIMITED NUMBER OF

CATEGORIES THAT ARE RANKED IN TERMS OF ORDER.

 ALTHOUGH NON-NUMERICAL, CAN BE CONSIDERED TO HAVE A NATURAL

ORDERING

EXAMPLES: PAIN LEVEL, CANCER STAGES, SOCIAL CLASS, ETC.

 PAIN LEVEL:

1. NONE
2. MILD
3. MODERATE
4. SEVERE

THE NUMBERS HAVE LIMITED MEANING 4>3>2>1 IS ALL WE KNOW APART

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FROM THEIR UTILITY AS LABELS

3. INTERVAL SCALE:

 MEASURED ON A CONTINUUM AND DIFFERENCES BETWEEN ANY TWO

NUMBERS ON A SCALE ARE OF KNOWN SIZE.

EXAMPLE: TEMP. IN OF ON 4 CONSECUTIVE DAYS

DAYS: MO TU WE TH

TEMP. OF: 50 55 60 65

 FOR THESE DATA, NOT ONLY IS DAY A WITH 50 O COOLER THAN DAY D
WITH 65O, BUT IS 15O COOLER.

 IT HAS NO TRUE ZERO POINT. “0” IS ARBITRARILY CHOSEN AND DOESN’T

REFLECT THE ABSENCE OF TEMP.

 IF YOU HAVE MEANINGFUL DIVISIONS, YOU HAVE SOMETHING ON THE

INTERVAL SCALE. 37
4. RATIO SCALE:

 MEASUREMENT BEGINS AT A TRUE ZERO POINT AND THE SCALE HAS

EQUAL SPACE.

EXAMPLES: HEIGHT, AGE, WEIGHT, BP, ETC.

 NOTE ON MEANINGFULNESS OF “ZERO”

 SOMEONE WHO WEIGHS 80 KG IS TWO TIMES AS HEAVY AS SOMEONE

ELSE WHO WEIGHS 40 KG.

 THIS IS TRUE EVEN IF WEIGHT HAD BEEN MEASURED IN OTHER

MEASUREMENTS.

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 39
Nominal

Interval
Ordinal

Ratio
Degree of precision in measuring
THANKS !!!!

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