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Application of Biostatistics

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Biostatistics, History, application in different fields etc.
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Application of Biostatistics

  3. 3. This session covers :  Introduction  History  Basis of Biostatistics  Applications of Biostatistics  Conclusion  References  Previous year Questions
  4. 4. Statistics It is the science which deals with collection, classification and tabulation of numerical facts as the basis for explanation, description and comparison of phenomenon. - Lovitt
  5. 5. BIOSTATISTICS O It is the branch of statistics concerned with mathematical facts and data related to biological events. O It is the science that helps in managing medical uncertainties.
  6. 6. O Biostatistics covers applications and contributions not only from health, medicines and, nutrition but also from fields such as genetics, biology, epidemiology, and many others. O It is mainly consists of various steps like generation of hypothesis, collection of data, and application of statistical analysis. Indian J Pharmacol. 2012 Jul-Aug; 44(4): 435–442.
  7. 7. O Any science needs precision for its development. O Precision is all the more important when it comes to health sciences. For precision; facts, observations or measurements have to be expressed in figures.
  8. 8. O Medicine is essentially an empirical science. It depends on observations and not on theories or theorems. O As a part of clinical practice or research we deal with many observations, which when systematically arranged, are called Data.
  9. 9. O The process of converting data into information requires a special approach called statistics. O ‘Statistic’ means a measured or counted fact or piece of the information, stated as a figure such as height of one person, birth weight of a baby etc.
  10. 10. Branches of Biostatistics O Descriptive Biostatistics  Methods of producing quantitative summaries of information in biological sciences.  Tabulation and Graphical presentation
  11. 11. Branches of Biostatistics… Inferential Biostatistics Methods of making generalizations about a larger group based on information about a sample of that group in biological sciences. Primarily performed in two ways: O Estimation O Testing of hypothesis
  12. 12. HISTORY O Sir Francis Galton is considered as the Father of Biostatistics.
  13. 13. O He was the first to apply statistical methods to the study of human differences and inheritance of intelligence, and introduced the use of Questionnaires and Surveys for collecting data on human communities, which he needed for genealogical and biographical works and for his anthropometric studies.
  14. 14. Origin and development of statistics in medical research O In 1929,a huge paper on application of statistics was published in physiology journal by Dunn. O In 1937, 15 articles on statistical methods by Austin Bradford Hill, were published in book form.
  15. 15. O In 1948, a RCT of streptomycin for pulmonary tb., was published in which Bradford Hill has a key influence. O Then the growth of statistics in Medicine from 1952 was a 8-fold increase by 1982.
  16. 16. Basis of Biostatistics
  17. 17. Sources of medical Uncertainties O Intrinsic due to biological, environmental and sampling factors. O Natural variation among methods, observers and instruments etc. O Errors in measurement or assessment or errors in knowledge. O Incomplete knowledge.
  18. 18. Intrinsic variation as a source of medical uncertainties O Biological due to age, gender, heredity, party, height, weight etc. Also due to variation in anatomical, physiological and biomechanical parameters. O Environment due to nutrition, smoking, pollution, facilities of water and sanitation, road traffic, legislation, stress and strain etc.
  19. 19. O Sampling fluctuations because the entire world cannot be studied and at least future cases can never be included. O Chance variation due to unknown or complex to comprehend factors.
  20. 20. O Biostatistics is the term used when tools of statistics are applied to the data that is derived from biological sciences such as medicine. O Any science demands precision for its development, and so does medical science. O For precision,facts,observations, or measurements have to be expressed in figures.
  21. 21. O Everything in medicine be it research, diagnosis or treatment, depends on counting or measurement. O High or low blood pressure has no meaning, unless it is expressed in figures. O Thus medical statistics or biostatistics can be called Quantitative medicine.
  22. 22. O In nature, blood pressure, pulse rate, action of a drug or any other measurement or counting varies not only from person to person but also from group to group. O The extent of this variability in an attribute or a character, whether it is by chance i.e. biological or normal, is learnt by studying statistics as a science.
  23. 23. O Variation more than natural limits may be pathological, i.e., abnormal due to the play of certain external factors. Hence biostatistics may also be called a science of variation.
  24. 24. O The data after collection, lying in a haphazard mass are of no use, unless they are properly sorted, presented, compared, analyzed and interpreted. O For such a study of figures, one has to apply certain mathematical techniques called statistical methods.
  25. 25. It is the science which deals with development and application of the most appropriate methods for the:  Collection of data.  Presentation of the collected data.  Analysis and interpretation of the results.  Making decisions on the basis of such analysis.
  26. 26. O Statistics arising out of biological sciences, particularly from the fields of Medicine and Public health. O The methods used in dealing with statistics in the fields of medicine, biology and public health for planning, conducting and analyzing data which arise in investigations of these branches.
  27. 27. ROLE OF BIOSTATISTICIANS Identify and develop treatments for disease and estimate their effects. Identify risk factors for diseases. Design, monitor, analyze, interpret, and report results of clinical studies. Develop statistical methodologies to address questions arising from medical/public health data. Locate , define & measure extent of disease Ultimate objective  improve the health of individual & community
  28. 28. APPLICATION OF BIOSTATISTICS As a Science As Figures
  29. 29. As a Science In Physiology And Anatomy O To define what is normal or healthy in a population. O To find the limits of normality in variables such as weight and pulse rate etc. in a population.
  30. 30. O To find the difference between means and proportions of normal at two places or in different periods. O Eg : The mean height of boys in Gujarat is less than the mean height in Punjab. whether this difference is due to chance or a natural variation or because of some other factors such as better nutrition playing a part, has to be decided.
  31. 31. O To find the correlation between two variables X and Y such as height and weight.  whether weight increases or decreases proportionately with height and if so by how much, has to be found.
  33. 33. O To find the action of drug – a drug is given to animals or humans to see whether the changes produced are due to the drug or by chance.
  34. 34. O To compare the action of two different drugs or two successive dosages of the same drug. O To find the relative potency of a new drug with respect to a standard drug.
  35. 35. IN MEDICINE
  36. 36. O To compare the efficacy of a particular drug, operation or line of treatment – for this, the percentage cured, relieved or died in the experiment and control groups, is compared and difference due to chance or otherwise is found by applying statistical techniques.
  37. 37. O To find an association between two attributes such as cancer and smoking or filariasis and social class –an appropriate test is applied for this purpose.
  38. 38. O To identify signs and symptoms of a disease or syndrome. O Cough in typhoid is found by chance and fever is found in almost every case. O The proportional incidence of one symptom or another indicates whether it is a characteristic feature of the disease or not.
  39. 39. O To test usefulness of sera and vaccines in the field – percentage of attacks or deaths among the vaccinated subjects is compared with that among the unvaccinated ones to find whether the difference observed is statistically significant.
  40. 40. O In epidemiological studies – the role of causative factors is statistically tested. O Deficiency of iodine as an important cause of goiter in a community is confirmed only after comparing the incidence of goiter cases before and after giving iodized salt.
  41. 41. Modern medicine O For decades, Biostatistics has played an integral role in modern medicine in everything from analyzing data to determining if a treatment will work to developing clinical trials. O The University of North Carolina's Gillings School of Global Public Health defines biostatistics as "the science of obtaining, analyzing and interpreting data in order to understand and improve human health.” [source: UNC School of Public Health,USA.]
  42. 42. O Most people have heard the statistic that Heart disease is the leading cause of death in America today*. O But how do we know this fact to be true? O Where did that information come from? * [source: Center for Disease Control, USA]
  43. 43. O Back in 1948, when a lot wasn't known about the factors leading to heart disease and stroke, a health research study -- known as the Framingham Heart Study -- was done on 5,209 people living in the town of Framingham, Mass. O These participants hadn't developed any known symptoms of cardiovascular disease and hadn't had a stroke or heart attack.
  44. 44. O They agreed to be followed over a period of time to help researchers learn what factors lead to both conditions. O The study was landmark in several ways. It showed that there was no one cause for getting a heart attack, and combining information about several risk factors could estimate the risk of someone getting the disease.
  45. 45. O Thanks to the Framingham Study, (which is still going on today), we now know the major risk factors that lead to cardiovascular disease. O To reach these conclusions, researchers simply followed the numbers -- the Biostatistics numbers to be exact.
  46. 46. CLINICAL MEDICINE O Documentation of medical history of diseases. O Planning and conduct of clinical studies. O Evaluating the merits of different procedures. O In providing methods for definition of ‘normal’ and ‘abnormal’.
  47. 47. PREVENTIVE MEDICINE O To provide the magnitude of any health problem in the community. O To find out the basic factors underlying the ill- health. O To evaluate the health programs which was introduced in the community(success/failure). O To introduce and promote health legislation.
  48. 48. Role of Biostatistics in Health Planning and Evaluation
  49. 49. O Statistics arising out of biological sciences, particularly from the fields of Medicine and Public health. O The methods used in dealing with statistics in the fields of medicine, biology and public health for planning, conducting and analyzing data which arise in investigations of these branches.
  50. 50. O In carrying out a valid and reliable health situation analysis, including in proper summarization and interpretation of data. O In proper evaluation of the achievements and failures of a health programs.
  51. 51. Biotechnology O Biotechnology can focus on a whole range of topics, from genetic modification of plants and animals to gene therapy, medicine and drug manufacturing, reproductive therapy, and even energy production. O In all cases, research is carried out by developing something and testing whether or not it has the desired performance. O Determining performance requires statistical analysis of results.
  53. 53. O To evaluate the efficacy of sera and vaccines in the field. O In epidemiological studies-the role of causative factors is statistically tested. O To test whether the difference between two populations is real or a chance occurrence.
  54. 54. O To study the correlation between attributes in the same population. O To measure the morbidity and mortality. O To evaluate achievements of public health programs. O To fix priorities in public health programs. O To help promote health legislation and create administrative standards for oral health.
  55. 55. O It helps in compilation of data, drawing conclusions and making recommendations. O For students of medicine/dentistry
  56. 56. O By learning the methods in biostatistics a student learns to critically evaluate articles published in medical and dental journals or papers read in medical and dental conferences. O To understand the basic methods of observation in clinical practice and research.
  57. 57. In GENETICS O Statistics and Human Genetics are twin subjects, having grown with the century together, and there are many connections between the two. O Some fundamental aspects in particular the concept of Analysis of Variance, first arose in Human Genetics, while statistical and probabilistic methods are now central to many aspects of analysis of questions is human genetics.
  58. 58. O The most common areas where one can find an extensive applications of statistical methods in human genetics is * Human Genome Project * Linkage Analysis * Sequencing
  59. 59. IN Environmental science Environmental statistics covers a number of types of study: O Baseline studies to document the present state of an environment to provide background in case of unknown changes in the future.
  60. 60. O Targeted studies to describe the likely impact of changes being planned or of accidental occurrences. O Regular monitoring to attempt to detect changes in the environment.
  61. 61. In NUTRITION O Over the past 2 decades, there have been revolutionary developments in life science technologies characterized by high throughput, high efficiency, and rapid computation. O Nutritionists now have the advanced methodologies for the analysis of DNA, RNA, protein, low- molecular-weight metabolites, as well as access to bioinformatics databases.
  62. 62. O Biostatistics, which can be defined as the process of making scientific inferences from data that contain variability, has historically played an integral role in advancing nutritional sciences. O Currently, in the era of systems biology statistics has become an increasingly important tool to quantitatively analyze information about biological macromolecules.
  63. 63. O Appropriate statistical analyses are expected to make an important contribution to solving major nutrition-associated problems in humans and animals (including obesity, diabetes, cardiovascular disease, cancer, ageing, and intrauterine growth retardation).
  64. 64. Application and Uses of Biostatistics As Figures
  65. 65. O Health and vital statistics are essential tools in demography, public health, medical practice and community services. O Recording of vital events in birth and death registers and diseases in hospitals is like book keeping of the community, describing the incidence or prevalence of diseases, defects or deaths in a defined population.
  66. 66. O Such events properly recorded form the eyes and ears of a public health or medical administrator.
  67. 67. O What are the leading causes of death? O What are the important cause of sickness? O Whether a particular disease is rising or falling in severity and prevalence? etc.
  68. 68. USES OF STATISTICS IN DENTAL SCIENCE: O 1. To find the statistical difference between means of two groups. Ex: Mean plaque scores of two groups. O 2. To assess the state of oral health in the community and to determine the availability and utilization of dental care facilities. O 3. To indicate the basic factors underlying the state of oral health by diagnosing the community and find solutions to such problems.
  69. 69. O 4. To determine success or failure of specific oral health care programs or to evaluate the program action. O 5. To promote oral health legislation and in creating administrative standards for oral health care delivery.
  70. 70. Conclusion: O Bio-statistical techniques can assure that the results found in such a study are not merely because of chance. O In every case of our life, Statistics plays a major role for better gaining and accurate results. O A well-designed and properly conducted study is a basic prerequisite to arrive at valid conclusions.
  71. 71. WA Wallis and HV Roberts, in Nature of Statistics. The Free Press, New York, 1965 “ He who accepts statistics indiscriminately, will often be duped unnecessarily. But he who distrusts statistics, indiscriminately will often be ignorant, unnecessarily.”
  72. 72. REFERENCES  Biostatistics – A foundation for Analysis in the Health Sciences: Wayne W. Daniel, Seventh Edition, Wiley Students Analysis.  A First Course in Statistics with Application: A.K. P. C Swain, Kalyani Publishers  Methods in Biostatistics sixth edition : BK Mahajan  Fundamentals of Biostatistics : Sanjeev BS
  73. 73.  Rao KV. Biostatistics: A manual of statistical methods for use in health, nutrition and anthropology. 2nd ed. New Delhi: Jaypee Brothers Medical Publisher (P) ltd; 2007.
  74. 74. PREVIOUS YEAR QUESTIONS  Discuss the utilization of biostatistics in Public health dentistry?(RGUHS 2006, 20 marks)  Discuss the role of biostatistics in oral health research ?(RGUHS 2011, 10 marks)
  75. 75. THANK YOU