Essential Statistics that you need to know

Dr. Biju George

How does statistics help us

1. 2. 3. 4. 5. 6. 7. 8. To sample from a study population To get an idea regarding sample size To do randomization To summarize data To display the data To get an estimate of population value Statistical testing / hypothesis testing Confounder control / adjusting for other variables

1. Sampling
Need for multiple subjects in a study Why not study one person and generalize????

Difficulties in whole population studies Situations where whole population is studied

1. Sampling
Types of sampling Random ( probability) methods Non random (non probability) methods Random methods
Simple random Systematic and stratified random methods Cluster methods

2. Sample size
Depend on
Variability of character Precision you want Some constant factors depending on the situation

Sample size formula Software

Statcalc (part of the Epi info) Winpepi

2. Sample size

2. Sample size

2. Sample size
WipPEPI- free download from http://www.brixtonhealth.com/pepi4windows .html

For proportion

For Mean

3. Randomization
In RCT Simple randomization Block randomization Use software for this Win pepi --- Free

4. How to summarize data

Summarization depend of type of variable Quantitative variable
Age FBS Systolic BP Diastolic BP GFR

Qualitative variable
Gender Presence of Diabetic Foot Years of education GCS score APGAR score IQ Pain score

4. How to summarize data

Quantitative variable Qualitative variable
Mean + Standard deviation Frequency and percentage Median + IQR/Range

4. How to summarize data

Mean FBS + SD - 152.1 + 47.98 152.1(47.98) Median (IQR) 145 (62) Males 1139 (60.2%) Female 754 (39.8%)

Supra-venticular approach of central venous catheter insertion

Tomar GS, Chawla S, Ganguly S, Cherian G, Tiwari A. Supraclavicular approach of central venous catheter insertion in critical patients in emergency settings: Re-visited. Indian J Crit Care

Adib-Hajbaghery M, Ansari A, Azizi-Fini I. Intensive care nurses' opinions and practice for oral care of mechanically ventilated patients. Indian J Crit Care Med

Gurjar M, Baronia AK, Azim A, Prasad N, Jain S, Singh RK, Poddar B, Bhadauria D. Septic acute kidney injury in critically ill Indian patients. Indian J Crit Care Med 2013

2. How to display the data

Display also depend of type of variable Quantitative variable
Box plot

Qualitative variable
Pie diagram Bar diagram

Adib-Hajbaghery M, Ansari A, Azizi-Fini I. Intensive care nurses' opinions and practice for oral care of mechanically ventilated patients. Indian J Crit Care Med

Box plot

Box plot of optic nerve sheath diameter (mm) comparing survivors and non-survivors among severe traumatic brain injury patients. Legrand et al. Critical Care 2013 17:R61

Box plot of optic nerve sheath diameter (mm) comparing survivors and non-survivors among severe traumatic brain injury patients. Legrand et al. Critical Care 2013 17:R61

Thinks to remember in graphs creation

Only two dimensional graphs Axis in graphs should be labeled properly Dont put graph, table and text about the same data

Data to ink ratio should be maximum

Graphs
Use excel to create the following
Bar Pie Line

Use Statistical software's like SPSS for

Scatter plot Box plot

5. Estimation of population value

What is population value Why we need it How to find this

It is the summary measure in the whole population. In every study we want to find this. But we cannot find this since we dont study the whole population If we get this we get an idea about how the population will behave / respond Estimated using 95% confidence intervals

5. Estimation of population value

This is done by using 95% confidence intervals 95% CI means that 95% chance that the population summary measure will occur in the given range

6. Statistical testing
Why do we need a statistical test What does the statistical test will give us How to interpret the results Types of statistical tests

6. Statistical testing
Why do we need a statistical test

We have 2 groups of people(>2 groups also) with summary value for each of the group We want to know whether these group differ which is checked by comparing the summary measure in one group to another group We also want to know whether these difference occur similarly in the population also

4. Statistical testing
What does the statistical test will give us All tests finally gives a p value for our interpretation

4. Statistical testing
How to interpret the results p value give us an idea regarding whether our observations occur due to chance or their is an true difference / association/ relation A lower p value indicate that the difference / association/ relation is not due to chance, which means that there is a true relation in population Traditionally the cutoff selected is 0.05 (5%)

4. Statistical testing
Types of statistical tests

Depend on the variables

Qualitative Quantitative

Assumptions to be satisfied for doing the test

Randomness assumption Distributional assumptions Variance assumptions Number assumptions others

6. Statistical testing
Types of statistical tests
Qualitative (HTN)
Qualitative (DM) Chi square RR and OR

Quantitative (Diastolic BP)

t test ANOVA Non parametric tests Quantitative t test Correlations (FBS) ANOVA ( parametric and Non parametric tests non parametric)

6. Statistical testing
Chi square test -> 2 qualitative variables DF present DF absent Total HTN present 195 (19.1%) 828 743 1023 870

HTN Absent 127 (14.6%) P value = 0.01

Saravu K, Somavarapu V, Shastry AB, Kumar R. Clinical profile, species-specific severity grading, and outcome determinants of snake envenomation: An Indian tertiary care hospital-based prospective study. Indian J Crit Care Med 2012

6. Statistical testing
t test -> one qualitative -2 groups only, other quantitative FBS (mg%) DF present DF absent

Mean

154.2

151.7

P value = 0.39

6. Statistical testing
t test -> one qualitative -2 groups only, other quantitative Systolic BP
(mm of Hg)

DF present

DF absent

Mean

136.9

132.6

P value < 0.001

Mahmoud KM, Ammar AS. Norepinephrine supplemented with dobutamine or epinephrine for the cardiovascular support of patients with septic shock. Indian J Crit Care Med [serial online] 2012

Mahmoud KM, Ammar AS. Norepinephrine supplemented with dobutamine or epinephrine for the cardiovascular support of patients with septic shock. Indian J Crit Care Med [serial online] 2012

6. Statistical testing
ANOVA -> one qualitative >2 groups , other quantitative BMI category Mean Diastolic BP Underweight Normal Over weight 79.6 81.0 83.5

Obese
P value < 0.001

84.8

Juneja D, Javeri Y, Singh O, Nasa P, Pandey R, Uniyal B. Comparing influence of intermittent subglottic secretions drainage with/without closed suction systems on the incidence of ventilator associated pneumonia. Indian J Crit Care Med [serial online] 2011

6. Statistical testing
Correlation -> 2 quantitative variable

r= .768 , p value < 0.001

6. Statistical testing
Correlation -> 2 quantitative variable

r= .256 , p value < 0.001

6. Statistical testing
Correlation -> 2 quantitative variable

r= -.148 , p value < 0.001

6. Statistical testing
Correlation -> 2 quantitative variable

Pillai LV, Ambike DP, Nirhale S, Husainy S M, Pataskar S. Cerebral venous thrombosis: An experience with anticoagulation with low molecular weight heparin. Indian J Crit Care Med [serial online] 2005

7. Confounder control / adjusting for other variables

HTN and DF associated Smoking and DF associated It is a well known fact that Smoking can cause increase BP (HTN) So is the association between HTN and DF , a true one or is it actually due to smoking alone How to answer these type of questions

7. Confounder control / adjusting for other variables

Done by using modeling techniques

Some common types of modeling used are

Linear regression Logistic regression Cox proportional hazard model ANCOVA General linear modeling

Thank you