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Primer of Biostatistics PDF

327 Pages·2011·19.58 MB·English
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Primer of Biostatistics Notice Medicine is an ever-changing science. As new research and clinical experience broaden our knowledge, changes in treatment and drug therapy are required. The author and the publisher of this work have checked with sources believed to be reliable in their efforts to provide information that is complete and generally in accord with the standards accepted at the time of publication. However, in view of the possibility of human error or changes in medical sciences, neither the author nor the publisher nor any other party who has been involved in the preparation or publication of this work warrants that the information contained herein is in every respect accurate or complete, and they disclaim all responsibility for any errors or omissions or for the results obtained from use of the information contained in this work. Readers are encouraged to confirm the information contained herein with other sources. For example, and in particular, readers are advised to check the product information sheet included in the package of each drug they plan to administer to be certain that the information contained in this work is accurate and that changes have not been made in the recommended dose or in the contraindications for administration. This recommendation is of particular importance in connection with new or infrequently used drugs. Primer of Biostatistics Seventh Edition Stanton A. Glantz, PhD Professor of Medicine American Legacy Foundation Distinguished Professor in Tobacco Control Director, Center for Tobacco Control Research and Education Member, Cardiovascular Research Institute Member, Philip R. Lee Institute for Health Policy Studies Member, Helen Diller Family Comprehensive Cancer Center University of California, San Francisco San Francisco, California New York Chicago San Francisco Lisbon London Madrid Mexico City Milan New Delhi San Juan Seoul Singapore Sydney Toronto Copyright © 2012 by The McGraw-Hill Companies, Inc. All rights reserved. Except as permitted under the United States Copyright Act of 1976, no part of this publication may be reproduced or distributed in any form or by any means, or stored in a database or retrieval system, without the prior written permission of the publisher. ISBN: 978-0-07-179440-4 MHID: 0-07-179440-9 The material in this eBook also appears in the print version of this title: ISBN: 978-0-07-178150-3, MHID: 0-07-178150-1. All trademarks are trademarks of their respective owners. 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Except as permitted under the Copyright Act of 1976 and the right to store and retrieve one copy of the work, you may not decompile, disassemble, reverse engineer, reproduce, modify, create derivative works based upon, transmit, distribute, disseminate, sell, publish or sublicense the work or any part of it without McGraw-Hill’s prior consent. You may use the work for your own noncommercial and personal use; any other use of the work is strictly prohibited. Your right to use the work may be terminated if you fail to comply with these terms. THE WORK IS PROVIDED “AS IS.” McGRAW-HILL AND ITS LICENSORS MAKE NO GUARANTEES OR WARRANTIES AS TO THE ACCURACY, ADEQUACY OR COMPLETENESS OF OR RESULTS TO BE OBTAINED FROM USING THE WORK, INCLUDING ANY INFORMATION THAT CAN BE ACCESSED THROUGH THE WORK VIA HYPERLINK OR OTHERWISE, AND EXPRESSLY DISCLAIM ANY WARRANTY, EXPRESS OR IMPLIED, INCLUDING BUT NOT LIMITED TO IMPLIED WARRANTIES OF MERCHANTABILITY OR FITNESS FOR A PARTICULAR PURPOSE. McGraw-Hill and its licensors do not warrant or guarantee that the functions contained in the work will meet your requirements or that its operation will be uninterrupted or error free. Neither McGraw-Hill nor its licensors shall be liable to you or anyone else for any inaccuracy, error or omission, regardless of cause, in the work or for any damages resulting therefrom. McGraw-Hill has no responsibility for the content of any information accessed through the work. Under no circumstances shall McGraw-Hill and/or its licensors be liable for any indirect, incidental, special, punitive, consequential or similar damages that result from the use of or inability to use the work, even if any of them has been advised of the possibility of such damages. This limitation of liability shall apply to any claim or cause whatsoever whether such claim or cause arises in contract, tort or otherwise. To Marsha Kramar Glantz This page intentionally left blank What I’ve proposed is that we have a panel of medical experts that are making determina- tions about what protocols are appropriate for what diseases. There’s going to be some disagreement, but if there’s broad agreement that, in this situation the blue pill works better than the red pill, and it turns out the blue pills are half as expensive as the red pill, then we want to make sure that doctors and patients have that information available to them. President Barack Obama, 2009* *Interview with ABC News’ Dr. Timothy Johnson, July 15, 2009. This page intentionally left blank Contents Preface ...........................................................xiii 4. The Special Case of Two Groups: The t test .................................................49 1. Biostatistics and Clinical Practice ................1 The General Approach .....................................49 What Do Statistical Procedures Tell You? ............3 The Standard Deviation of a Difference Why Not Just Depend on the Journals? ...............4 or a Sum ....................................................51 Why Has the Problem Persisted? ........................5 Use of t to test Hypotheses About Two Groups .................................................52 2. How to Summarize Data .............................7 What if the Two Samples Are Not Three Kinds of Data ..........................................7 the Same Size? ..........................................56 The Mean .........................................................9 Cell Phones Revisited ......................................56 Measures of Variability ......................................9 The t test is an Analysis of Variance ...................59 The Normal Distribution ...................................10 Common Errors in the Use of the t test Getting the Data .............................................10 and How to Compensate for Them ................60 Random Sampling .......................................10 How to Use t tests to Isolate Differences Bias ...........................................................12 Between Groups in Analysis of Variance ........62 Experiments and Observational Studies ........13 The Bonferroni t test ...................................62 Randomized Clinical Trials............................14 More on Cell Phones and Rabbit Sperm ........63 How to Estimate the Mean and Standard A Better Approach to Multiple Comparisons: Deviation from a Sample ...............................15 The Holm t test .......................................64 How Good Are These Estimates? ......................15 The Holm-Sidak t test ..................................65 Percentiles .....................................................19 Multiple Comparisons Against Pain Associated with Diabetic Neuropathy .....23 a Single Control ..........................................67 Summary ........................................................25 The Meaning of P .....................................................67 Problems ........................................................25 Statistical Versus Real (Clinical) Thinking ......69 Why P < .05? ..............................................70 3. How to Test for Differences between Problems ........................................................71 Groups ....................................................27 5. How to Analyze Rates and Proportions .......73 The General Approach .....................................27 Two Different Estimates of the Back to Mars ..................................................73 Population Variance .....................................31 Estimating Proportions from Samples ...............75 What is a “Big” F? ...........................................34 Hypothesis Tests for Proportions .......................78 Cell Phones and Sperm ...................................38 The Yates Correction for Continuity ...............79 An Early Study.............................................38 Effect of Counseling on End-of-Life A Better Control Group.................................40 Planning in Homeless People ...................79 An Experimental Study .................................41 Another Approach to Testing Nominal Data: Unequal Sample Size ......................................41 Analysis of Contingency Tables .....................80 Two Way Analysis of Variance ...........................44 The Chi-Square Test Statistic .......................81 Problems ........................................................44 The Yates Correction for Continuity ...............84 ix

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A concise, engagingly written introduction to understanding statistics as they apply to medicine and the life sciences Don’t be afraid of biostatistics anymore! Primer of Biostatistics, 7th edition demystifies this challenging topic in an interesting and enjoyable manner that assumes no prior know
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