Beruflich Dokumente
Kultur Dokumente
&
fundamentals of epidemiology
Dr.Asma Rahim
Dr.Bindhu vasudevan
Causes of deaths
Religious distribution
Age group distribution
Age distribution
4. Which is an ordinal variable
A)Blood pressure
B)Name of residing place
C)Grading of carcinoma
D) temperature
5. Which is not a nominal scale
variable
A)Causes of death
B) religion
C)diagnosis
D)visual analogue scale
Quantitative data Qualitative data
Height in cm Tall/short
B.P in mm of Hg Hypo/normo/
hypertensives
In a group of 100 under five children
attending IMCH O.P the mean weight is
15kg. The standard deviation is 2.
17
19
16
17kg
18
15
Central limit Theorem
Central limit theorem states that
The random sampling distribution of
sample means will be normal distribution
Means of random sample means will be
equal to population mean
The standard deviation of sample means
from population mean is the standard error
The PEFR of 100, 11 year old girls follow a
normal distribution with a mean of 300 1/min,
standard deviation 20 l/min and standrd error of
2 l/min
Sample size
Calculate the sample size to find out the
prevalence of a disease after implementing
a control programme with 10% allowable
error. Prevalence of the disease before
implementing the programme was 80 %
Sample size
Qualitative data N = 4pq/L2
P = positive factor /prevalence/proportion
Q = 100 p
L = allowable error or precision or
variability
Quantitative data N = 4SD2/L2
N= 4 x 80 x 20/8 x 8 = 100
Determine the sample size to find out the Vitamin A
requirement in the under five children of Calicut
district . From the existing literature the mean daily
requirement of the same was documented as 930 I.U
with a SD of 90 I.U. Consider the precision as 9.
N = 4SD2/L2
4 x 90 x 90 /9 x9 = 400
Determine the sample size to prove that
drug A is better than drug B in reducing the
S.Cholesterol. The findings from a previous
study is given
Drug Mean SD
A 215 20
B 240 30
Quantitative data N =
(Z + Z )2 x S2 x 2 /d2
Z = Z value for level = 1.96 at 0.05
Z = Z value for level =1.28 for at 10%
S = average SD
d = difference between the two means
Qualitative data N =
(Z + Z )2 p x q /d2
Z = Z value for level = 1.96 at 0.5
Z = Z value for level =1.28 for at 10%
P = average prevalence
d = difference between the prevalence
Reject Accept
Null hypothesis Null hypothesis
Two related
groups Qualitative (nominal) Chi square Chi square
C
Two groups
>30
Continuous variable
Comparing mean
The most appropriate test to
compare birth weight in 3
different regions is
A) t test
B) Anova
C) Z test
D) Chi square test
Answer
B
Continuous variable
Compare means
> 2 groups
The most appropriate test to
compare BMI in two different
adult population of size 24 and
30 is
A) Two sampled t test
B) Paired t test
C) Z test
D) Chi square test
Answer
A
Two different groups
Continuous variable
Size <30
The association between smoking
status and MI is tested by
A) t test
B) Anova
C) F test
D) Chi square test
Standard drug used 40% of patients responded
and a new drug when used 60% of patients
responded. Which of the following tests of
parametric significance is most useful in this
study?
A) Fishers t Test
B) Independent sample t test
C) Paired t test
D) Chi square test.
A consumer group would like to evaluate
the success of three different commercial
weight loss programmes. Subjects are
assigned to one of three programmes
(Group A , Group B ,GROUP C) . Each
group follows different diet regimen. At
first time and at the end of 6 weeks subjects
are weighed an their BP measurements
recorded.
Test to detect mean difference in
body weight between Group A &
Group B
T-TEST
Correlation
Correlation coefficient
Shows the relation between two quantitative
variable
Shows the rate of change of one variable as
the other variable change
The value lies between 1 to + 1
Correlation coefficient of zero means that
there is no relationship
No.of deaths in 8 villages due to
water borne diseases before &
after installation of water supply
system
Villages: 1 2 3 4 5 6 7 8
Before :13 6 12 13 4 13 9 10
After :15 4 10 9 1 11 8 13
Did the Installation of water
supply system significantly
reduce deaths
Allopathy: 6 3 5 6 2 4 8
Is herbal treatment is better than
allopathic treatment?
Small sample size
Distribution is not normal
Non parametric test
Mann- Whitney test
After applying a statistical test an
investigator get the p value as
0.01. It means that
A)The probability of finding a significant
difference is 1%
B) The probability of finding a significant
difference when there is no difference is 1%
C) The difference is not significant 1%
times and significant 99% times
D) The power of the test used is 99%
Answer
B
Null hypothesis states there is no difference,If
there is any difference it is due to chance
P value = If the null hypothesis is true the
probability of the sample variation to occur by
chance
P value 0.05= probability of the sample variation
by chance is only 5% if null hypothesis was true
95% the sample variation is not due to chance,&
there is a difference. So we will reject NH
P = 0.01 - probability of the sample
variation by chance is only 1% if null
hypothesis was true
99 % the sample variation is not due to
chance,& there is a difference. So we will
reject NH
As p value decreases the difference become
more significant
For practical purpose p value < 0.05 ; the
difference is significant
In assessing the association between
maternal nutritional status and Birth
weight of the newborns two investigators
A and B studied separately and found
significant results with p values 0.02 &
0.04 respectively. From this what can you
infer about the magnitude of association
found by the
two investigators
Type of study Alternative Unit of study
name
Descriptive Case series Prevalence
Cross sectional study Individual
Longitudinal Incidence study
Correlational
Analytical Ecological Case reference Populations
studies Case control Follow up Individuals
(observational Cohort Individuals
a b
+ 2 21
Pet animals
- c d
3 24
Odds ratio = ad /bc
2 x 24 = 0.76
21 x3
Interpretation
OR =1,RISK FACTOR NOT RELATED
TO DISEASE
No.malnourished
At age one 102 51
Study design Cohort study
Measure of risk Relative risk ,Attributable
risk.
Relative risk Incidence among exposed
Incidence among nonexposed
= 102/300 = 0.34 = 2
51/ 300 0.17
Inference ?
An out break of Pediculosis capitis being
investigated in a girls school with 291
pupils.Of 130 Children who live in a nearby
housing estate 18 were infested and of 161
who live elsewhere 37 were infested. The
Chi square value was found to be 3.93 .
P value = 0.04
Is there a significant difference in the
infestation rates between the two groups?
Results of a screening test
Disease
Positive Negative
Positive TP(a) FP(b)
Test
Negative FN TN(d)
Features of a screening test
Sensitivity = a/ a+c
Specificity = d/b+d
30a+c 70b+d
Sensitivity = a/a+c - 21/30=70%
Specificity = d/b+d = 42/70=60%
Positive predictive value = a/a+b =
21/49=43%
Negative predictive value = d/c+d = 42/51
Exercise 11
Disease prevalence in a population of
10,000 was 5%. A urine sugar test with
sensitivity of 70% and specificity of 80%
was done on the population. The positive
predictive value will be :
a)15.55% b) 70.08% c) 84.4%
d)98.06%
Total population = 10,000
Disease prevalence = 5%
No diseased = 500
Applying this to a 2x2 table :
2x2 table
+ -