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Statistical Inference
• What is inference ?

Hypothesis Testing • Making interpretation about population based on sample

Statistical Inference, tests & P value results

Dr. Biju George • Random variation of sample statistic from the population
parameter has to considered for this

Sample number Mean

1 148.8
2 156.1
3 158.7
4 142.8
5 155.1
6 Observed 153.1
7 154.6
8 148.9
9 138.5
10 156.9
Total population Truth 152.1

2 strategies Hypothesis approach

• Hypothesis testing approach • What is Hypothesis?

• Point and Interval approach • Statement showing relation between two variables in a
( Sample statistic and 95% Confidence Interval approach ) testable format

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Types of Hypothesis Null Hypothesis. (P1 =P2; !1 = !2; r1= r2)

• Research Hypothesis • There is no difference in the average Hb value between
two study group. ( difference )
• Statistical Hypothesis • There is no difference in the cure rate between the two
• Null Hypothesis treatment group ( difference)
• Alternate Hypothesis • There is no association between the two variables
( association)

• There is no correlation between the two variables

( correlation)

Alternate hypothesis
• Opposite to Null hypothesis
• There is a difference
• There is an association
• There is a correlation

• Non – Directional Alternative

• Directional Alternative

In a Clinical trial What are the possible

Truth
declaration by the researcher
Truth
Results in a trial Drug Drug Not
Drug Effective Effective effective
Drug Not Effective Results in Drug
the trial Effective
Drug Not
Effective

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Truth Truth
Truth Truth
Drug Drug Not Drug Drug Not
Effective effective Effective effective
Results in
the trial
Drug
Effective
√ Results in
the trial
Drug
Effective
√ ×
Drug Not √ Drug Not × √
Effective Effective

Truth Truth
Truth Truth
Drug Drug Not Drug Drug Not
Effective effective Effective effective
Results in Drug √ Type 1 Results in Drug √ Alpha error
the trial Effective error the trial Effective
Drug Not Type 2 √ Drug Not Beta Error √
Effective Effective
Error

Why is it important Type I and II errors

• Before doing any study that plan to do an inferential analysis • Should be reduced as far as possible

• Null and Alternate Hypothesis is created
• After study we reject the Null or don’t reject the null
• Type 1 and 2 errors come along with it
• In sample size calculation we inflate the sample size to
reduce this
• They should be limited to 5% and 20% respectively

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Once a study is completed- only one type of

error is possible
• If the study conclusion is that the drug is effective – Alpha
error is possible

• If the study conclusion is that the drug is Not effective – Beta

error is possible

• Reverse of beta error is called as Power

Philosophy in research Philosophy of Research

• Induction • Switch and Light
• All swan are black
• Karl Popper theory of Falsification and Refutation
• Deduction • If observations are consistent with hypothesis it does not
• Eg Einstein and path of light prove hypothesis
• If observations are not consistent with hypothesis
we can reject the hypothesis
• Observations can be consistent with Multiple hypothesis

Statistical Inference
• Inference about the population based on the samples

• Inference taking into consideration about the Sampling

variability or Random variation or Chance variation

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Need for Statistical inference
• Need to extrapolate result from sample to population
• In study we observe that
• Group A has a cure rate of 75% Vs Group B which has a cure
rate of 85%
• What is the results in population
• Do A differ from B in cure rate
Process of Statistical Inference
• Even if Null is correct
• Samples may differ-> so mild inconsistency OK due to
sampling variability ( 81% vs 80%)
• Huge Inconsistency -> ??? ( 60 % vs 1000%)
• Huge inconstancy indicate that probably Null is Wrong
Frequentist Approach
• P (D|H).
• P (difference of 10% cure rate| Null)
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Process of Statistical Inference
• Null and Alternate hypothesis
• Check whether observation is consistent with Null
Hypothesis
• If observations are consistent -> cannot reject the Null
• If observations are not consistent -> can reject the Null
and accept the Alternate
• Reject the null / Does not reject the null
P value as degree of consistency of data with
Null
• If p value is high -> data is consistent with null
• If p value is too low -> data is inconsistent with null
• Traditional cutoff for p value is 0.05
Bayesian Approach
• P (H|D).
• P (Research hypothesis being true| difference of 10% cure
rate between group)
• Need Prior Probability for its calculation
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How to obtain the p value

Hypothesis testing – involve statistical testing
(frequentist approach )
• By using certain statistical test • Different statistical tests

• Tests may use estimates of population parameter for test

• What test to be used statistic calculation
• Or
• Use parameter independent methods

Parametric tests – use estimates of

Non- Parametric tests
parameters
• Have strong assumptions regarding population parameters • They don’t use the estimates of Population parameter

• Normality assumption • Use Sign, Rank, Count for statistic calculation

• Equal variance assumption
• Have less stringent assumptions

• Use Mean and SD OR Proportion (p) for the calculation

Parametric tests Non Parametric tests

• Z test for mean • Wilcoxon rank sums test
• Z test for proportion • Mann Whitney U test
• t test ( students t test / Two sample t test / Unpaired t test / • Sign test
Independent sample t test)
• Paired t test (dependent sample t test) • Wilcoxon signed rank test
• One sample t test • Median test
• ANOVA ( Analysis of Variance) • Friedman's test
• Repeated measure ANOVA • Chi square test
• Pearson correlation coefficient • Fishers exact test

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How to decide what test has to be used? Paired – single variable

• 3 step process • Qualitative – Mc Nemar Chi Square test

• 1. Paired / Un paired data • Quantitative – Paired t test / Sign / Wilcoxon signed rank test
- Repeated measure ANOVA
• 2. Type of variable
• Paired – singe variable
• Unpaired – 2 variables

• 3. Assumptions

Unpaired – 2 variables Unpaired – 2 variables

Second Variable
First Variable
Qualitative Quantitative • Both Qualitative variable -> Chi square test
(HTN) (Diastolic BP) • Both Quantitative -> Correlations
• One Quantitative other Qualitative -> Z / t / ANOVA
Qualitative Chi square Z test / t test Levels in Qualitative variable
(DM) RR and OR ANOVA 2 level / Categories -> Z / t test
Non parametric tests
> 2 level / Categories -> ANOVA test
Quantitative Z test / t test Correlations
(FBS) ANOVA ( parametric and
Non parametric tests non parametric)

We get a p value <0.05 Eg.

• It mean that the groups differ in population
Cured Not
• Whether it is important clinically is a different question cured
Drug 1 16000 4000
(80%)
Drug 2 15800 4200
(79%)
P value =0.01

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We get a p value >0.05 Eg.

• It mean that the observed difference between group is could
be due to sampling variability
Cured Not
cured
• Always look for the power of the study
Drug 1 20 5
• Sample size
(80%)
Drug 2 15 10
(60%)
P value =0.12

OR/RR/HR interpretation
Confidence intervals
for MI
• Range in which the population parameter can occur Variable OR/RR/HR 95% CI
• Commonly used for Odds Ratio, Relative Risk and Hazard Older age (>60) 2.8 1.1 – 4.6
ratio Male 1.4 0.8 – 5.2
• Also for difference in mean and difference in proportion
Exercise 0.6 0.46 – 0.72
Alcohol 0.9 0.82 – 1.22
Alcohol 0.9 0.49 – 5.87

3 things that deviate the results from truth Multivariable methods

• Chance à estimated using p value
• Bias à reduced by good design and methods
• Confounding àControlled by statistical methods
• Influence of multiple exposure variable on a single outcome is
studied
• MI ßAge of patient, BMI, Regular exercise, DM etc
• BMI ß Regular exercise, daily caloric intake, DM

Main Types Outcome

• Linear Regression Continuous
• Logistic regression Binary
• Cox Regression Time to event
( time of follow up & event Y/N)

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Questions??

Thank You
bijugeorge1@gmail.com
9846100093
Wednesday, November 7, 2018 Dept of Community Medicine 50