Sie sind auf Seite 1von 7

SPECIAL CONTRIBUTION

biostatistics

Introduction to Biostatistics: Part 2,


Descriptive Statistics

Descriptive statistics include measures of central tendency and vari- Gary M Gaddis, MD, PhD
ability. Measures of central tendency include mean, median, and mode. Monica L Gaddis, PhD
The mean is the arithmetic average of data from interval or ratio scales. Kansas City, Missouri
The median reflects the 50th percentile score. The mode is the most fre-
quently occurring value of a data distribution. Measures of variability in- From the Departments of Emergency
clude range, interquartile range, standard deviation, and standard error of Health Services and Surgery, Truman
the mean. The range describes the spread between the extreme values of Medical Center, University of Missouri,
Kansas City.
data. Interquartile range is data included between the 25th and 75th per-
centile of a distribution. Standard deviation describes variability of data
about the sample mean, while standard error of the mean helps describe Received for publication September 1,
1989. Accepted for publication
the distribution of several sample means about a true population mean. December 4, 1989.
Finally, confidence intervals, which are derived from the standard error of
the mean, define an.interval likely to include a true population value,
Address for reprints: Monica L Gaddis,
based on sample statistical values and probability characteristics of data PhD, Department of Surgery, Truman
distributions. [Gaddis GM, Gaddis ML: Introduction to biostatistics: Part Medical Center, 2301 Holmes, Kansas
2, descriptive statistics. Ann Emerg Med March 1990;19:309-315.] City, Missouri 64108.

INTRODUCTION
Statistical analysis is the process by which numerical data obtained by
scientific inquiry are transformed into a useable form for scientific inter-
pretation. This involves manipulation of data for describing characteristics
studied (descriptive statistics) and transformation of the data to help infer
conclusions from the data (inferential statistics).
This second of a six-part series on biostatistics focuses on descriptive
statistics. A thorough understanding of this topic is needed before advanc-
ing to discussions about inferential statistics. Familiarity with the con-
cepts regarding types of data and data distributions, as presented in part 1,1
is required for understanding the concepts presented herein. Numerical ex-
amples are provided to facilitate understanding. Finally, there exist many
common, yet inappropriate uses of statistics, which will be discussed in
this article.

MEASURES OF CENTRAL TENDENCY


Mean
The mean is the arithmetic average of data and is expressed by the
equation:
X = ~ Xi/n
where X equals the mean, Xi equals each individual data point, and n is the
number of data points in the sample. The mean can be calculated for inter-
val and ratio scale data. However, mean values for ordinal scale data are
generally misleading or invalid due to the lack of a consistent level of
magnitude between numeric units of the scale. 1 Therefore, the mean is
useful for data such as heart rate and blood pressure, but is misleading for
arbitrarily constructed data scales such as the Apgar Scale, Glasgow Coma
Score, and Trauma Score. 2,3
The mean is affected by outliers, which are extreme values of a data
distribution. 2 This is not true of other measures of central tendency.

19:3 March 1990 Annals of Emergency Medicine 309/141


BIOSTATISTICS
Gaddis & Gaddis

FIGURE L Systolic blood pressure of


30 m e n aged 31 to 40 years. The
mean, median, and mode all equal
120.

FIGURE 2. Systolic blood pressure in


persons with renovascular hyperten-
sion. Mean, 228.7; m e d i a n , 230;
mode, 240.

FIGURE 3. Systolic blood pressure in


young men and pregnant women. M I I I I I I I I I I I

denotes male subjects, Fdenotes fe- 100 110 120 130 140

male subjects. Mean, 106.1; median,


105; mode, 95, 120. M e a n = 120
Median = 120
M o d e = 120

Median
T h e m e d i a n is t h e " m i d - m o s t "
value of a data distribution. It is the
v a l u e above w h i c h or b e l o w w h i c h
half of the data points lie.2,4, 5 Alter-
natively, the m e d i a n is the 50th per-
centile value of a distribution.
T h e m e d i a n is unaffected by out-
liers and m a y be m o r e useful t h a n
the m e a n to describe data w h e n out-
liers exist 2 or w h e n c o n t i n u o u s data
are n o t n o r m a l l y d i s t r i b u t e d . 4 T h e
m e d i a n is useful for describing ordi-
nal d a t a 4 b e c a u s e the m a g n i t u d e of x x X X X X X X
I I I I I I I I
difference b e t w e e n p o i n t s of a data 180 190 200 210 220 230 240 250
scale need n o t be consistent to deter-
m i n e the 50th percentile value. 2 The
m e d i a n is n o t u s e f u l to d e s c r i b e Mean = 228.7
Median = 230
n o m i n a l data 2 b e c a u s e of the arbi-
2 M o d e = 240
trary s e l e c t i o n of n u m b e r s used to
generate this scale.

Mode
T h e m o d e is the m o s t c o m m o n l y
o b t a i n e d v a l u e or v a l u e s on a data
scale, or the highest p o i n t of a peak
on a f r e q u e n c y d i s t r i b u t i o n . 2 T h e
m o d e is m o s t useful w h e n two clus- F F
ters of data exist (bimodal distribu-
F F F M M F M M \
tion), such that a group m e a n is mis-
I ! I I I I I !
leading or meaningless. 2 T h e m o d e is
70 80 90 100 110 120 130 140
useful to describe n o m i n a l data, de-
fining the m o s t prevalent characteris-
tic of a sample. M e a n = 106,1
Median = 105
M o d e = 95,120
Numerical Examples 3
T h r e e d i f f e r e n t d i s t r i b u t i o n s of
data will be e x a m i n e d to d e t e r m i n e
h o w the type of data d i s t r i b u t i o n ob- Figure 2 p r e s e n t s t h e o r e t i c a l sys- will alter the value of the mean, b u t
tained affects the previously defined tolic blood pressure data of patients n o t the m e d i a n or mode.
measures of central tendency. w i t h u n t r e a t e d r e n o v a s c u l a r hyper- Figure 3 p r e s e n t s s y s t o l i c b l o o d
Figure 1 r e p r e s e n t s n o r m a l l y dis- t e n s i o n . T h e d i s t r i b u t i o n is n e g a - p r e s s u r e for a s a m p l e t h a t i n c l u d e s
tributed data for systolic blood pres- tively skewed. In the absence of nor- t w o groups, pregnant w o m e n in their
sure of 30 m e n aged 31 to 40 years. mality, the mean, median, and m o d e second t r i m e s t e r and men. Again, the
For n o r m a l l y d i s t r i b u t e d data, t h e are not equal. Also, an outlier, such m e a n and m e d i a n are u n e q u a l in this
v a l u e s of t h e m e a n , m e d i a n , a n d as a systolic blood pressure value of n o n - n o r m a l l y distributed data. Also,
m o d e are identical. 150 m m Hg instead of 180 m m Hg, there exist t w o peaks of data cluster,
142/310 Annals of Emergency Medicine 19:3 March 1990
50 th percentile

15.9 th percentile
S 84.1 percentile

2.3 rd percentile ! , / 7.7 TM percentile


2"14°/°
, "13°/° , ~ I 13"59°/° 34.13% 34.13% 13"59% i

-4SO -3SD -2SD -1 SD o


+1 SD +2SD +3 SD +4SD
I 68.26% I
I 95.44o/0 J
99.720/0
I
99"980/0 ,,, I
4

FIGURE 4. SD and the normal distri-


TABLE 1. Applicability of measures of central tendency bution: 6 8 . 2 6 % of all scores fall
w i t h i n ± 1 SD f r o m t h e m e a n ;
95.44% of all scores fall within ± 2
Characteristic Mean Median Mode SD f r o m the m e a n ; 99.72% of all
Useful with interval, ratio data Yes Yes Yes scores fall within +_ 3 SD from the
m e a n ; 9 9 . 9 8 % of all s c o r e s fall
Useful with ordinal data No Yes Yes wqthin ± 4 SD from the mean. £6
Useful with nominal data No No Yes
Affected by outliers Yes No No a series of m e a s u r e s , and t h u s t h e
presence of one outlier can m a r k e d l y
i n f l u e n c e t h e r a n g e . T h e r a n g e is
two modes. To ignore the b i m o d a l as- dency is best for all situations. 5 The purely a descriptive tool and should
pect of this d i s t r i b u t i o n w o u l d be to a p p l i c a b i l i t y of m e a s u r e s of central n o t be used to infer w h e t h e r groups
overlook its u n i q u e feature. Also, the t e n d e n c y is s u m m a r i z e d (Table 1). differ statistically.
presence of an outlier w o u l d alter the
mean, b u t n o t the m e d i a n or modes. MEASURESOF VARIABILITY InterquartileRange
In Figures 2 and 3 the mean, me- M e a s u r e s of c e n t r a l t e n d e n c y do T h e i n t e r q u a r t i l e range is a m e a -
dian, a n d mode(s) are u n e q u a l be- not describe the variability, or sure of v a r i a b i l i t y directly related to
cause data are n o t n o r m a l l y distrib- spread, of data. S t a n d a r d i z e d esti- the median. Recall that the median, a
uted. 5 Thus, the m e a s u r e of central m a t e s d e f i n i n g d a t a v a r i a b i l i t y are m e a s u r e of central t e n d e n c y applica-
t e n d e n c y m o s t useful to data analy- n e e d e d to h e l p i n f e r w h e t h e r t w o ble to ordinal and n o n - n o r m a l l y dis-
sis depends on the type of data, and groups studied differ significantly. In t r i b u t e d d a t a , is t h e m i d d l e m o s t
w h a t aspect of the data is to be con- other words, measures of variability v a l u e of a set of data. T h e m e d i a n
veyed. Fortunately, m o s t physiologic are used to help infer w h e t h e r two or r e p r e s e n t s the 50th p e r c e n t i l e . T h e
d a t a are n o r m a l l y or n e a r n o r m a l l y m o r e groups studied are drawn from i n t e r q u a r t i l e range is t h a t range de-
d i s t r i b u t e d so t h a t m e a n , m e d i a n , d i f f e r e n t p o p u l a t i o n s . S e v e r a l esti- scribed by the interval b e t w e e n the
and m o d e are equal. However, ordi- m a t e s of variability exist. 25th and 75th percentile values. 6
nal scale data have no consistent It has been suggested that the in-
m a g n i t u d e of d i f f e r e n c e b e t w e e n Range terquartile range be used for describ-
u n i t s of the data scale, and m o s t or- The range is the interval b e t w e e n ing the v a r i a b i l i t y of data that do n o t
d i n a l d a t a are n o t n o r m a l l y distrib- the lowest and highest values w i t h i n m e e t p a r a m e t r i c analysis standards,
uted. 3 Therefore, t h e m e a n is mis- a data group. 2 It is the s i m p l e s t mea- such as ordinal scale data. 6 T h e inter-
leading as a m e a s u r e of central ten- sure of v a r i a b i l i t y to u n d e r s t a n d and q u a r t i l e range clearly defines w h e r e
dency for ordinal scale data.Z, 3 identify. While simple, the range the m i d d l e 50% of measures occurs
N o single m e a s u r e of central ten- only considers the e x t r e m e values of and indicates the spread of the data

19:3 March 1990 Annals of Emergency Medicine 311/143


BIOSTATISTICS
Gaddis & Gaddis

TABLE 2. Estimates of variability of systolic blood pressure data of men aged 31 to 40 years

Systolic
Subject Blood Pressure (X - Xi) (X - X=)2
1 135 15 225
2 115 5 25
3 110 10 100
4 130 10 100
5 125 5 25
6 125 5 25
7 105 15 225
8 120 0 0
9 120 0 0
10 120 0 0
11 125 5 25
12 110 "10 100
13 115 5 25
14 115 5 25
15 135 15 225
16 100 20 400
17 120 0 0
18 125 5 25
19 120 0 0
20 130 10 100
21 140 20 400
22 120 0 0
23 115 5 25
24 1t0 10 100
25 130 10 100
26 105 15 225
27 120 0 0
28 115 5 25
29 125 5 25
30 120 0 0
Mean = ~ X/n = 3,600~0 = 120
Median = 120
Mode = 120
Variance: .Y.;(X - Xi)2/(n-1) = 2,550/29 = 87.931
SD = ~ = 9.377
SEM = 9.337 = 1.712

without using statistical techniques individual s a m p l e data points about points of a n o r m a l l y distributed pop-
improperly. the s a m p l e mean. ulation fall w i t h i n plus or m i n u s one
The usefulness of the SD lies in its SD of t h e m e a n , a n d 9 5 . 4 4 % of
Standard Deviation properties as related to the Gaussian, points fall w i t h i n plus or m i n u s two
T h e standard deviation (SD) is one or normal, distribution. The SD itself SD of the mean. 5
of the m o s t c o m m o n l y encountered can be u s e d to d e f i n e an e x t r e m e The SD is calculated as the square
e s t i m a t e s of d a t a v a r i a b i l i t y and is score, s u c h as the v a l u e t h a t is ex- root of a n o t h e r t e r m called the vari-
integral to performance of inferential ceeded by 5% or 95% of all scores ance. Because individual data p o i n t s
statistical techniques. 2 It provides an from a s a m p l e of a population. 2 Fig- w i l l fall b o t h above and b e l o w t h e
e s t i m a t e of t h e degree of s c a t t e r of u r e 4 s h o w s t h a t 6 8 . 2 6 % of d a t a mean, the effect of direction of differ-

144/312 Annals of Emergency Medicine 19:3 March 1990


~XX.K, x

x21¢xN

<~3¢.K;

I I l l I I I I I I I I
100 110 120 130 140
SD = 9.37 SD = 9.37
SEM = 1,71 SEM = 1,71
I 1

I 9 5 % CI l

MEAN

FIGURE 5. Systolic blood pressure of


TABLE 3. Applicability of measures of variability m e n aged 31 to 40 years. SD, SE, and
95% CI are noted.

Interquartile
statistical inference techniques. T h e
Characteristic Range Range SD SEM
calculation of SD from the n o r m a l l y
Useful to describe interval or Yes Yes Yes Yes distributed systolic blood pressure
ratio data data of Figure 1 is shown (Table 2).
Used to describe ordinal data Yes Yes No No
Standard Error of the Mean
Descriptive of sample variability Yes Yes Yes No
T h e s t a n d a r d error of t h e m e a n
Assists in statistical inference No No Yes Yes (SEM) is a statistic derived from the
Used to calculate confidence No No No* Yes SD, and is s i m p l y calculated as
intervals SEM - SD/N/~-
*SEM = SD/x/~, thus SD is involved indirectly in calculating a confidence interval. It is o b v i o u s f r o m t h e c a l c u l a t i o n
that the SEM is always smaller t h a n
ence will cause some deviations from instance, in Figure 1, the variance of t h e SD and t h e g r e a t e r t h e n, t h e
the m e a n to be positive and some to s y s t o l i c b l o o d p r e s s u r e is expressed s m a l l e r the SEM will be.
be negative. To overcome this effect, as m m Hg 2. However, these squared T h e SEM is an a b s t r a c t concept.
d e v i a t i o n s are s q u a r e d to o b t a i n a units are n o t meaningful. Therefore, Imagine repeating an e x p e r i m e n t nu-
p o s i t i v e n u m b e r . I n d i v i d u a l squared t h e s q u a r e r o o t of t h e v a r i a n c e is merous times. With each experi-
d e v i a t i o n s from the m e a n are t h e n t h e n c a l c u l a t e d , to b r i n g t h e vari- ment, a different sample group w o u l d
averaged to calculate the e s t i m a t e of a b i l i t y e s t i m a t e b a c k to t h e correct be drawn from the study population.
v a r i a b i l i t y k n o w n as t h e v a r i a n c e . scale. This is the value k n o w n as the Because each repetition of the experi-
Numerically SD: m e n t contains u n i q u e sample m e m -
bers, different m e a n v a l u e s w i l l be
Variance = ~ (X - Xi)2/(n-1 ) SD -
generated w i t h each study. The col-
w h e r e X equals the mean, X i equals T h e SD is meaningful only w h e n ap- lection of these m e a n values, as gen-
each individual data point, and n p l i e d to d a t a t h a t are n o r m a l l y or erated from repetitive sampling and
e q u a l s t h e t o t a l n u m b e r of d a t a n e a r l y n o r m a l l y distributed.2,s, 9 It is e x p e r i m e n t a t i o n , w i l l reflect "scat-
points. 5-7 T h e variance represents the a p p l i c a b l e to i n t e r v a l or r a t i o scale ter" about the true but unknown
d e v i a t i o n f r o m t h e m e a n , expressed data. ~ p o p u l a t i o n mean. The SEM is s i m p l y
as the square of the u n i t s used. For The SD is useful in application to a quantification of the variability of
19:3 March 1990 Annals of Emergency Medicine 313/145
BIOSTATISTICS
Gaddis & Gaddis

these sample m e a n values. The SEM


is properly used to e s t i m a t e the pre- TABLE 4. Effect of confidence level and sample size on confidence
cision or r e l i a b i l i t y of a sample, as it interval width
relates to the p o p u l a t i o n from w h i c h
the sample was drawn.lO, 11 The SEM
does not provide an e s t i m a t e of the Calculation of CIs for Data Presented in Table 2
scatter of s a m p l e data about the sam- C1(%) SD n SEM CI
ple m e a n la and should n o t be used as 90 9.377 30 1.712 120 -+ 2.82
such.
T h e SEM is u s e f u l b e c a u s e i t is 95 9.377 30 1.712 120 -+ 3.36
u s e d in t h e c a l c u l a t i o n of " c o n f i - 99 9.377 30 1.712 120 _+ 3.83
dence i n t e r v a l s , " w h i c h c o n t a i n an
e s t i m a t e of the true m e a n for an en- Effect of Sample Size on CI for Data With A Mean of 120 and a SD of 9.377
tire p o p u l a t i o n from w h i c h the sam-
ple was drawn. Confidence intervals C1(%) SD n SEM CI
can be used for descriptive or inferen- 95 9.377 30 1.712 120 _+ 3.36
tial purposes. 95 9.377 100 0.938 120 _+ 1.84
A calculation of SEM for the nor-
m a l l y d i s t r i b u t e d data p r e s e n t e d in 95 9.377 1000 0.297 120 ± 0.582
Figure 1 is s h o w n (Table 2).

Standard Deviation Versus error to u s e SEM in s p e c u l a t i n g a lationA s Also, the closer a p o i n t lies
Standard Error of the Mean range, or confidence interval, w i t h i n to t h e m i d d l e of t h e CI, t h e m o r e
Both SD and SEM are measures of w h i c h a t r u e population m e a n is l i k e l y it is-representative of the pop-
variability. However, the two statis- l i k e l y to fall. The SD and SEM of the ulation. 16
tics are different and are f r e q u e n t l y data shown in Figure 1 are given (Fig- Though by convention the 95% CI
confused or m i s u s e d , la T h e SD de- u r e 5). T a b l e 3 s u m m a r i z e s t h e is m o s t c o m m o n l y reported, the 95%
f i n e s v a r i a b i l i t y of s a m p l e d a t a proper use of e s t i m a t e s of variability. level is n o t rigidly required. W i d e r
points about a sample mean. The SD CIs, such as a 99% or 99.9% CI, are
is always greater than the SEM. The Confidence Intervals even m o r e l i k e l y to include the true
SEM is m o s t c o m m o n l y calculated to W h e n s t a t i s t i c s derived from the p o p u l a t i o n p a r a m e t e r v a l u e and are
help derive confidence intervals. sampling of a p o p u l a t i o n are studied c o m m o n l y used for critical appraisal
Various a u t h o r s have c o m m e n t e d to infer values for p o p u l a t i o n param- of data. T h e y are also advocated for
about the i n t e l l e c t u a l sleight of h a n d eters, it w o u l d be useful to have con- e x a m i n a t i o n s of data during ongoing
of incorrectly using SEM when only fidence that the sample statistical a c c u m u l a t i o n of subjects in a clinical
SD is appropriate to describe sample value, such as a m e a n or SD, w o u l d trial. 15 N a r r o w e r CIs, s u c h as t h e
data variability.6A2A3 Bunce et aU 3 be representative of the true popula- 90% CI, can be used w h e n s t u d y au-
reviewed 608 articles in six journals tion p a r a m e t e r . One c a n n o t be cer- thors find it acceptable that ten
in w h i c h m e a n _+ SD or SEM were tain that a s a m p l e statistical value is t i m e s out of 100, the true p o p u l a t i o n
reported. In 50%, SEM values were representative of the true population p a r a m e t e r m a y n o t lie w i t h i n the CI.
r e p o r t e d w h e n o n l y t h e SD w o u l d parameter, b u t one can c a l c u l a t e a However, the w i d t h of a CI depends
have been appropriate. T h e a u t h o r s range of values l i k e l y to be represen- n o t only on the variability of the data
concluded that " m a n y workers m a y t a t i v e of t h e p o p u l a t i o n p a r a m e - and the level of confidence selected,
choose to report the SEM because it ter.4,14 That range of values is called but also the sample size.
is s i m p l y s m a l l e r t h a n t h e SD. ''13 a c o n f i d e n c e i n t e r v a l (CI). Calcula- W h e n one broadens a CI by mov-
The inappropriate use of SEM to de- tion of a CI is a m e t h o d of e s t i m a t i n g ing a 95% to a 99% CI, accuracy is
scribe sample data v a r i a b i l i t y m a y be the range of values l i k e l y to include i n c r e a s e d b e c a u s e t h e c a l c u l a t e d CI
p r e s e n t e d by a u t h o r s in an a t t e m p t the true value of a p o p u l a t i o n param- b e c o m e s m o r e l i k e l y to i n c l u d e a
to i m p l y that a significant difference eter. Since one cannot study all true p o p u l a t i o n parameter. However,
exists b e t w e e n groups, w h e n in fact m e m b e r s of a population, a represen- w h e n the level of CI is held constant
no difference exists. Elenbaas et al la t a t i v e s a m p l e of t h e p o p u l a t i o n is and s a m p l e size is increased, SEM is
were m o r e blunt, concluding that au- studied, and from this one uses the d e c r e a s e d a n d t h u s t h e CI is nar-
thors w h o p r e s e n t data as m e a n _+ m e a n and SEM to w o r k backward to rowed. This narrowing of the CI in-
SEM instead of m e a n ± SD m a y be e s t i m a t e a CI. creases the precision of the CI. The
trying to actively i m p a i r the reader's T h e w i d t h of the CI depends on effect of level of confidence selected
a b i l i t y to accurately identify the vari- the SEM and the degree of confidence and s a m p l e size on the w i d t h of a CI
ability in the s t u d y data. we arbitrarily choose. For instance, a is shown (Table 4).
W h e t h e r by error or by design, it is 95% CI, w h i c h is the degree of confi- C a l c u l a t i o n of the CI for e s t i m a -
incorrect to underrepresent the vari- dence m o s t c o m m o n l y expressed, ~4 tion of true p o p u l a t i o n m e a n values
a b i l i t y of s a m p l e d a t a as m e a n _+ is a range of v a l u e s b r o a d e n o u g h applies to c o n t i n u o u s data from nor-
SEM. We suggest that readers m u l t i - that, if the entire p o p u l a t i o n could be m a l or n e a r - n o r m a l d i s t r i b u t i o n s . 4
p l y the SEM by ~ n - t o obtain the SD studied, 95% of the t i m e the popula- Also, a CI can be e s t i m a t e d for such
w h e n SEM is erroneously used to ex- tion m e a n w o u l d fall w i t h the CI es- o t h e r s t a t i s t i c s as m e d i a n s , regres-
press sample variability. It is not an t i m a t e d from the sample of the popu- s i o n slopes, r e l a t i v e r i s k data, re-

146/314 Annals of Emergency Medicine 19:3 March 1990


sponse rates, intergroup differences proper use has been discussed. 7. Sokal RR, Rohlf F]: Biometry, ed 2. New
of r e s p o n s e rates, X year s u r v i v a l Finally, the concept and proper use of York, WH Freeman and Co, 1981.
rates, median survival duration, and CIs have been outlined. 8. Maxfield M, 8chweitzer J, Gouvier WD: Mea-
h a z a r d ratios.14, t6 In addition, CI The next installment of this series, sures of central tendency, variability, and rela-
tive standing in nolmormal distributions: Alter-
m a y be used to visually compare data in the May issue, will cover hypoth- natives to the mean and standard score. Arch
w h e n two or more sample groups are esis testing. Included will be types of Phys Med Rehabil 1988;69:406-409.
studied but their members were not experimental error, the terms alpha 9. Nierenberg A, Jekel J, Singer B: Is standard
r a n d o m l y selected or assigned be- (oL) and beta (f3), statistical power, and deviation always the right choice? (letter). A m J
tween the groups, is sensitivity, specificity, and predictive Psychiatry 1986;143:1198-1199.
Pitfalls in the use of the CI exist. value. 10. Davis RH: How to use standard error in a
Confidence intervals convey the ef- clinical study. J A m Podiatric Med Assoc
fects of sampling variation but do not 1987;77:154-156.
control for such nonsampling errors REFERENCES 11. Hamer RM: Measures of precision for
in study design or execution as im- 1. Gaddis ML, Gaddis GM: Introduction to bio- means: SE or SD? (letter). A m J Psychiatry
statistics: Part 1, Basic concepts. Ann Emerg t986; 143:804-805.
proper selection of subjects, poor ex- Med 1990;19:86-89.
perimental design, and the like. 4 12. Elenbaas RM, Elenbaas JK, Cuddy PG, et ah
2. Clegg F: Introduction to statistics I: Descrip Evaluating the medical literature, Part II: Statis-
tive statistics. Br J Hospital Med 1987;37: tical analysis. Ann Ernerg Med 1983;12:610-620.
356-357.
SUMMARY 13. Bunce H, Hokanson JA, Weiss GB: Avoiding
This article has highlighted com- 3. Forrest M, Andersen B: Ordinal scale and sta- ambiguity when reporting variability in bio-
tistics in medical research. Br Med J 1986; medical data. Am J Med 1980;69:8-9.
m o n proper and improper use of mea- 292:537-538.
sures of central tendency and mea- 14. Gardner MJ, Altman DG: Confidence inter-
4. Campbell MJ, Gardner MJ: Calculating confi- vals rather than P values: Estimation rather
sures of variability. The relationship dence intervals for some non-parametric analy- than h y p o t h e s i s testing. Br Med J 1986;
between the type of data scale and ses. Br Med J 1988;296:1454-1456. 292: 746-750.
the correct use of mean, median, and 5. Hopkins KID, Glass GV: Basic Statistics for 15. Bulpitt CJ: Confidence intervals. Lancet
mode have been presented. The vari- the Behavioral Sciences. Englewood Cliffs, New 1987:494-497.
ability estimates of range, interquar- Jersey, Prentice-Hail, Inc, 1978.
16. Simon R: Confidence intervals for reporting
tile range, SD, and SEM have been in- 6. Glanz SA: Primer of Biostatistics, ed 2. New results of clinical trials. Ann Intern Meal
troduced, and their proper and ira- York, McGraw-Hill Book Co, 1987. 1986; 105:429-435.

19:3 March 1990 Annals of Emergency Medicine 315/147

Das könnte Ihnen auch gefallen