The goal of this text is
to provide you with the tools and skills you need to be a smart
user and consumer of medical statistics. This goal has guided us
in the selection of material and in the presentation of information.
This chapter outlines the reasons physicians, medical students,
and others in the health care field should know biostatistics. It
also describes how the book is organized, what you can expect to
find in each chapter, and how you can use it most profitably.
The word “statistics” has several meanings:
data or numbers, the process of analyzing the data, and the description
of a field of study. It derives from the Latin word status, meaning “manner of
standing” or “position.” Statistics were
first used by tax assessors to collect information for determining
assets and assessing taxes—an unfortunate beginning and
one the profession has not entirely lived down.
Everyone is familiar with the statistics used in baseball and
other sports, such as a baseball player’s batting average,
a bowler’s game point average, and a basketball player’s
free-throw percentage. In medicine, some of the statistics most
often encountered are called means, standard deviations, proportions,
and rates. Working with statistics involves using statistical methods
that summarize data (to obtain, for example, means and standard
deviations) and using statistical procedures to reach certain conclusions
that can be applied to patient care or public health planning. The
subject area of statistics is the set of all the statistical methods
and procedures used by those who work with statistics. The application
of statistics is broad indeed and includes business, marketing,
economics, agriculture, education, psychology, sociology, anthropology,
and biology, in addition to our special interest, medicine and other
health care disciplines. Here we use the terms biostatistics and biometrics to refer to the application
of statistics in the health-related fields.
Although the focus of this text is biostatistics, some topics
related to epidemiology are included as well. These topics and others
specific to epidemiology are discussed in more detail in the companion
book, Medical Epidemiology (Greenberg,
2000). The term “epidemiology” refers to the study
of health and illness in human populations, or, more precisely,
to the patterns of health or disease and the factors that influence these
patterns; it is based on the Greek words for “upon” (epi) and “people” (demos). Once knowledge of the epidemiology
of a disease is available, it is used to understand the cause of
the disease, determine public health policy, and plan treatment.
The application of population-based information to decision making
about individual patients is often referred to as clinical epidemiology and, more recently, evidence-based medicine. The tools
and methods of biostatistics are an integral part of these disciplines.
Clinicians must evaluate and use new information throughout their
lives. The skills you learn in this text will assist in this process
because they concern modern knowledge acquisition methods. In ...