Basic & Clinical Biostatistics
introduces the medical
student, researcher, or practitioner to the study of statistics applied to
medicine and other disciplines in the health field. The authors, a
statistician who is professor emeritus in a department of medicine and a
practicing physician who participates in numerous clinical trials, have
incorporated their experiences in medicine and statistics to develop a
comprehensive text. The book covers the basics
of biostatistics and
quantitative methods in epidemiology and the clinical
evidence-based medicine and the decision-making methods. Particular emphasis
is on study design and interpretation of results of research.OBJECTIVE
objective is to provide the resources to help the reader become an informed
user and consumer of statistics, and we have endeavored to make our
presentation lively and interesting. This book should allow you to:
• Develop sound judgment about data applicable to
• Read the clinical literature critically,
understanding potential errors and fallacies contained therein, and apply
confidently the results of medical studies to patient care.
Interpret commonly used vital statistics and understand the ramifications of
epidemiologic information for patient care and prevention of disease.
• Reach correct conclusions about diagnostic procedures and laboratory
• Interpret manufacturers' information about drugs,
instruments, and equipment.
• Evaluate study protocols and
articles submitted for publication and actively participate in clinical
• Develop familiarity with well-known statistical
software and interpret the computer output.APPROACH
& DISTINGUISHING FEATURES
attempted to keep the practitioner's interests, needs, and perspectives in
mind. Thus, our approach embraces the following features:
• A genuine medical context is offered for the
subject matter. After the introduction to different kinds of studies is
presented in Chapter 2, subsequent chapters begin with several Presenting
discussions of studies that have been published in the
medical literature. These illustrate the methods discussed in the chapter
and in some instances are continued through several chapters and in the
exercises to develop a particular line of reasoning more fully.
Actual data from the presenting problems are used to illustrate the
• A focus on concepts is accomplished by
using computer programs to analyze data and by presenting statistical
calculations only to illustrate the logic behind certain statistical
• The importance of sample size (power analysis) is
emphasized, and computer programs to estimate sample size are illustrated.
• Information is organized from the perspective of the research
question being asked.
• Terms are defined within the relevant
text, whenever practical, because biostatistics may be a new language to
you. In addition, a glossary of statistical and epidemiologic terms is
provided at the end of the book.
• A table of all symbols used in
the book is provided on the inside back cover.
• A simple
classification scheme of study designs used in clinical research is
discussed (Chapter 2). We employ this scheme throughout the book as we
discuss the presenting problems.
• Flowcharts are used to relate
research questions to appropriate statistical methods (inside front cover
and Appendix C).
• A step-by-step explanation of how to read the
medical literature critically (Chapter 13)a necessity for the modern
health professionalis provided.
• Evidence-based medicine
and decision making are addressed in a clinical context (Chapters 3 and 12).
Clinicians will be called on increasingly to make decisions based on
• The reference section is divided into
two categories to facilitate the search for the sources of a presenting
problem or for a text or an article on a specific topic.
Numerous end-of-chapter exercises (Chapters 2 through 12) and their complete
solutions (Appendix B) are provided.
• A posttest of
multiple-choice questions (Chapter 13) similar to those used in course final
examinations or licensure examinations is included.SPECIAL FEATURES IN THIS EDITION
several important enhancements to the fourth edition.
To facilitate and
increase learning, each chapter (except Chapter 1) contains a set of key
to orient the reader to the important ideas discussed in the
chapter. The icon shown above marks the point in the chapter where the
concept is discussed.
• In addition to the
key concepts, we added a completely new chapter on survey research (Chapter
11) and expanded the discussion of logistic regression, the Cox model, and
other multivariate statistical methods in Chapter 10.
• We updated
many of the presenting problems and, through the generosity of the authors
of these studies, have been able to use the actual data to illustrate the
statistical methods and design issues.
• We continue to organize
the chapters to reflect the way investigators ask research questions, as
opposed to the traditional organization of texts based strictly on
statistical methods. For instance, three chapters discuss how to analyze
questions about means and proportions depending on the number of groups in
the study: one, two, or more than two.
• Please refer to our Web
where we will list updates and other items of interest. You may also wish to
take a look at the NCSS Web site http://www.ncss.com
for new developments.
Beth Dawson, PhD
Robert G. Trapp, MDMarch 2004