Lecture 3.

Medical statistics.
Statistical quantities and
their applications.
Issues under consideration:

 definition of medical statistics as a science;

 • sections and content of medical statistics;
 • stages of statistical research;
 • drawing up a plan and program of statistical research;
 • definition of the object and unit of observation;
 • rules for constructing layouts of statistical tables;
 • average and relative values ​- calculation methodology, units of measurement,
graphic representation;
 • definition of medical demographics;
 • the value of demographic indicators.
Statistics is a science that studies the
quantitative side of mass social
phenomena and processes in an
inextricable connection with their
qualitative side in specific conditions of
place and time. It allows you to identify
patterns of mass phenomena using
generalized indicators.
Features of statistics:

 1. Studying the mass character of the phenomenon, that is, a sufficiently large
number of observations. It is only in mass phenomena that certain objective laws
come to light.
 2. Study of qualitatively homogeneous phenomena.
 3. Study of this or that phenomenon in dynamics.
 Medical statistics develops methods, forms and techniques
for collecting, processing and analyzing data
characterizing the level and changes in the state of health
of the population, reveals the most important laws of such
complex mass processes as physical development,
morbidity, disability and reproduction of various
population groups in specific working conditions, life and
life.
 The use of medical statistics methods allows an in-
depth statistical study of the level and changes in
the health of the population due to the influence on
it of various environmental factors, socio-
economic conditions, working conditions, life,
upbringing, and the characteristics of the system of
medical care for the population. The statistical
method is the main method of medical and social
analysis.
Medical statistics tasks:
 • studying the health of the population as a whole or its individual groups,
identifying the quantitative characteristics of public health;
 • identification of links between health indicators and various factors of the
natural and social environment, assessment of the impact of these factors on the
health of the population;
 • study of data on the network of medical institutions, personnel, analysis of their
activities;
 • evaluation of the effectiveness (medical, social, economic) of medical,
preventive, anti-epidemic measures and health care in general;
 • the use of statistical methods in clinical, sanitary-hygienic and experimental
research.
There are three sections of medical
statistics:
 1. Population health statistics studies the health of the
population as a whole or its individual groups (by
collecting and statistical analysis of data on the size and
composition of the population, its reproduction, natural
movement, physical development, prevalence various
diseases, life expectancy, etc.). Assessment of health
indicators is carried out in comparison with generally
accepted assessment levels and levels obtained in different
regions and in dynamics.
 2. Health statistics solves the collection,
processing and analysis of information on the
network of health care institutions (their location,
equipment, activities) and personnel (on the
number of doctors, nurses, nursing staff, their
distribution by specialties, work experience, etc.).
When analyzing the activities of medical and
prophylactic institutions, the data obtained are
compared with the normative levels, as well as the
levels obtained in other regions and in dynamics.
3. Clinical statistics - the use of
statistical methods in processing the
results of clinical, experimental and
laboratory studies. It allows you to
quantitatively assess the reliability of
the results and solve a number of
other problems.
General population - a collection
consisting of all observation units that can
be attributed to it in accordance with the
purpose of the study. When studying
public health, the general population is
often considered within specific territorial
boundaries or may be limited by other
characteristics (gender, age, etc.),
depending on the purpose of the study.
Sample population - a part of the general
population, selected by a special
(sampling) method and intended to
characterize the general population.
To ensure representativeness, the sample
population must meet two basic
requirements:
 1) be similar to the general population, have the
main features as the general population, that is, in
the selected part, all elements must be represented
in the same ratio as in the general population;
 2) be sufficient in volume.
Statistics allows using special formulas or
tables to calculate the required number of
observations in the sample population:
-if the number of observations is> 30, this
is a large sample;
-if the number of observations is <30, this
is a small sample.
 Random selection is carried out by lot, according to the initial letter of the
surname or birthday, according to a random sign.
 Mechanical selection is a selection from the general population of every n-th
observation unit (every 5th, 10th, etc.).
 Typological selection presupposes a breakdown of the studying object into a
number of similar qualitative groups, from which units are further selected for
observation.
 Nest (serial) selection - selection from the entire set of groups called nests. Then,
in these nests, observation units are studied by a continuous method or selectively.
 Directed selection is most commonly used in biological experiments. The use of
this method makes it possible to reveal the influence of unknown factors while
eliminating the influence of known ones.
Statistical quantities and their
application in health care practice
 Absolute values ​are used to determine the absolute size of the phenomenon under
study. For example, the absolute population of a country.
Relative values ​(indicators, coefficients) are the ratio of one absolute value to
another. The following indicators are most often used: intensive, extensive,
correlation, visibility.
Intensive
indicators are indicators of the frequency, intensity, prevalence of the
phenomenon in the environment producing the given phenomenon. In health care,
morbidity, mortality, disability, fertility and other indicators of the population's health
are studied.
Intensive indicators can be general and specific.
 General intensive indicators characterize the phenomenon as a whole, for example, general
indicators of fertility, mortality, morbidity, calculated for the entire population of the city, district, the
general indicator for mortality in the hospital as a whole or by departments, calculated for all those
treated, etc.
Special intensive indicators (group-by-group) are used to characterize the frequency of the
phenomenon in different groups (morbidity by sex, age, mortality among children under 1 year of
age, mortality in individual nosological forms of diseases, etc.).
Extensive indicators - indicators of share, structure- characterize the division of the
phenomenon into its component parts, its internal structure. Extensive indicators are calculated by
dividing a part of the phenomenon by the whole and are expressed as a percentage or fraction of a
unit.
Ratio indicators are the ratio of two independent from each other, qualitatively dissimilar
quantities. The ratio indicators include data on the provision of the population with doctors,
paramedics, hospital beds, as well as indicators reflecting the number of laboratory tests per doctor,
the number of blood transfusions operated
patient, etc.
 The visibility indicators are used for the purpose of a more visual and accessible
comparison of statistical values. They provide a convenient way to convert absolute,
relative, or average values ​into an easy-to-compare form. When calculating these
indicators, one of the compared values ​is equated to 100 (or 1), and the remaining
values ​are recalculated according to this number.

Averages, their application in statistical
analysis
 Average values ​give a generalizing characteristic of the statistical population for a
certain changing quantitative attribute.
 Average values ​are widely used in everyday medical practice. They are applied:
• to characterize physical development, the main anthropometric signs: height,
body weight, chest circumference, etc.;
• to assess the patient's condition by analyzing physiological, biochemical changes
in the body: blood pressure, heart rate, body temperature, biochemical indicators,
hormone content, etc.;
• when analyzing the activities of medical and prophylactic institutions, for
example, when analyzing the work of hospitals, indicators of the average annual bed
occupancy, the average duration of a patient's stay in a hospital, etc. are calculated.
Assessment of the reliability of the
results of a statistical study
 Statistical indicators and characteristics of medical phenomena obtained in practice represent the results of
observation of a limited number of these phenomena, as a rule, a sample study is carried out when not all units of
the statistical population are studied, but only a part of them
To reduce the error, i.e., to increase the reliability or degree of compliance of the indicator of the reality
displayed by it, it is necessary to:
1) reduce the standard deviation (o), that is, reduce the degree of variability of the variation series (for average
values);
 2) increase the number of observations.
 This follows from the law of large numbers:

1) as the number of observations increases, the results on a sample population tend to reproduce the general
population;
2) when a certain number of observations of the sample population is reached, the research results will be as
close as possible to the data of the general population.
 .