Indrayan - Medical biostatistics

Chapman & Hall/CRC Biostatistics Series

CRC Press
Taylor & Francis Group
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2013 by Taylor & Francis Group, LLC
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Version Date: 20120717

International Standard Book Number-13: 978-1-4665-1390-7 (eBook - ePub)

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Biostatistical aspects are receiving increased emphasis in medical books, medical journals, and pharmaceutical literature, yet there is a lack of appreciation of biostatistical methods as a medical tool. This book arises from the desire to help biostatistics earn its rightful place as a medical, rather than a mathematical, subject. Medical and health professionals may then perceive biostatistics as their own discipline instead of an alien discipline. A book that effectively focuses on the statistical aspects of medicine with a medical perspective is clearly needed. To enhance focus, this book is titled Medical Biostatistics. Prefix medical precludes fishes and plants that a purist might include under the genre of biostatistics.

Variation is an essential, and perhaps the most enjoyable, aspect of life. But the consequent uncertainties are profound. Thus, methods are needed to measure the magnitude of uncertainties and to minimize their impact on decisions. Biostatistics is the science of management of uncertainties in health and medicine. Beginning with this premise, this book provides a new orientation to the subject. This theme is kept alive throughout the text. I have tried to demonstrate that biostatistics is not just statistics applied to medicine and health sciences but is two steps further, providing tools to manage some aspects of medical uncertainties.

The primary target audiences are students, researchers, and professionals of medicine and health. These include clinicians who deal with medical uncertainties in managing patients and want to practice evidence-based medicine; research workers who design and conduct empirical investigations to advance knowledge, including research workers in pharmaceutical industry who search new regimens that are safer and more effective yet less expensive and more convenient; and health administrators who are concerned with epidemiological aspects of health and disease.

Although the text is tilted to the viewpoint of medical and health professionals, the contents are of sufficient interest to a practicing biostatistician and a student of biostatistics as well. They may find some sections very revealing, particularly the heuristic explanations provided for various statistical methods.

The boundary between epidemiology methods and biostatistics is thin, if at all. This book does not limit itself to the conventional topics of confidence intervals and tests of significance. It discusses at length study designs, measurement of health and diseases, clinimetrics, and quality control in medical setup. The text fosters the thought that medicine has to be individualized yet participatory. It tries to develop pathways that can achieve this through biostatistical thinking. Emphasis is laid on the concepts and interpretation of the methods rather than on theory or intricacies. Theoretical development is intentionally de-emphasized and applications increasingly emphasized. A large number of real-life examples are included that illustrate the methods and explain the medical meaning of the results. Many statistical concepts are repeatedly explained in different contexts to bring home the point, keeping the requirement of the target audience in mind.

In the process of projecting biostatistics as a medical discipline, it is imperative to place less emphasis on mathematical aspects. But the essential algebra that is needed to communicate and understand some statistical concepts is not ignored. In fact, the second half of the book makes liberal use of notations. An attempt is made to strike an even balance. Medical and health professionals, who are generally not well trained in mathematics, may find the language and presentation very conducive. Equations and formulas are separately identified and manual calculations are described for the fundamentals, but the emphasis is on the use of computers for advanced calculations. Software illustrations for intricate methods are provided in Appendix C of this book.