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PubMed1998

An update on biostatistics requirements in U.S. medical schools.

PURPOSE: To update the results of previous surveys of medical schools in the United States concerning their courses in introductory biostatistics and to acquire additional information about these courses. METHOD: In 1993, the authors sent a questionnaire to each of the 125 U.S. medical schools listed in the 1992-93 AAMC Directory of American Education. The questionnaire sought information about biostatistics courses and the subjects covered therein. RESULTS: One hundred of the 125 medical schools (80%) responded to the survey. Of those, 74 required a course in biostatistics as part of their undergraduate medical curriculum. The courses had large enrollments (median, 134) and a median of only 20 hours of instructional time. Most courses included a large amount of material, with 25 possible topics covered by at least 75% of the schools with required courses. CONCLUSION: While efforts have been made to incorporate innovative instructional techniques into these courses, most still follow the traditional lecture format and make minimal use of computers. Nevertheless, medical students appeared to have a favorable attitude toward these courses at over half of the schools surveyed.

Biometry↗

PubMed2003

Using the case-discussion method to teach epidemiology and biostatistics.

Medical students must learn the principles of epidemiology and biostatistics to critically evaluate the medical literature. However, this subject has traditionally been difficult to teach. In 1997 at the Albert Einstein College of Medicine, the required first-year course in epidemiology and biostatistics was revised to use the case-discussion teaching method. In preparation for the course, experienced faculty participated in an intensive, two-day training workshop. The course, taught to 163 first-year medical students, was structured in two parts: (1) three lectures complemented by a detailed syllabus, followed by a multiple-choice midterm exam; and (2) six case-discussion seminars, followed by a short answer/essay final exam. There were seven case-discussion groups with 23-24 students each. The program was evaluated using subjective faculty feedback, examination scores, and student evaluation questionnaires. Faculty noted excellent student preparation and participation. Multiple-choice exam scores were comparable to those from earlier years, and a short answer/essay exam demonstrated good student mastery of the required material. Student evaluation was overwhelmingly positive, and significantly improved from prior years of the course. Positive student evaluations of the course using this teaching method continued over the next four years; National Board of Medical Examiners examination scores indicated success in mastery of the material; and student assessment of the course improved on the AAMC Graduation Questionnaire. This favorable experience suggests that case-discussion teaching can be employed successfully in teaching principles of epidemiology and biostatistics to medical students.

Biometry↗

PubMed1987

Clinical relevance: an issue in biostatistical training of medical students.

Significant trends in teaching biostatistics to medical students include: recognition of the dependence of advancement in the medical sciences upon the quantitative sciences; integration of biostatistics and other disciplines such as epidemiology and community medicine; increased emphasis on clinical relevance through the introduction of such topics as medical decision-making, evaluation of diagnostic test, genetic counselling and evaluating health-science literature; growing emphasis on analytic skills and computer literacy as precipitated by the presence of computer-based patient and medical information systems, expert systems, imaging and signal analysis systems; the emergence of new applications of statistics in health and medicine; and changes in the learning environment, for example emphasis on small-group discussions and problem-solving sessions. The evolution and future directions of biometrical training in medicine as precipitated by these trends, and the response of course directors at the Medical University of South Carolina to the demand for a 'new' curriculum in biostatistics for medical students are described.

Attitude of Health Personnel↗

PubMed1992

Epidemiology and biostatistics content in baccalaureate education for community health nursing.

Community health nursing leaders recommend including epidemiology and biostatistics in baccalaureate curricula but do not define essential content. Topic coverage and emphasis vary across schools; students differ in academic achievement and in readiness for an epidemiologic approach to nursing. A review of textbooks showed wide variance in topic presentation. A survey of baccalaureate community health nursing faculty in a southeastern state uncovered a core of epidemiology course work comparable to that in graduate programs. Biostatistical content was sparse, and participatory learning strategies were seldom noted. Definition of essential introductory epidemiology and biostatistics content and greater linkage between knowledge and application is necessary to show their congruence with community health nursing practice, and enable differentiation between the level and scope of learning appropriate for undergraduate and graduate education.

Biometry↗

PubMed1998

Integrating biostatistics and experimental physiology: students' perceptions and future scope.

The use of biostatistics in experimental physiology is recognised by researchers. However, there has been no concerted attempt to integrate biostatistics into the undergraduate experimental physiology programme. This paper describes one such initiative. The student's response to the exercise was largely positive; it enabled them to describe and interpret data more effectively and understand the experiments more completely. The attitudes of the students to the exercise and their performance at a statistics examination at the end of the exercise was determined by a number of parameters, including prior statistical knowledge, general academic performance and the extent to which they liked mathematics. However, even those students who disliked mathematics indicated that they appreciated the value of the exercise. The results indicate the need to integrate biostatistics into the undergraduate physiology course.

Biometry↗

PubMedDate not supplied

The effect of a medical journal club on residents' knowledge of clinical epidemiology and biostatistics.

BACKGROUND: We performed a prospective controlled trial of a monthly journal club to determine if it would increase pediatric residents' knowledge of clinical epidemiology and biostatistics. METHODS: Intervention residents received two didactic sessions before the journal club started. Eight monthly journal club sessions followed. Pediatric residents at another institution served as controls. Intervention and control residents completed a pre- and post-test on clinical epidemiology and biostatistics. RESULTS: Neither the intervention nor the control group showed a significant change in test scores over the 9-month period. CONCLUSION: A more intensive and more structured approach is needed to effectively teach clinical epidemiology and biostatistics to residents.

Biometry↗

PubMed2004

[Research design strategy in medical and biostatistical studies].

OBJECTIVE: The purpose of this review is to discuss basic methods of the biostatistical study design and analysis. DESIGN: A review article. SETTING: OBGYN clinic, 1st Medical Faculty, Charles University, Teaching Hospital Bulovka, Prague. SUBJECT: The medical research requires the complexity of special skills, including medical practice, biological understanding and biostatistical expertise. The following article discusses methods of the biostatistical study design and analysis using synoptical clinical and health examples.

Biomedical Research↗

PubMed1990

Biostatistical collaboration in medical research.

There has been an explosive growth in the development of statistical methodology over the past several decades. Research in both medicine and public health, in which the involvement of biostatisticians has increased dramatically during this period, has been both a beneficiary of this new methodology as well as a source of new problems. The contributions of statistical methodology in design, implementation, and analysis as they relate to the role that biostatistics and biostatisticians now play in the field of medical research are addressed. We comment on: (1) the acceptance by the medical community that biostatistical concepts are an integral part of sound medical research; (2) the sometimes unrealistic expectations placed on biostatistics and biostatisticians given limited resources and/or limited control; (3) some controversies among biostatisticians; and (4) the need for emphasizing the design and implementation phases of medical investigations.

Biometry↗

PubMedDate not supplied

Short course training in epidemiology and biostatistics for graduate and undergraduate public health professionals.

The University of South Florida has developed short courses of 2 to 3 days in epidemiology and biostatistics geared to public health workers. A key focus is providing skills which will assist local and State public health units to assess their status and measure progress with respect to achieving their explicitly stated health objectives for the year 2000. The courses were developed after the identification of the training needs in health departments and other public health settings. The training objectives were (a) to enhance the biostatistics skills of professionals involved in the analysis of health data; (b) to reinforce basic knowledge of epidemiologic methods and its practical applications in public health settings, including measures of disease frequency and association, epidemic outbreak investigations, and the identification and use of surveillance data; and (c) to demonstrate the application of the risk factor approach to select the interventions needed to reach health objectives for year 2000 and how to evaluate such interventions. A total of 43 students have taken this course series. Professional staff in health departments cannot always enroll in formal training in epidemiology and biostatistics because of time limitations or a lack of a bachelor's degree. However, the need exists. An alternative to such training could be the short course program described in this paper.

Biometry↗

PubMed1997

The future of biostatistics: expecting the unexpected.

The paper explores the future of (clinical) biostatistics. In the first part of the paper important trends in biostatistics are reviewed: new applications and more complex data; causal models for observational data; cross-validation-based model building; graphical chain and random effect models; faster computing and new algorithms as Markov chain Monte Carlo; generalized estimating equations and pseudo-likelihood; pooled data sets for meta-analysis and prognostic modelling. In the second part some dreams and nightmares of the author are sketched. Dreams are: implementation of prognostic and diagnostic models in the clinic; an instantaneous numeric integrator; much more and better organized follow-up data; disease mapping in space and time. 'Nightmares', that is, issues which it is hoped will go out of use in the future, are: P-value; rank tests; exact methods; meta-analysis; matched case-control studies.

Biometry↗

PubMed2002

A seminar series in applied biostatistics for clinical research fellows, faculty and staff.

Familiarity with experimental design and statistical analysis techniques is necessary for investigators to conduct state-of-the-art research in clinical medicine. A wide range of options for biostatistical training is available. These include formal academic courses for credit, one-on-one education offered under the guise of consultation, self-paced textbook or computer learning, intensive short courses, portions of extended courses spanning an assortment of other subjects, and a continuing series of seminars or lectures covering selected topics in statistics. The latter structure is described in this article. We offered an eight-week lecture series focusing on a new topic in biostatistics each week. The course targeted clinical faculty, postdoctoral fellows, residents, and other interested research staff at a large medical research institution. The series focused on interpretation of medical journal articles with regard to statistical issues. Another objective was to provide information to increase a participant's expertise in the design of research studies. Guidance was offered for effective communication with collaborating biostatisticians. The format and contents of the seminar series are described. Aspects of the course that proved to be successful are discussed.

Biometry↗

PubMed1976

Self-instructional teaching of biostatistics for medical students.

A growing body of literature deals with the use of self-instructional methods for teaching biostatistics to medical students. The University of Tennessee Department of Community Medicine tested the hypothesis that, in controlled, randomized situations, learning of statistical material by self-instruction is equivalent to learning identical material by the lecture method. An analysis of student performance, in terms of the grades obtained on two separate examinations, showed that students learning by self-instruction did as well or better than their colleagues taking lectures. On the basis of these results, self-instructional biostatistics for medical students at the University of Tennessee has been selected as the major teaching method of that subject.

Education, Medical↗

PubMedDate not supplied

RECPAM: a computer program for recursive partition and amalgamation for censored survival data and other situations frequently occurring in biostatistics. I. Methods and program features.

The methodology of recursive partition and amalgamation in biostatistics is presented and a FORTRAN program for its implementation, RECPAM, is described. RECPAM can be used to obtain classifications of patients according to several criteria commonly occurring in clinical biostatistics: an example is prognostic classification based on survival data. Classes are defined by simple statements, expressed in clinical terms, about predictor variables (e.g. prognostic factors). Special features of RECPAM are: the possibility of implementing a variety of classification criteria, the integration of recursive partition and amalgamation, and the availability of several strategies for constructing classification trees. A simple example to illustrate input and output features is given. The scope and flexibility of RECPAM will be illustrated in greater detail in a subsequent paper.

Algorithms↗

PubMed1991

Teaching epidemiology and biostatistics through interactive problem solving.

Medical education should prepare students for the reasoning and decision making that are required in a physician's clinical work. The disciplines of epidemiology and biostatistics, as combined in clinical epidemiology, lend themselves very well to this purpose. A lecture course in epidemiology and biostatistics was redesigned to emphasize interactive learning through problem-solving workshops in which students worked with actual data from two epidemiologic studies. A third workshop provided experience in the critical appraisal of an epidemiologic study from the current literature. Students respond favorably to these active learning experiences, which deal with relevant contemporary health problems. The concepts of clinical epidemiology should be integrated into clinical teaching in all stages of training.

Biometry↗

PubMed2000

Biostatistics in the new millennium: a consulting statistician's perspective.

This article attempts to predict the future for biostatistics and biostatisticians in the twenty-first century. Life will certainly be more complex and there will be growth in population, large corporations, and globalization generally. However, there will continue to be problems relating to biology, medicine, health and the environment, so biostatisticians can surely play an important role, if they are willing to adapt to changing circumstances. Personal views are expressed concerning those areas of most recent development that seem likely to be continued in the coming years: applications (clinical trials, epidemiology, vital statistics), philosophies, models, advances in computing, and the profession of biostatistics.

Biometry↗

PubMed2000

Do taught courses on community medicine change knowledge status regarding clinical epidemiology and biostatistics in medical students?

This study aimed to explore the changes in medical student's knowledge and attitudes regarding clinical epidemiology and biostatistics (CEB) after community medicine (CM) taught courses. All the 3rd (before CM-taught courses) and 4th year (after CM-taught courses) undergraduate students of Dhaka Medical College, Bangladesh, were given a questionnaire concerning some introductory level problems on CEB and attitudes towards them. Mean knowledge scores were not statistically different between these two groups: 3.70 and 3.85 (out of 9) on clinical epidemiology; 0.20 and 0.18 (out of 4) on biostatistics; and 3.91 and 4.04 as a total (out of 13) among them, respectively. Most of the 3rd and 4th year students agreed that CEB is essential for smooth understanding of clinical medicine and journals, and asserted to include it in CM-taught courses. Since the current CM-curriculum does not offer any improvement of knowledge among them, well-planned taught courses on it should be included as a component of CM.

Adult↗

PubMed1991

Interpreting the literature in obstetrics and gynecology: I. Key concepts in epidemiology and biostatistics.

The proper interpretation of research findings in obstetrics and gynecology increasingly requires some understanding of epidemiology and biostatistics. The disciplines of epidemiology and biostatistics are inextricably related; the goal of epidemiology is accurate measurement of the relationship between an exposure and a disease, and statistical methods are required for achieving that objective. Most epidemiologic studies in the obstetrics and gynecology literature can be classified as 1) cross-sectional, 2) case-control, or 3) cohort (follow-up) studies. The 2 x 2 table represents the basic analytic format for all three types of epidemiologic studies. Information from this table can be used to estimate both the magnitude of the exposure-disease relationship and the relative likelihood that chance explains study findings. Accurate measurement of the relationship between an exposure and a disease can be impeded by two major sources of error: bias and chance. In broad terms, biases can be classified as those related to 1) selection, 2) information, and 3) the presence of extraneous variables. Because biases in epidemiologic studies distort measurements, they must be identified, characterized, and, if possible, avoided. When biases cannot be avoided, knowledge of their likely impact on study findings must be assessed. The role of chance is evaluated by statistical testing of the null hypothesis, ie, the hypothesis that two factors are not associated.(ABSTRACT TRUNCATED AT 250 WORDS)

Bias↗

PubMed1990

Methodological aspects of a clinical trial in chronic lymphocytic leukemia: necessity to develop new biostatistical methods.

The CLL protocol allowed a better understanding of the natural history of Chronic Lymphocytic Leukemia and an assessment of several treatment strategies. From the point of view of biostatistical research, it raised several important problems. In this paper, we show the interest of applying sequential methods, particularly the triangular test. Other biostatistical problems raised by the CLL 80 protocol are still not, or only partially, resolved. They include taking into account prior belief about treatment benefit in sample size calculations, using surrogate endpoints, developing methods to take into account the causes of death, to analyse repeated measurements, and to assess and compare staging systems.

Biometry↗