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At least 19 recordsLinked to original sources

Medical students' perspective on the teaching of medical statistics in the undergraduate medical curriculum.

Two undergraduate medical students at the University of Bristol commented on their experiences of learning medical statistics. In general, medical students' focus is on acquiring skills needed to practice clinical medicine, and great care must be taken to explain why disciplines such as statistics and epidemiology are relevant to this. Use of real examples and an emphasis on the need for evidence has meant that medical students are increasingly aware of the pressure on clinicians to justify their treatment decisions, and the associated need to be able to understand and critically appraise medical research. It was felt that medical statistics courses should focus on critical appraisal skills rather than on the ability to analyse data, which can be acquired by particular students when they need to do this. Medical statistics should be taught early in the curriculum, but there is a need to reinforce such skills throughout the course. Teaching and assessment methods should recognize that what is being taught is a practical skill of clinical relevance. This means that problem based small groups, data interpretation exercises and objective structured clinical examinations will be more productive than traditional teaching and examination methods.

Attitude of Health Personnel↗

[Medical statistics in compulsory accident insurance].

The medical statistics in the compulsory accident insurance are conceived as a secondary statistic. It includes both injuries and medical services. Since the Swiss National Accident Insurance Fund started in 1918, there were regular reports about medical statistics. The current statistics of the agency are organized as a sampling statistic. Only disability benefits are covered in toto. The statistical organization permits the identification of single cases in terms of specific characteristics and to analyze them further. The new accident insurance law makes accident insurance obligatory for all persons who are not self-employed. The regulation, included in this law, to record statistics uniformly will hopefully help toward the improvement of medical statistics within the compulsory accident insurance scheme.

Accidents↗

[The importance of ADP for medical statistics].

Recent german articles concerning medical statistics give priority to data acquisition. This contribution describe the statistical analysis and presentation of the results of the Swiss accident insurance Company (SUVA) with 1.9 million of insured workers. This documentation covers per year approximately 450,000 accidents at work and in free time. The documentation include primarily the insurance-data, for medical purposes we use the adjacent diagnoses (up to 20 per accident). The new medical statistic (SUMEST) begins with the accidents of the year 1984, updated until 1988, this means, that we have a statistic of the outcome of accidents. For the analysis we use properties of the personality, details of what happened, injury, expenses for healing and results. The primary presentation is a collection of tables for every diagnosis (total 417) with the most important criteria for the cases. It is provided to publish results of special problems like time of disability, influence of algodystrophy etc. The possibility to analyse a big documentation (25 MBytes) with a personal computer give to the physician the possibility to perform the statistical analysis himself and to select the significant results immediately.

Data Interpretation, Statistical↗

Medical statistics: content and objectives of a core course for medical students.

British medical school teachers of medical statistics aspire to teach statistical concepts without requiring medical students to undertake every statistical technique in the book. In the typical course of 20 to 30 hours, about 50 topics are taught, usually requiring the student to perform a technique. In a survey of current practice in 20 courses it is shown that a core syllabus of 36 topics, including 14 techniques to be performed, is feasible for almost all existing courses. Clear student learning objectives now need to be agreed to encapsulate this syllabus.

Curriculum↗

Patients and medical statistics. Interest, confidence, and ability.

BACKGROUND: People are increasingly presented with medical statistics. There are no existing measures to assess their level of interest or confidence in using medical statistics. OBJECTIVE: To develop 2 new measures, the STAT-interest and STAT-confidence scales, and assess their reliability and validity. DESIGN: Survey with retest after approximately 2 weeks. SUBJECTS: Two hundred and twenty-four people were recruited from advertisements in local newspapers, an outpatient clinic waiting area, and a hospital open house. MEASURES: We developed and revised 5 items on interest in medical statistics and 3 on confidence understanding statistics. RESULTS: Study participants were mostly college graduates (52%); 25% had a high school education or less. The mean age was 53 (range 20 to 84) years. Most paid attention to medical statistics (6% paid no attention). The mean (SD) STAT-interest score was 68 (17) and ranged from 15 to 100. Confidence in using statistics was also high: the mean (SD) STAT-confidence score was 65 (19) and ranged from 11 to 100. STAT-interest and STAT-confidence scores were moderately correlated (r=.36, P<.001). Both scales demonstrated good test-retest repeatability (r=.60, .62, respectively), internal consistency reliability (Cronbach's alpha=0.70 and 0.78), and usability (individual item nonresponse ranged from 0% to 1.3%). Scale scores correlated only weakly with scores on a medical data interpretation test (r=.15 and .26, respectively). CONCLUSION: The STAT-interest and STAT-confidence scales are usable and reliable. Interest and confidence were only weakly related to the ability to actually use data.

Adult↗

[Military medical statistics: the status, problems and outlook].

The reform of medical service of the RF Armed Forces has objectively required the conduction of quite definite changes and military and medical statistics as an applied science, the teaching subject and field of practical activity of medical service. The results obtained during analysis of experience of the Armed Forces personnel medical support for the last years have shown that it is necessary to widen the scope of military and medical statistics applications by military physicians, medical specialists of medical service head-quarters in the form of their informative and statistic activity which is one of the integrated part of medical service in military men. The article presents the main results of military and medical statistics reformation, as well as principal trends of its further improvement.

Data Collection↗

The need for medical statistics in the training of health personnel.

Medical statistics is essential in the training of all categories of health workers and early involvement with the subject is advocated during the training of these health personnel. Four important areas of the application of statistical methods have been defined, namely, (1) the study of specific rates, (2) evaluation of clinical trial of drugs, (3) the assessment of factors affecting health or disease, and (4) the establishment of new avenues of medical research. Using examples from the training of the undergraduate medical student, the midwife and the family planning field health worker, different aspects of medical statistics should be emphasized at different levels of learning depending on the professional or academic needs of the trainee health worker.

Community Health Workers↗

[Significance of medical statistics in insurance medicine].

Knowledge of medical statistics is of great benefit to every insurance medical officer as they facilitate communication with actuaries, allow officers to make their own calculations and are the basis for correctly interpreting medical journals. Only about 20% of original work in medicine today is published without statistics or only with descriptive statistics--and this trend is falling. The reader of medical publications should be in a position to make a critical analysis of the methodology and content, since one cannot always rely on the conclusions drawn by the authors: statistical errors appear very frequently in medical publications. Due to the specific methodological features involved, the assessment of meta-analyses demands special attention. The number of published meta-analyses has risen 40-fold over the last ten years. Important examples for the practical use of statistical methods in insurance medicine include estimating extramortality from published survival analyses and evaluating diagnostic test results. The purpose of this article is to highlight statistical problems and issues of relevance to insurance medicine and to establish the bases for understanding them.

Actuarial Analysis↗

Does EBM offer the best opportunity yet for teaching medical statistics?

Trends in the teaching of statistics to medical undergraduates since the 1970s are traced. I conclude that the aim of enabling doctors to evaluate statistical information relevant to their practice preceded the arrival of evidence-based medicine (EBM). However this aim was not well realized before 1990. EBM has given an enormous opportunity for statisticians to teach critical appraisal and to orientate future doctors towards evidence-based practice. This advantage should outweigh any disadvantage of loss of our discipline's identity in modern curricula.

Curriculum↗

An 'electronic' extramural course in epidemiology and medical statistics.

This article describes an extramural university course in epidemiology and medical statistics taught using a computer conferencing system, microcomputers and data communications. Computer conferencing was shown to be a powerful, yet quite easily mastered, vehicle for distance education. It allows health personnel unable to attend regular classes due to geographical or time constraints, to take part in an interactive learning environment at low cost. This overcomes part of the intellectual and social isolation associated with traditional correspondence courses. Teaching of epidemiology and medical statistics is well suited to computer conferencing, even if the asynchronicity of the medium makes discussion of the most complex statistical concepts a little cumbersome. Computer conferencing may also prove to be a useful tool for teaching other medical and health related subjects.

Computer Communication Networks↗

Sir Austin Bradford Hill: medical statistics and the quantitative approach to prevention of disease.

Sir Austin Bradford Hill (1897-1991), son of a prominent medical physiologist, was destined for the study of medicine when World War I intervened. He chase to enlist as a pilot in the Royal Navy Air Service. Having contracted tuberculosis on his way to the Dardanelles, Hill was 'sent home to die'. In spite of the odds he recovered; but with no chance of working in physically taxing fields such as medicine or science. Advised and encouraged by Major Greenwood, he carved out for himself a career in medical statistics, first at the Medical Research Council and subsequently at the London School of Hygiene and Tropical Medicine, where his inspired teaching helped to shape the development of medical research in the second half of the twentieth century. He is particularly remembered for the way he made medical statistics an essential part of modern epidemiology, a new phase in an epidemiology concerned with chronic as well as with infectious diseases. At the same time, he introduced randomization where therapies-beginning with streptomycin in tuberculosis-could be evaluated in large-scale clinical trials. Perhaps his best known achievement is his design of the smoking and lung cancer trials, carried out with Richard Doll who later extended-and still extends-the trials which so convincingly have linked addiction to tobacco to patients' later problems with cancers and with coronary heart disease.

England↗