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EBM Guidebook

Table of Contents

    Title Page
  1. Introduction
  2. STEP 1: Formulating the Question
    1. POEM
    2. PICO
  3. STEP 2: Finding the Best Evidence
  4. STEP 3: Appraising the Evidence
    1. CAMeL General Steps
    2. CAMeL Critical Appraisal Protocols
      1. Therapy
      2. Diagnostic Tests
      3. Review Articles
      4. Screening Tests
      5. Prognosis
      6. Causation
  5. STEP 4: Preparing an EBM Presentation
    1. Protocol for the Presentation
    2. Sample Presentation
  6. Overview of Statistics
    1. Statistics Without Statistics
    2. Ten Ways to Cheat
  7. Glossary of Terms
    Terms marked with an asterisk (*)
    are defined in the Glossary.
  8. References
Back to Informatics & EBM Instruction page  Back to Evidence-Based Instruction page

VI.  Overview of Statistics

  1. Statistics Without Statistics: Did They Use the Right Test?
If you are interested in knowing more of the fine details on statistics, check out Clinical Epidemiology: A Basic Science for Clinical Medicine, Sackett et al, Little Brown (WA 950 S121C 1991, located at Science Library and Grunigen Medical Library). However, if you just want a sense of what the tests are and how they should be used, read further.
 
The Variables
After reading the article, formulate the general question the authors are trying to answer. Also note the type of study used: cohort, case control, randomized, etc. Next, flip through the article. Look at the tables and graphs. What information is being presented? Are the variables categorical or continuous? Categorical variables are data sets with definite groups. The variable gender, for instance, is either male or female. Cholesterol can be broken down into normal, borderline, and high. Note that categorical variables are usually words and groups. Continuous variables, on the other hand, are number sets. A range exists for each variable. Systolic blood pressure, body mass index, and height are all continuous variables. The categorical cholesterol variable (normal, borderline, high) mentioned earlier was a continuous variable that was converted into categorical to describe the population's cholesterol risk. A categorical variable is the descriptive data in an article. A continuous variable is a set of plotted points that can be drawn through to demonstrate a line. Not necessarily as descriptive as categorical variables, but generally more powerful in terms of statistical analysis. The line drawn can demonstrate associations and rates of change. Most of all, the continuous variables in an appropriate statistical test can display a normal distribution.
 
Normal distribution is the crux of all statistics. Most statistical tests assume that the variable being tested in a population has a normal distribution, where the mean and median of the variable are approximately equal generating a bell curve. If mean or median deviate from center then the curve can be skewed from normal. Statistical analyses of skewed variables are less valid.
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