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Essentials of Medical Statistics Blackwell Publishing Is Delighted To Announce That This Book Has Been Highly Commended In The BMA Medical Book Competition Here Is The Judges Summary Of This Book This Is A Technical Book On A Technical Subject But Presented In A Delightful Way There Are Many Books On Statistics For Doctors But There Are Few That Are Excellent And This Is Certainly One Of Them Statistics Is Not An Easy Subject To Teach Or Write About The Authors Have Succeeded In Producing A Book That Is As Good As It Can Get For The Keen Student Who Does Not Want A Book For Mathematicians, This Is An Excellent First Book On Medical Statistics Essential Medical Statistics Is A Classic Amongst Medical Statisticians An Introductory Textbook, It Presents Statistics With A Clarity And Logic That Demystifies The Subject, While Providing A Comprehensive Coverage Of Advanced As Well As Basic Methods The Second Edition Of Essential Medical Statistics Has Been Comprehensively Revised And Updated To Include Modern Statistical Methods And Modern Approaches To Statistical Analysis, While Retaining The Approachable And Non Mathematical Style Of The First Edition The Book Now Includes Full Coverage Of The Most Commonly Used Regression Models, Multiple Linear Regression, Logistic Regression, Poisson Regression And Cox Regression, As Well As A Chapter On General Issues In Regression Modelling In Addition, New Chapters Introduce Advanced Topics Such As Meta Analysis, Likelihood, Bootstrapping And Robust Standard Errors, And Analysis Of Clustered Data Aimed At Students Of Medical Statistics, Medical Researchers, Public Health Practitioners And Practising Clinicians Using Statistics In Their Daily Work, The Book Is Designed As Both A Teaching And A Reference Text The Format Of The Book Is Clear With Highlighted Formulae And Worked Examples, So That All Concepts Are Presented In A Simple, Practical And Easy To Understand Way The Second Edition Enhances The Emphasis On Choice Of Appropriate Methods With New Chapters On Strategies For Analysis And Measures Of Association And Impact Essential Medical Statistics Is Supported By A Web Site At Blackwellpublishing Essentialmedstats This Useful Online Resource Provides Statistical Datasets To Download, As Well As Sample Chapters And Future Updates Medical Statistics 2nd ed by Kirkwood and Sterne is a 501 page book printed on semi glossy paper There are six chapters and nine appendices Essentially every page has a mathematical formula or a table of numbers This is a good thing because it keeps the narratives concrete and firmly grounded Only high school math is needed.We learn about standard deviations, standard normal distributions, t distributions, Z statistic, t statistic, confidence intervals, hypothesis testing, p values, and advanced formulas such as goodness of fit, Mandel Haenszel methods, hazard ratio, Wilcoxon signed rank test, and Bayseian statistics All of the examples concern clinical studies This is in contrast to David Jones excellent statistics book, where the many examples tend to concern manufacturing pills and vials.Kirkwood s book and David Jones david jones book appear to be the best of the clinical statistics books, but neither is a standalone book Both books suffer from the organizational problems that seem to characterized most books on clinical statistics The reader will need to turn to Lange and to Durham to fill in various gaps.I was specifically interested in understanding standard deviations, the Z statistic, the t statistic, p values, confidence intervals, alpha values, hazard ratios, Wilcoxon rank sum test, critical values, sample size and power calculations, hazard ratios, logrank statistics, and survival curves Kaplan Meier curves.In setting out to understand these equations, bought and read 1 Dawson and Trapp 2004 Basic 2 Durham and Turner 2008 Introduction to Statistics in Pharmaceutical Clinical Trials 3 Kirkwood and Sterne 2003 Medical Statistics 4 Motulsky 1995 Intuitive Biostatistics In my opinion, Motulsky leaves the reader in a free fall On occasion, Motulsky provides some insight or guidance on using the various equations But I would not recommend that any novice interested in statistics look first to Motulsky 5 Bart J Harvey 2009 Statistics for Medical Writers and Editors This tiny book is the best for understanding Standard Deviations Harvey does not get much beyond SDs, and there is almost nothing about the t test or about p values 6 Rosner Fundamentals of Statistics.Providing that you have all four of these books 1 Jones, 2 Kirkwood, 3 Lange, and 4 Dawson, it is possible to learn statistics for clinical trials The following compares the Jones, Kirkwood, Lange, and Dawson.KAPLAN MEIER PLOTS survival plots Kirkwood pages 272 286 discloses survival plots Jones fails to disclose Kaplan Meier curves For this topic, I refer the reader to the excellent discussion in Dawson page 140 141, Lange To repeat, once you have a value for the t statistic, you can use this value for two different purposes 1 PLUG IT INTO A TABLE TO GET A P VALUE or 2 COMPARE IT WITH THE CRITICAL VALUE OF THE t STATISTIC TO DO HYPOTHESIS TESTING.SECOND DECISION If you are working with the Z statistic, you can use it to acquire a P value page 92, Jones , or you can use it to do hypothesis testing pages 157 159 of Jones, page 244 of Rosner, page 141 of Lange To repeat, once you have a value for the Z statistic, you can use this value for two different purposes 1 PLUG IT INTO A TABLE TO GET A P VALUE or 2 COMPARE IT WITH THE CRITICAL VALUE OF THE NORMAL DISTRIBUTION TO DO HYPOTHESIS TESTING.THIRD DECISION If you are working with the Z statistic, you need to decide between two formulas Z X u SD FIRST FORMULA and Z X u SD square root of n SECOND FORMULA.The question is, when do you use the FIRST FORMULA and when do you use the SECOND FORMULA Kirkwood fails to address this question But Jones in combination with Lange provides excellent guidance as to when to use the FIRST FORMULA and when to use the SECOND FORMULA For use of the FIRST FORMULA, see Jones pages 87 89 and Lange page 87 For use of the SECOND FORMULA, see Jones pages 156 159, and Lange pages 85 86 In a nutshell, the FIRST FORMULA is used for comparing data from a mean with a hypothetical value of interest to you a value that you dreamed up out of thin air The SECOND FORMULA is used when numbers are available for a Population Mean and Population SD , and where numbers are available for a Sample Mean, and where your goal is to find probability of a hypothetic sample mean will have a value that is higher than or lower than the value of the sample mean Jones does a better job at distinguishing between the two formulas than does Lange Jones comes to the rescue The above collection of decisions in the decision tree is inherent in all of the statistics books, including Kirkwood, but the books fail to make explicit the fact that these decisions are what statistics is about In my opinion, there is no excuse for this sort of obscurity and disorganization that so characterizes statistics books It does not have to be this way.The formulas used for clinical statistics have been around for over 100 years The mathematics used in these books is on the level of a college freshman Why is it that the presentation of statistics in all of these books, including Kirkwood s book, is so disorganized, disjointed, and sporadic These formulas are not rocket science There is no excuse for generally uneven quality of the available statistics books.Kirkwood is further confusing when a specific symbol in a formula needs a subscript What is confusing is that Kirkwood fails to print the subscript worthy symbol as a subscript The consequence is that the reader might think that the first symbol needs to be multiplied by the second subscript worthy symbol What a CONFUSING MESS this is Kirkwood s confusing mess can be found, for example, on pages 148 164 We read about s.c p1 po But the p1 po , or in other formulas the p1 , which occur in the part of a formula to the left of the equal sign and also in parts of a formula to the right of an equal sign is not properly subscripted Mess, MESS, MESSSSSSSSS Fortunately, Lange comes to the rescue Lange properly shows subscripted subscripts on pages 137 and 147 of Lange Thank you, Lange This is not rocket science, gang Subscripting is what we learn in middle school math There is no excuse for this time wasting, confusing, way of writing statistics books.Actually, Lange does provide a DECISION TREE for determining which statistics formula to use This DECISION TREE is located on the inside front cover, but it does not come with any written commentary Lange has the right idea, as far as efficacy in statistics teaching is concerned But Lange does not go far enough.I finally found a statistics book with this kind of decision tree The book is Daniel WW 2009 Biostatistics, 9th ed., John Wiley Sons, Inc., Hoboken, NJ, p 176 Another fine book is as follows Norman GR, Streiner DL 2008 Biostatistics 3rd ed B.C Decker, Inc., Hamlton, Ontario, p 35 Norman and Streiner know how to teach, and they warn students of the various ambiguities and inconsistencies found in other statistics books The Daniel book, and the Norman Streiner book, fill in the gaps where other statistics book are just plain confusing These confusing statistics books at least confusing in some issues are as follows Kirkwood Sterne, David Jones, Dawson Trapp, and Durham Turner I am still puzzled as to why all of these statistics books use such strikingly different approaches to using the Z statistic, and different approaches for plugging the Z statistic into a table to get the P value At any rate, Norman Streiner is unique among all statistics books, in actually recognizing this inconsistency in the table that must be used, for plugging in the Z value. This book is very comprehensible and based on a lot of good examples It essentially skips over mathematical derivations, which could be seen as a downside, but emphasizes its practical side and the audience medical researchers rather than statisticians.As a physician I found it to provide a very helpful overview and confidence that one can at any point go back to it and refresh the knowledge of any specific statistical method when planning your projects or interpreting data.Highly recommended I admit though, I have no comparison to other books in the field, this one turned out to be just what I needed. I purchased this book to help understand medical statistics as used in medical journal articles and to help understand their use for my own articles I still intend to use the aid of a trained biostatistician for data evaluation however, this book has helped me better to understand what all the tests mean The book is easy to read and each chapter builds logically on the chapter before I would highly recommend it to physicians who have similar needs I see the book will be coming out in 2009 under a slightly different title I guess that is a positive sign of the popularity of this book.

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