医学统计学在临床科研中的应用

医学统计学是一门繁杂、枯燥、逻辑性很强的基础学科,在医学科研中的应用越来越受到国内广大医学科研工作者的重视,统计分析结果表达已成为医学论文中一个不可缺少的重要组成部分。然而,在医学职业生涯中,临床医生最容易搞错的要数医学统计学的知识了。有报道称近年发表的论文来看,有不少作者对统计方法的使用还不熟悉,实际应用中统计方法滥用、错用和误用的情况时有发生。笔者就医学统计学在常用临床科研的应用方面作一简要介绍。     

护理人员医学统计学知识需求调查及继续教育对策

目的 探讨护理人员医学统计学知识需求情况,为做好相关继续教育及培训工作提供指导依据.方法 自行设计问卷,对全国48家医院共776名2008年参与《护理学报》继续教育学习的在职护理人员进行统计学知识需求调查.结果 98.5％的护理人员认为统计学知识对开展科研重要,97.4％认为在职人员有必要学习统计学,97.3％认为需要充实统计学知识,96.4％觉得护理专业期刊有必要开展统计学知识讲座,并有80.9％准备参加学习.结论 护理人员对统计学知识的重要性认知程度高,并且学习需求强烈.应针对护理人员的需求,在继续教育中加大统计学知识与技能的学习培训,并注重实用性和针对性,以方便省时为原则,提高护理人员统计学处理能力,以推动护理科研及学科的发展.     

中医药院校《医学统计学》教学改革探索

本文论述了中医药院校《医学统计学》教学中存在的主要问题:学生的统计知识薄弱,处理实际问题的能力不足,教材和教学内容不适宜。提出了一系列教学改革的建议:转变教学理念、以培养学生兴趣为先导,结合中医药科研的实例,倡导问题导入式教学法开展教学,推进中医药统计学教材改革和教学内容改革,使学生养成科学的统计思维和解决医学实际问题的能力。     

基于“1+5”阶段性整合式临床医学专业研究生医学统计学课程教学模式构建

<正>临床医学的发展是以临床科研的发展为前提,而临床科研设计的科学性是以统计学知识为基础。就临床医学专业研究生而言,医学统计能力是其开展临床科研的重要工具之一^[1],统计知识的掌握是其选题设计、数据分析及论文撰写等方面的根本保障。医学统计学强调理论与实践的综合应用,但这门课程相对枯燥,概念抽象难以理解,学生掌握难度较大。而鉴于专业研究生的特殊性,集中上课的时间仅3个月,理论授课课时一再压缩,有限的课时里,学生对统计知识点掌握不透彻,     

我国医学统计学课程研究热点及趋势的知识图谱分析

医学统计学是研究医药卫生领域中数据收集、整理、分析和解释的一门应用型学科,是科研与实践的重要工具,也是我国大多数高等医学院校本科生和研究生的一门必修课程[1-2]。掌握医学统计学知识,有助于培养学生的科学思维能力、提高分析和解决问题能力。     

《医学统计学》多媒体CAI课件简介

《医学统计学》多媒体CAI课件紧密结合医学统计学知识与计算机知识各自的特点 ,充分发挥多媒体技术的优势 ,利用文字、声音、图像以及动画把平时看似枯燥的统计学知识生动形象地在计算机上展现出来 ,使学习者通过多角度、多途径获得大量信息 ,特别是在以往教学中缺乏的视觉信息 ,充分调动学习积极性 ,开阔思维领域 ,提高学习效率 ,达到很好的学习效果。1 背景目前 ,国内各个学科的CAI课件多种多样 ,但关于医学统计学方面的却少之又少。具有代表性的是张高魁等开发的《医学统计学基础多媒体CAI课件》〔1,2〕,该系统已进行了教学评价 ,效…     

《生物医学研究的统计方法》书评

近年来生物统计学越来越受到医学基础和临床研究人员的关注和重视,医学科研中统计学方法的使用已经成为普遍做法。与此相应,众多的统计学书籍也不断涌现,其中不乏一些构思缜密,结构严谨的佳作。此次由方积乾教授主持,胡良平、赵耐青、宇传华等6位教授任副主编编写的《生物医学研究的统计方法》(2007年6月由高等教育出版社出版)就是一本对医学科研统计分析有着较大指导作用的统计学教材。方教授等几位老师在统计学方面有着深厚的理论功底,同时也具备多年的教学和科研实践经验,该书可以说是厚积薄发之作。在内容的编排和布局上,本书独具匠心地…     

医学论文中常见的统计学错误及对策

分析医学科研论文中统计学方法应用中常出现的错误 ,提高编辑人员识别统计学常见错误的能力 ,确保科研论文的科学性、准确性和可信性 ,努力办成精品期刊。     

伦敦卫生和热带病学院医学统计学教学及考核方法

伦敦卫生和热带病学院医学统计学教学及考核方法山西医科大学卫生统计教研室武俊青随着医学研究的发展，医学统计学已成为医学生的必修课，它不仅是医学生通向医学科研的桥梁，更是培养医学生科学统计思维、正确认识疾病的金钥匙。近几年来，为加强卫生统计学科建设，提高...     

基于文献导向的混合式教学在医学统计学教学中的效果评价

【目的】探讨基于文献导向的混合式教学模式在临床医学专业本科生医学统计学教学中的效果及满意度。【方法】以同济大学医学院2018级共83名临床医学本科生为研究对象,开展基于文献导向自主学习(reference⁃induced self⁃education,RISE)的混合式教学模式在医学统计学课程中的效果评价;通过自行设计学生问卷调查学生满意度。【结果】与传统教学组相比,RISE混合式教学组学生总评成绩优良率和及格率分别为53.7%和96.3%;学生评价总体授课效果的满意率为83.3%。RISE混合式教学在激发学习兴趣(满意率90.7%,P=0.034)和科研能力培养(满意率96.3%,P=0.048)方面满意度更高。【结论】RISE混合式教学通过文献引导、线上线下相结合,将统计学知识与临床科研问题有机地结合起来,在医学统计学课程教学中应用效果良好,有助于激发学习兴趣和培养科研创新能力。     

Statistics in medical journals

The general standard of statistics in medical journals is poor. This paper considers the reasons for this with illustrations of the types of error that are common. The consequences of incorrect statistics in published papers are discussed; these involve scientific and ethical issues. Suggestions are made about ways in which the standard of statistics may be improved. Particular emphasis is given to the necessity for medical journals to have proper statistical refereeing of submitted papers.     

Statistics in medical journals: developments in the 1980s.

This paper reviews changes in the use of statistics in medical journals during the 1980s. Aspects considered are research design, statistical analysis, the presentation of results, medical journal policy (including statistical refereeing), and the misuse of statistics. Despite some notable successes, the misuse of statistics in medical papers remains common.     

浅谈医院统计工作应注意的问题

随着市场经济的发展和医疗体制改革的深入发展,医院统计工作的重要性日益显现。医院需要不断加强和改进统计工作,通过统计工作对医院发展、医疗资料的利用、医疗护理质量、医技科室的工作效率和全院社会效率、经济效率等情况进行科学的搜集、整理、分析,实现统计服务及统计监督职能。该文对如何改进医院统计工作进行了初步思考。     

A weighted generalized score statistic for comparison of predictive values of diagnostic tests

Positive and negative predictive values are important measures of a medical diagnostic test performance. We consider testing equality of two positive or two negative predictive values within a paired design in which all patients receive two diagnostic tests. The existing statistical tests for testing equality of predictive values are either Wald tests based on the multinomial distribution or the empirical Wald and generalized score tests within the generalized estimating equations (GEE) framework. As presented in the literature, these test statistics have considerably complex formulas without clear intuitive insight. We propose their re‐formulations that are mathematically equivalent but algebraically simple and intuitive. As is clearly seen with a new re‐formulation we presented, the generalized score statistic does not always reduce to the commonly used score statistic in the independent samples case. To alleviate this, we introduce a weighted generalized score (WGS) test statistic that incorporates empirical covariance matrix with newly proposed weights. This statistic is simple to compute, always reduces to the score statistic in the independent samples situation, and preserves type I error better than the other statistics as demonstrated by simulations. Thus, we believe that the proposed WGS statistic is the preferred statistic for testing equality of two predictive values and for corresponding sample size computations. The new formulas of the Wald statistics may be useful for easy computation of confidence intervals for difference of predictive values. The introduced concepts have potential to lead to development of the WGS test statistic in a general GEE setting. Copyright © 2012 John Wiley & Sons, Ltd.     

A survey of abstracts of high-impact clinical journals indicated most statistical methods presented are summary statistics

OBJECTIVES: To assess what statistical methods are commonly used in high-impact clinical research and how they are presented in abstracts of articles published in high-impact medical journals. STUDY DESIGN AND SETTING: A cross-sectional survey of abstracts of original articles published in July 2003 in four high-impact medical journals was conducted. The primary outcome was the distribution of statistical methods used in study results presented in the abstract of articles. RESULTS: Seventy articles met inclusion criteria. One hundred twenty-five unique statistical method presentations were analyzed. Sixty-eight percent of statistical methods used summary statistics, and 27.2% used regression analysis. When summary statistics were used, clinical evidence was presented with a P-value or confidence interval (CI) in 51.8% of statistical methods compared to 72.5% when summary statistics were not used (P=0.0282). Clinical evidence was presented verbally in 7.1% of statistical methods when summary statistics were used and in 20.0% when summary statistics were not used (P=0.0323). CONCLUSIONS: Summary statistics are the most frequently used statistical method to generate high-impact clinical evidence presented in the abstract of a medical article. Evidence described by summary statistics is significantly associated with less frequent reporting of a P-value or CI, and less frequent verbal presentations.     

我院医学统计服务调查分析

目的分析我院2006年医学统计服务中常用统计方法的类型、使用频率和服务对象基本资料,探讨医学统计服务的一般规律。方法用Excel输入统计人员填写的记录单,使用SPSS11.0 for windows计算各种统计方法出现的类型、使用频率和用户基本资料的分析。结果在72人次的统计学处理中,共涉及统计方法10种,常见统计方法依次为t检验(54.1%)、2检验(52.7%)、方差分析(16.6%)、相关分析(9.7%)和回归分析(6.9%)等。72人次统计处理中有9人次是为科研课题,占12.5%;63人次是为撰写论文,占87.5%。高级职称人员占63.9%。结论临床实验设计的咨询较少,医务人员应当重视实验设计工作;加强医学统计的多因素分析,克服单因素分析的不足,提高医学科研论文的科学价值。     

医院统计在医院要素分配中的作用

目的 为支持医院内部要素分配调整改革，医院统计应展开与要素分配有关的项目进行统计，为医院要素分配向高、精、尖、绩效好的医务人员倾斜提供统计数据。方法 应用ExCEL软件的合并功能对病人信息和病案信息进行深层次的挖掘、提取、重新整合统计，制成简明易懂的统计报表给予反馈公布，作为医师提取个人奖酬、职称晋升或聘任竞岗的考核依据。结果通过统计作用实现了劳动价值创造，调动了广大医务人员的积极性，促使医院经营理念成为引导个人自觉行为的杠杆，实现了医院提高综合竞争实力的整体效应。结论 要素分配中统计工作应遵循公平、合理、反映医院经营理念的原则和利用网络科技实现高效管理并且应与改革同步，深化统计内涵，完善医院的统计方法。     

Die Todesursachenstatistik in Deutschland

The causes of death statistics is widely used as a major source of data for monitoring particular health indicators and their change over time. Results of these comparisons are used for epidemiologic and medical research and as a starting point to give recommendations for prevention programs and for health policy. Nevertheless, the quality of the causes of death statistics is often criticized. Beside the quality of the medical information the critic aims in particular at the restricted comparability of the data and the limitation of the statistics on mono-causal causes of death. The latter aspects refer to steps which are performed within the scope of the data processing in the statistical offices. With the introduction of an automated coding system, which is able to code all causes of deaths on the death certificate and select the underlying cause of death automatically, it will be possible to solve these problems. Furthermore the automated coding system is the prerequisite for a routine multiple-cause coding which is demanded by several medical and statistical experts.