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1Formulas and methods
Evidence-based practice statistics
Sensitivity and specificity
Se = a/(a + c), Sp = d/(b + d)
Predictive values
PPV = a/(a + b), NPV = d/(c + d)
Accuracy
(a + d)/n
Likelihood ratios
LR+ = Se/(1 − Sp), LR− = (1 − Se)/Sp
PPV at prevalence p
Se·p / (Se·p + (1 − Sp)(1 − p))
Odds
odds = p/(1 − p); p = odds/(1 + odds); post-test odds = pre-test odds × LR
Risk measures
RR = EER/CER, ARR = CER − EER, RRR = ARR/CER
Number needed to treat
NNT = 1/ARR, rounded up; NNH = 1/(EER − CER)
Odds ratio
OR = ad/(bc)
Incidence rate
new cases / person-time
Method
Draw the 2 × 2 table and label a, b, c and d before you calculate.
Read sensitivity and specificity down the columns, predictive values along the rows.
For another prevalence, imagine 10 000 people and fill the table with Se, Sp and the prevalence.
For a likelihood ratio, convert the probability to odds, multiply, and convert back.
For a trial, find EER and CER first; then RR = EER/CER, ARR = CER − EER and NNT = 1/ARR rounded up.
Descriptive statistics
Mean
x̄ = Σx/n
Sample standard deviation
s = √(Σ(x − x̄)²/(n − 1))
Median
middle value of the sorted data
z-score
z = (x − μ)/σ
Normal distribution
68% within ±1σ, 95% within ±2σ
Confidence intervals
σ known
x̄ ± z·σ/√n
σ unknown
x̄ ± t·s/√n, df = n − 1
Critical z
90%: 1.645, 95%: 1.96, 99%: 2.576
Sample size
n = (z·σ/E)², rounded up
Method
Decide between z (population σ known) and t (only the sample s, with n − 1 degrees of freedom).
Find the critical value for the confidence level.
Margin of error: E = critical value × standard deviation/√n.
Interval: x̄ ± E.
Hypothesis tests & confidence intervals
z-test for a mean
z = (x̄ − μ0)/(σ/√n)
t-test for a mean
t = (x̄ − μ0)/(s/√n), df = n − 1
Two-sided at 5%
reject H0 if |z| > 1.96
Confidence interval
x̄ ± z·σ/√n
Method
State H₀ and H₁ and decide whether the test is one- or two-sided.
Calculate the test statistic: (x̄ − μ₀)/(σ/√n), or with s and t.
Compare with the critical value, or find the p-value.
Reject H₀ if the statistic is beyond the critical value (p below α), and state the conclusion in words.
2Practice problems
1.Evidence-based practice statisticsMedium
Practice exercise (made-up values, not clinical guidance). A new test was compared with the reference standard in a study (see the 2 × 2 table). Find the negative likelihood ratio LR−. Round to two decimal places.
a = 281b = 76c = 89d = 114
LR− =
2.Evidence-based practice statisticsHard
Practice exercise (made-up values, not clinical guidance). A patient has a pre-test probability of 5% for a disease. A test with sensitivity 77% and specificity 63% comes back positive. Find the post-test probability p′ of the disease as a percentage. Round to one decimal place.
pre-test 5%Se = 77%Sp = 63%positive
p′ = %
3.Descriptive statisticsMedium
Find the sample standard deviation s of the data: 56, 22, 39, 25, 42, 52, 31.
n = 7
s =
4.Descriptive statisticsHard
Exam scores are normally distributed with mean 500 and standard deviation 50. Find the z-score z of a score of 475.
μ = 500σ = 50x = 475
z =
5.Confidence intervalsMedium
The blood pressure of 9 patients is measured before and after a treatment. The differences d = before − after (mmHg) have mean −9.6 and standard deviation 4.3. Find the upper limit of the 90% confidence interval for the mean difference.
n = 9d̄ = −9.6sd = 4.390%t(8) = 1.86
upper limit = mmHg
6.Confidence intervalsHard
Two fertilisers are tested. Plot group 1: 8 plots, mean yield 65 kg, standard deviation 9 kg. Plot group 2: 6 plots, mean 57.5 kg, standard deviation 3 kg. Assume equal variances (pooled t, df = n₁ + n₂ − 2). Find the lower limit of the 95% confidence interval for μ₁ − μ₂.
A sample of 64 students has a mean score of 73.7 and a sample standard deviation of 4. Find the test statistic t for H₀: μ = 75.
μ₀ = 75x̄ = 73.7s = 4n = 64
t =
8.Hypothesis tests & confidence intervalsHard
A one-sided z test of H₀: μ = 100 against H₁: μ < 100 is done at α = 0.01 with a sample of 25; the standard deviation is known to be 10. In reality the mean is 95.2. Find the power 1 − β of the test in percent.
μ₀ = 100μ = 95.2σ = 10n = 25α = 0.01
1 − β = %
3Solutions
1.Evidence-based practice statistics
Answer: LR− = 0.4
Likelihood ratios and risk measures: LR+ = sensitivity/(1 − specificity), LR− = (1 − sensitivity)/specificity. In a trial, EER and CER are the event rates with and without treatment: RR = EER/CER, ARR = CER − EER, RRR = ARR/CER and NNT = 1/ARR, rounded up. In a case-control study only the odds ratio OR = ad/(bc) can be used. An incidence rate = new cases/person-time.
Sensitivity and specificity
Se = 281/370 = 0.7595
Sp = 114/190 = 0.6
Negative likelihood ratio
LR− = (1 − 0.7595)/0.6 = 0.4009 ≈ 0.4
Answer
LR− = 0.4
2.Evidence-based practice statistics
Answer: p′ = 9.9 %
Predictive values depend on prevalence: PPV = Se·p/(Se·p + (1 − Sp)(1 − p)) and NPV = Sp(1 − p)/(Sp(1 − p) + (1 − Se)p). With likelihood ratios: pre-test odds = p/(1 − p), post-test odds = pre-test odds × LR, probability = odds/(1 + odds). For a population of N, true positives = N·p·Se and false positives = N·(1 − p)·(1 − Sp). NNT = 1/(CER × RRR), rounded up.
Likelihood ratio
LR+ = 0.77/(1 − 0.63) = 2.081
Pre-test odds
0.05/(1 − 0.05) = 0.05263
Post-test odds
0.05263·2.081 = 0.1095
Post-test probability
p′ = 0.1095/(1 + 0.1095) = 0.09872 ≈ 9.9%
Answer
p′ = 9.9%
3.Descriptive statistics
Answer: s = 12.98
Descriptive statistics: the mean is the sum divided by n; the median is the middle value of the sorted data (the average of the two middle values when n is even). The sample standard deviation is s = √(Σ(x − x̄)²/(n − 1)). A z-score z = (x − μ)/σ says how many standard deviations a value lies from the mean.
Descriptive statistics: the mean is the sum divided by n; the median is the middle value of the sorted data (the average of the two middle values when n is even). The sample standard deviation is s = √(Σ(x − x̄)²/(n − 1)). A z-score z = (x − μ)/σ says how many standard deviations a value lies from the mean.
Standardise
z = (475 − 500)/50 = −0.5
Answer
z = −0.5
5.Confidence intervals
Answer: upper limit = −6.934 mmHg
Interval for a difference: estimate ± critical value × standard error. For two independent means with known σ: SE = √(σ₁²/n₁ + σ₂²/n₂) and z. With equal unknown variances: pooled s_p and t with n₁ + n₂ − 2 degrees of freedom. For paired data, work with the differences: d̄ ± t·s_d/√n.
Critical value
df = 8, t = 1.86
Margin of error
E = 1.86·4.3/√9 = 2.666
Interval
−9.6 ± 2.666 → [−12.27, −6.934]
Answer
upper limit = −6.934 mmHg
6.Confidence intervals
Answer: lower limit = −0.904 kg
Interval for a difference: estimate ± critical value × standard error. For two independent means with known σ: SE = √(σ₁²/n₁ + σ₂²/n₂) and z. With equal unknown variances: pooled s_p and t with n₁ + n₂ − 2 degrees of freedom. For paired data, work with the differences: d̄ ± t·s_d/√n.
Pooled standard deviation
sp² = (7·9² + 5·3²)/12 = 51
sp = 7.141
Margin of error
E = 2.179·7.141·√(1/8 + 1/6) = 8.404
Interval
7.5 ± 8.404 → [−0.904, 15.9]
Answer
lower limit = −0.904 kg
7.Hypothesis tests & confidence intervals
Answer: t = −2.6
Testing a mean: the test statistic measures how many standard errors the sample mean lies from the value claimed in H₀: z = (x̄ − μ₀)/(σ/√n) when σ is known, t = (x̄ − μ₀)/(s/√n) when it is estimated from the sample. A confidence interval is x̄ ± (critical value)·(standard error).
Standard error
SE = 4/√64 = 4/8 = 0.5
Test statistic
t = (73.7 − 75)/0.5 = −2.6
Answer
t = −2.6
t0.025; df = 63 = 1.998
|t| > 1.998, so H₀ is rejected at the 5% level (two-sided).
8.Hypothesis tests & confidence intervals
Answer: 1 − β = 52.95 %
Power of a test: power = 1 − β is the probability of rejecting H₀ when it is false. Find the cutoff x̄c from μ₀ and z_α, then compute the probability of landing beyond x̄c using the true mean: z = (x̄c − μ)/(σ/√n).