Teaching Statistics By

Example
Lisa M Sullivan, PhD
Boston University
Outline
Statistics in the News
The Introductory Statistics
Requirement
Course Content
Recent Efforts at Reform
Modifications?
Examples for Specific Topics
News Week of May 29, 2006
Preserve brain function with spicy
foods.
Kicking your food up a notch with spices
could preserve brain function and keep
your brain sharp and strong as you age.

Turmeric, a spice that lends curries their
yellow tint, can curb mental decline and
even slow the effects of neurodegenerative
diseases such as Alzheimers.
News Week of May 29, 2006
Education linked to better fathers
study
U.S. data shows trend between education
and time spent with kids

Well-educated men tend to make better
fathers, according a new U.S. government
report on fatherhood.
News Week of May 29, 2006
U.S. Releases Bird Flu Response Plan -
Details outline containment policies; focus
on worst-case scenarios may spread fear,
experts say

Breast Cancer Survivors Lax About
Mammograms - Only 33% get them
annually for five years after diagnosis,
study finds
News Week of May 29, 2006
The FDA issued a long-awaited
approval on a new human growth
product.
Approval of Omnitrope, made by Sandoz,
was announced Tuesday in a statement on
the FDAs Web site.
Omnitrope, also known as somatropin, is a
hormone used to treat growth disorders in
children and adults.
Statistics Requirement
Numerical literacy
Provide quantitative foundations for
study in specific disciplines
Understand and interpret data
Perform independent research
Careers in Statistics
Business and Industry (Manufacturing, Marketing,
Engineering)
Health and Medicine (Public Health, Clinical Trials,
Epidemiology, Genetics, Health Communication)
Government (Census, Surveys)
Academia
Social Sciences
Health Insurance
Demand for statisticians far exceeds supply
today and this is expected to increase
through 2008.
The Introductory Statistics Course
Difficult and frustrating for students
Difficult and frustrating for instructors

Hundreds of thousands of
undergraduates across a variety of
majors are required to take statistics
- most not mathematically inclined
Typical Course Content
Descriptive Statistics
Classification of Variables
Means, Standard Deviations, Medians
Graphical Displays
Principles of Probability
Probability Models
Binomial, Poisson, Normal
Central Limit Theorem
Course Content
Estimation
Point Estimates
Margin of Error
Precision
Hypothesis Testing
Hypotheses
Test Statistic
Critical Region
Level of Significance, P-values
Course Content
Associations Between Variables
Regression Analysis
Analysis of Variance
Chi-Square Tests
Reforms in Undergraduate
Education in Statistics
NSF funded various projects to
improve teaching of undergraduate
statistics courses
May 1999 the ASAs Undergraduate
Statistics Education Initiative (USEI)
was launched
Focus of the Reform
Emphasize concepts over procedures
Teach students to:
Formulate research questions
Collect data
Analyze data
Interpret results

Focus of the Reform
Gain experience working with real
data
Focus on active learning
Build communication skills

MAJOR FOCUS on statistical literacy/
statistical thinking

Statistical Thinking
Process of using wide ranging and interacting
data to understand processes, problems, and
solutions. The opposite of one factor at a time,
where ones natural born tendency is to change
one factor and see what happens. Statistical
thinking is the tendency to want to understand
how several control factors may be interacting
at once to produce an outcome. Common
cause variation becomes your friend and
special cause variation your enemy. Attribute
judgments of good and bad are replaced with
estimates of significance with given confidence.

---Six Sigma
http://www.isixsigma.com/dictionary/Statistical_Thinking-454.htm
Statistical Thinking
Recognize and attempt to
understand/explain variation
The process of asking a good
question, collecting, analyzing and
interpreting data and appropriately
recognizing limitations

How do we teach statistical thinking?
Recommendations for Instructors
Provide working examples that
include questions and processes to
solve statistical problems
Allow students to practice using
statistical thinking with open-ended
questions and problems
Use technology to collect, manage
and analyze data
Recommendations for Instructors
Use real data
Choose data and questions that are of
interest to students
Reduce content to focus on key
concepts in greater detail
Whats Missing
Study Design Issues and Implications
Real Data
Interpretation of Results
Practical Implications
Limitations of Inferences
Statistical Computing
Limitations/Interpretation
Association is not causation
Statistical significance is not practical
importance
Lack of statistical significance does
not imply no difference
Understand how to interpret news
stories/articles with statistical
information
Modifications?
Include design and analysis issues in
curriculum
Sharpen skills in interpretation of
results
Include projects with real data
Stress communication skills
Focus more on big picture

Big Picture
What is a statistical study?
How is sample constructed?
What are the key questions?
How is information collected analyzed
interpreted?
What makes a good study?
A poorly analyzed study can be re-
analyzed. A poorly designed study cannot
be re-designed.
Biostatistics
A specialized branch of applied
mathematics/statistics that deals with
the statistical evaluation of
experimental research or clinical trial
results.
Statistical applications in the medical
or public health arena.

Biostatistics

Mathematics/Statistics Medicine/Public Health
Biostatistics
Computer Science
Examples
What proportion of college students
drink alcohol, use illegal drugs?
Should driving age be increased?
Are cell phones safe for children?


How can we address these questions?
Research Teams
Principal Investigator (Clinicians,
Scientists)
Statistician/Biostatistician
Co-Investigators
Project Manager
Statistical Programmers
Research Assistants
Statisticians Role on Team
Develop Study Design
Research question
Study sample
Sample size
Enrollment/Follow-up strategies
On-going monitoring
Perform Interim and Final Analysis
Interpret and Report Results
Cell Phones for Children?
University of Washington scientist states
70-80% of the energy emitted from the
antenna of a mobile phone is absorbed in
the head: Childrens skulls are thinner and
their growing brains may be much more
susceptible to radiation exposure.
FDA states that scientific evidence does not
show a danger to users of wireless
communication devices including children.
Study of Cell Phone Safety
What is the outcome?
What is exposure/risk factor?
How can we assess relationship
between cell phone use and health
outcomes?
Study Design
Data Collection and Analysis
Interpretation/Attribution
Issues for Biostatisticians
Children - Obesity, Immunizations, Asthma,
Autism..
Adolescents Alcohol & Tobacco Use,
Depression, STDs, Traffic Accidents.
Adults Cancer, CVD, Substance Abuse,
HIV/AIDS, Mental Health

What is #1 killer of men and women in US?
What are the risk factors?
Research Set Context
Framingham Heart Study
Pharmacologic Clinical Trials in
Children with Autism
Effect of Alcohol Exposure in
Pregnancy on SIDS
The Framingham Heart Study
5000+ men and women enrolled in 1948
Longitudinal cohort study
Exams every 2 years for cardiovascular risk
factors - surveillance
Ancillary studies hearing, exercise,
nutrition, neurological studies
5000+ offspring & spouses enrolled in 1976
Third generation enrolled in 2002

http://www.nhlbi.nih.gov/about/framingham/
Milestones from Framingham
1960 Cigarette smoking increases risk of heart
disease
1961 Cholesterol & blood pressure increase risk of
heart disease
1967 Physical activity reduces risk of heart disease,
obesity increases risk of heart disease
1970 High blood pressure increases risk of stroke
1978 Psychosocial factors increases heart disease
1988 High levels of HDL cholesterol reduces risk of
death
More than 1500 scientific papers published
Framingham Study Risk
Functions
Risk prediction models
Predict likelihood that a person will have
coronary heart disease in the next 10 years
Models designed to include risk factors
that are readily available
Age, blood pressure, cholesterol, smoking,
diabetes, treatment for hypertension & high
cholesterol, obesity

Risk Calculator
http://hp2010.nhlbihin.net/atpiii/calculator.asp
Clinical Trial in Children with
Autism
Autism-brain disorder usually diagnosed
before age 3 that affects communication,
social interaction, and creative play.
Affects over 500,000 children in the US

Trial to assess the efficacy of drug
treatment in reducing repetitive behaviors
Children randomized to receive study drug
or placebo
Clinical Trial in Children with
Autism
144 children with autism aged 5-17 years
followed every 2 weeks for 12 weeks for
improvements in repetitive behaviors

Issues
Randomization/Blinding
Measurement of outcome (child, parent,
teacher)
Safety/Ethical issues

Effect of Alcohol Exposure in
Pregnancy on SIDS
SIDS Unexplained infant death
before 1 year of life
Extremely high rates of SIDS among
American Indians in Northern Plains
of North and South Dakota and in
Cape Town South Africa
High rates of alcohol consumption
Effect of Alcohol Exposure in
Pregnancy on SIDS
SIDS 0.57/1000 in US
3.4/1000 in Northern Plains
3.5/1000 in Cape Town

In US 13% of women report drinking
alcohol in pregnancy
58% in Northern Plains
41% in Cape Town
Effect of Alcohol Exposure in
Pregnancy on SIDS
Study of 12,000 pregnant women in
Northern Plains and Cape Town
Assess relationship between alcohol
and SIDS
Issues
Measuring alcohol exposure
Ethical Issues e.g., Autopsies
Examples for Specific Topics
Conditional Probability
Performance of screening tests for
prenatal diagnosis, prostate cancer,
breast cancer, HIV


Prenatal Diagnosis
Your family is pregnant should you
have a screening test?

Standard of Care in the US is serum
screen
68% sensitivity
5% false positive rate
Performance Characteristics of
Screening Tests

Disease + Disease
Test + a b
Test - c d


Performance Characteristics
Sensitivity = True Positive Fraction =
P(Test + | Disease)

False Positive Fraction =
P(Test + | No Disease)

For the Patient
Positive Predictive Value =
P(Disease | Test +)

Negative Predictive Value =
P(No Disease | Test -)

Examples for Specific Topics
Normal Probability Model
Percentiles
Height, Weight, BMI for age

http://www.cdc.gov/growthcharts/


Statistical Inference
Estimation and Hypothesis Testing
Clinical Trials
Search for clinical trials
Recent results (press releases and scientific
articles)

http://www.clinicaltrials.gov/
Introductory Statistics
Big Picture and Make it Real!
Real Data
Relevant Examples
Focus on Interpretation Practical
Importance

http://health.msn.com/
Academic Programs at Boston U
www.bu.edu
BA in Mathematics/Statistics
Minor in Applied Statistics

Summer Institute for Training in Biostatistics

MA in Biostatistics
PhD in Biostatistics

Minor in Public Health
(Biostatistics, Epidemiology, Environmental Health,
International Health, Health Law, Maternal and
Child Health, Health Services, Social and Behavioral
Science)