ABNORMALITY

Putri Eyanoer, MD.,Ms.Epi,Ph.D.

 NUMERICAL NFORMATION
ALLOWS BETTER
CONFIRMATION

QUANTITATIVE

PREDICTION – ‘EXACT’
PROBABILITIES

 Symptomatic coronary disease

occur in 1 in 100 middle aged men
per year
 Cigarettes smoking doubles one’s
risk of dying at all ages
 Extrogenos estrogens reduce the
risk of fractures from osteoporosis
by half
 SCALE CHARACTERISTIC EXAMPLES
CATEGORICAL
Nominal Occur in categories without any Race, religion, occupation
inherent order

Ordinal Posses some inherent Level of education, salary

ordering/rank

NUMERICAL
Interval Posses inherent ordering and the Temperature
interval between successive
values is equal

Ratio Similar to that of interval BUT Height, weight, age

with existing absolute zero
 HIGH VALIDITY LOW

HIGH
RELIABILITY

FREQUENCY
LOW

MEASUREMENT
VALIDITY
• the degree to which the data measure what they
were intended to measure
• the result of a measurement correspond to the true
state
• accuracy

RELIABILITY
• Reliability=the extent that repeated measurement of
a stable phenomenon by different people and
instrument, at different time/place get similar
results
 INSTRUMENT
MEASUREMENT
OBSERVER
VARIATIONS
WITHIN
INDIVIDUALS
BIOLOGIC
AMONG
INDIVIDUALS
 Monitored fetal heart
Number of Observations rate 130-150

Monitored fetal heart

rate < 130

Monitored fetal heart

rate >150

-50 40 30 20 10 0 10 20 30 40 50+
UNDERESTIMATE OVERESTIMATE
400 -

300 -

200 -
DAY 1

DAY 3
100 -
DAY 2

0-
NOON 6 PM MIDNIGHT 6 AM
SOURCE OF CONDITION OF MEASUREMENTS DISTRIBUTIONS
VARIATIONS

MEASURE 1 patients, 1 observer, repeated

MENTS observation at one point in time

1 patient, many observers, at one time

BIOLOGIC 1 patient, 1 observer at many times of

and the day
MEASURE
MENT Many patients

DIASTOLIC BP (mmHg)
 BLINDED :
•SINGLE
•DOUBLE
•TRIPLE

CALIBERATED
INSTRUMENTS
ASSOCIATED
WITH DISEASE

TREATABLE
ASSESING NORMALITY
 Based in statistical theory and has no necessary relationship to natural distribution

KURTOSIS

SKEWNESS

χ+3s χ +2s χ -s χ χ +s χ +2s χ +3s

68%
95%
99%
www.psychlotron.org.uk
 Based in statistical theory and has no necessary relationship to natural distribution

Average IQ in the
population is 100pts. The further from 100
you look, the fewer
frequency

people you find

70 100 130
www.psychlotron.org.uk
IQ Scores
• Many statistical methods require that the
numeric variables we are working with have
an approximate normal distribution.
• For example, t-tests, F-tests, and
regression analyses all require in some
Standardized
normal distribution
sense that the numeric variables are rule
with empirical
approximately normally distributed.
percentages.
• Histogram and Boxplot
• Normal Quantile Plot
(also called Normal Probability Plot)
• Goodness of Fit Tests
Shapiro-Wilk Test (JMP)
Kolmogorov-Smirnov Test (SPSS)
Anderson-Darling Test (MINITAB)
The cholesterol levels of the
patients appear to be
approximately normal,
although there is some
evidence of right skewness
as the mean is larger than
the median.
The red curve represents a
normal distribution fit to
these data and the blue
curve the density estimate
for these data, these curves
should agree if our data is
normally distributed.
 The systolic volumes of the
male heart patients in this
study suggest that they come
from a right skewed
population distribution.
The red curve represents a
Outliers are not normal distribution fit to these
consistent with
data and the blue is the
normality.
estimated density from the
data which does not agree with
the imposed normal.
Ho: The distribution of systolic volume
is normal
HA: The distribution of systolic volume
is NOT normal
Because p < .0001 we have
strong evidence against
normality for the systolic
volume population
distribution using the
Shapiro-Wilk test.
Ho: The distribution of systolic volume
is normal
HA: The distribution of systolic volume
is NOT normal

We do not have evidence at

the α = .05 level against the
normality of the population
systolic volume distribution
when using the Kolmogorov-
Smirnov test from SPSS.
Ho: The distribution of cholesterol level
is normal
HA: The distribution of cholesterol level
is NOT normal
We have no evidence
against the normality of
the population
distribution of
cholesterol levels for
male heart patients (p =
.2184).