ANOVA: Analysis of variance.
If our aim is to quantify the association between an outcome and exposure, we can apply linear regression (assuming all assumptions are met, see Table 1 ). As outlined earlier, we need to consider possible effect modifiers and confounders. To assess for effect modification, we can do so by introducing an interaction term in the model. As a simple example, the model would contain the exposure variable, the possible effect modifier, and a multiplication term between the exposure and possible effect modifier (termed the interaction term). If the interaction term is statistically significant, we would conclude effect modification is present. If a variable is not an effect modifier, consideration for confounding is then checked. There exist different approaches for assessing confounding but the most widely used is the 10% rule. This rule states that a variable is a confounder if the regression coefficient for the exposure variable changes by more than 10% with the inclusion of the possible confounder in the model. A nice example of this can be seen in Ray et al. (2020). 16
Count data are the number of times a particular event occurs for each individual, taking non-negative integer values. In biomedical science, we most often look at count data over a period of time, creating an event rate (event count / period of time). The simplest analysis of these data involves calculating events per patient-year of follow-up. When conducting patient-year analyses in large populations, it is often acceptable to look at this statistic in aggregate (sum of total events in the population / sum of total patient-years at risk in the population). Confidence intervals can be calculated by assuming a Poisson distribution.
Statistical modeling of count data or event rates is common with a Poisson model. These models can adjust for confounding by other variables and incorporate interaction terms for effect modification. When a binary treatment variable is used with event rate as the outcome, incidence rate ratios (with confidence intervals) can be estimated from these models. The model can be extended to a zero inflated Poisson (ZIP) model or a negative binomial model when the standard Poisson model does not fit the data well. Population level analyses often look at disease incidence rates and ratios using these methods. 17 , 18 Recently, this type of statistic modeling is at the core of statistical methods used to calculate vaccine efficacy against COVID-19 in a highly impactful randomized trial. 19
Arguably, the simplest form of an outcome variable in clinical research is the binary variable for which every observation is classified in one of two groups (disease versus no disease, response versus no response, etc.). 20 We typically assume a binomial statistical distribution for this type of data. When the treatment variable is also binary, results can be analyzed by the simple analysis of the classic 2 × 2 table. From this table, we can estimate the proportion of responses, odds of response, or risk of response/disease within each treatment group. We then compare these estimates between treatment groups using differences or ratio measures. These include the difference in proportions, risk difference, odds ratios, and risk ratios (relative risk). Hypothesis testing around these estimates may utilize the chi-square test to assess the general association between the two variables, large sample asymptotic tests relying on normality under the central limit theorem, or exact tests that do not assume a specific statistical distribution.
Statistical models for binary outcomes can be constructed using logistic regression. In this way, the effect estimates (typically the odds ratio) can be adjusted for confounding by measured variables. These models typically rely on asymptotic normality for hypothesis testing but exact statistics are also available. The models can also assess effect modification through statistical interaction terms. An example of the classical 2 × 2 table can be referenced in Khan et al. 21 A typical application of logistic regression can be seen in Ray et al. 22 We have summarized methods for categorical data in Table 2 .
Summary of discrete data analyses and assumptions (all observations are independent).
Type of outcome variable | Outcome statistical distribution | Theoretical hypotheses | Assumptions | Commonly used point estimate | Commonly Used Effect estimate – | Common statistical methods |
---|---|---|---|---|---|---|
Discrete | ||||||
One binary variable | Binomial | | One binary variable. | Proportion | Proportion | Z-test or binominal exact test |
Two binary variables | Binomial | | 1. One binary metric measured on two different samples. 2. Two samples are independent. | Proportions | Difference in proportions or Cohen’s h | Z-test |
H1 : OR ≠ 1 | 1. Two binary variables measured on same sample. 2. One variable measuring outcome. 3. One variable measuring exposure. | Odds | Odds ratio | Logistic regression | ||
H1 : RR ≠ 1 | 1. Two binary variables measured on same sample. 2. One variable measuring outcome. 3. One variable measuring exposure. | Risk | Risk ratio | Logistic, Poisson, or negative binomial regression | ||
Two discrete variables | No Assumption | | 1. Two variables measured on the same sample. 2. Each variable is measuring a different metric. | None | Cramer’s V or Phi | Chi-squared test, Fisher’s exact test (small sample sizes), or logistic regression |
Association analyses: modeling outcome as a function of one or more explanatory variables | ||||||
One binary variable | Binomial | or or H1 : ORi ≠ 1 | 1. Outcome variable is binary 2. Explanatory variables are independent 3. Explanatory variables are linearly associated with the log odds. | Odds | Odds ratio | Logistic regression |
One discrete variable with > 2 levels | Multinomial (ordered or unordered) | If outcome data are nominal, the assumptions are the same as binomial logistic regression. If outcome data are ordinal, the proportional odds assumption must be met in addition to binomial logistic regression assumptions. | Odds | Odds ratio | Multinomial logistic regression: generalized logit link for unordered and cumulative logit link for ordered | |
Counts and events per follow-up | Poisson or negative binomial | or or H1 : IRR ≠ 1 | 1. Outcome variable is positive integer counts following a Poisson or negative binomial distribution | Incidence rate | Incidence rate ratio | Poisson or negative binomial regression |
Time-to-event | No Distribution Assumed | | 1. Single discrete exploratory variable (with categories) 2. Censoring is not related to explanatory variables | 5-year survival | Difference in 5-year survival | Kaplan–Meier (Log-rank test) |
or or H1 : ≠ 1 | 1. Hazard remains constant over time (hazards are proportional assumption). 2. Explanatory variables are independent. 3. Explanatory variables are linearly associated with the log hazard. | None | Hazard ratio | Cox proportional hazards model |
Multinomial data are a natural extension of binary data such that it is a discrete variable with more than two levels. It follows that the extensions of logistic regression can be applied to estimate effects and adjust for effect modification and confounding. However, multinomial data can be nominal or ordinal. For nominal data, the order is of no importance and, therefore, the models use a generalized logit link. 23 This will select one category as a referent category and then perform a set of logistic regression models, each comparing one non-referent level to this referent level. For example, in Kane et al. , 24 they applied a multinomial logistic regression to model type of treatment (five categories) as a function of education level and other covariates. They select watchful waiting as the referent treatment. The analysis thus had four logistic regressions to report, respective of each of the other treatment categories compared to watchful waiting.
If the multinomial data are ordinal, we use a cumulative logit link in the regression model. This link will model the categories cumulatively and sequentially. 23 For example, suppose our outcome has three levels, 1, 2, and 3 and are representative of the number of treatments. Cumulative logit will conduct two logistic regressions: first, Modeling Category 1 versus Categories 2 and 3 (combined) and then Categories 1 and 2 (combined) versus Category 3. Because of the combining of categories, this assumes that the odds are proportional across categories. Thus, this assumption must be checked and satisfied before applying this model. Depending on the outcome, only one of the logistic models may be needed, such as in Bostwick et al. , 25 where their outcome was palliative performance status (low, moderate, and high) and the effects of cancer/non-cancer status. Here, they only reported high-performance status versus moderate and low combined as their outcome.
Time-to-event data, often called survival data, compare the time from a baseline point to the potential occurrence of an outcome between groups. 26 These data are unique as a statistical outcome because they involve a binary component (event occurred or event did not occur) and the time to event occurrence or last follow-up. Both the occurrence of event and the time it took to occur are of interest. These outcomes are most frequently analyzed with two common statistical methodologies, the Kaplan–Meier method and the Cox proportional hazards model. 26
The Kaplan–Meier method allows for the estimation of a survival distribution of observed data in the presence of censored observations and does not assume any statistical distribution for the data. 26 , 27 In this way, knowledge that an individual did not experience an event up to a certain time point, but is still at risk, is incorporated into the estimates. For example, knowing an individual survived 2 months after a therapy and was censored is less information than knowing an individual survived 2 years after a therapy and was censored. The method assumes that the occurrence of censoring is not associated with the exposure variable. In addition to estimating the entire curve over time, the Kaplan–Meier plot allows for the estimation of the survival probability to a certain point in time, such as “5-year” survival. Survival curves are typically estimated for each group of interest (if exposure is discrete), shown together on a plot. The log-rank test is often used to test for a statistically significant difference in two or more survival curves. 26 An analogous method, known as Cumulative Incidence, takes a similar approach to the non-parametric Kaplan–Meier method, but starts from zero and counts events as they occur, with estimates increasing with time (rather than decreasing). 26 Cumulative Incidence analyses can also be adjusted for competing risks, which occur when subjects experience a different event during the follow-up time that precludes them from experiencing the event of primary interest. In the presence of competing risks, Cumulative Incidence curves can be compared using Gray’s test. 26
Time-to-event data can also be analyzed using statistical models. The most common statistical model is the Cox proportional hazards model. 28 From this model, we can estimate hazard ratios with confidence intervals for comparing the risk of the event occurring between two groups. 26 Multiple variable models can be fit to incorporate interaction terms or can be adjust for confounding (the 10% rule can be applied to the hazard ratio estimate). Although the Cox model does not assume a statistical distribution for the outcome variable, it does assume that the ratio of effect between two treatment groups is constant across time (i.e., proportional hazards). Therefore, one hazard ratio estimate applies to all time points in the study. Extensions of this model are available to allow for more flexibility, with additional complexity in interpretation. Examples of standard applications of the Kaplan–Meier method and Cox proportional hazards models can be seen in recent papers by Mok et al. 29 and Aparicio et al. 30
With the exception of time-to-event data, all of the statistical modeling techniques described above can be classified as some form of generalized linear model (GLM). 20 Modern statistical methods utilize GLMs as a broader class of statistical model. In the GLM, the outcome variable can take on different forms (continuous, categorical, multinomial, count, etc) and it is mathematically transformed using a link function. In fact, the statistical modeling methods we have discussed here are each a special case of a GLM. The GLM can accommodate multiple covariates that could be either continuous or categorical. The GLM framework is often a useful tool for understanding the interconnectedness of common statistical methods. For the interested reader, an elegant description of the most common GLMs and how they interrelate is given in Chapter 5 of Categorical Data Analysis by Alan Agresti. 20
While statistical significance is necessary to demonstrate that an observed result is not likely to have occurred by chance alone, it is not sufficient to insure a valid result. Bias can arise in clinical research from many causes, including misclassification of the exposure, misclassification of the outcome, confounding, missing data, and selection of the study cohort. 10 , 31 Care should be taken at the study design phase to reduce potential bias as much as possible. To this end, application of proper research methodology is essential. Confounding can sometimes be corrected through statistical adjustment after collection of the data, if the confounding factor is properly measured in the study. 10 , 31 All of these issues are outside the scope of basic statistics and this current summary. However, good clinical research studies should consider both statistical methodology and potential threats to validity from bias. 10 , 31
In this review, we have discussed five of the most common types of outcome data in clinical studies, including continuous, count, binary, multinomial, and time-to-event data. Each data type requires specific statistical methodology, specific assumptions, and consideration of other important factors in data analysis. However, most fall within the overarching GLM framework. In addition, the study design is an important factor in the selection of the appropriate method. Statistical methods can be applied for effect estimation, hypothesis testing, and confidence interval estimation. All of the methods discussed here can be applied using commonly available statistical analysis software without excessive customized programming.
In addition to the common types of data discussed here, other statistical methods are sometimes necessary. We have not discussed in detail situations where data are correlated or clustered. These scenarios typically violate the independence assumption required by many methods. Common subsets of these include longitudinal analyses with multiple observations collected across time and time series data which also require specialized techniques. We have also not covered situations where outcome data are multidimensional, such as the case for research in genetics. The analysis of large amounts of genetic information often relies on the basic methods discussed here, but special considerations and adapted methodology are needed to account for the large numbers of hypothesis tests conducted. One consideration is multiple comparisons. When a single sample is tested more than one time, this increases the chance of making either type I or II error. 32 This means we incorrectly reject or fail to reject the null hypothesis given the truth at the population level. Because of this increased likelihood of error, the significance level must be adjusted. These types of adjustments are not discussed here. Moreover, this overview is not comprehensive, and many additional statistical methodologies are available for specific situations.
In this work, we have focused our discussion on statistical analysis. Another key element in clinical research is a priori statistical design of trials. Appropriate selection of the trial design, including both epidemiologic and statistical design, allows data to be collected in a way that valid statistical comparisons can be made. Power and sample size calculations are key design elements that rely on many of the statistical principals discussed above. Investigators are encouraged to work with experienced statisticians early in the trial design phase, to ensure appropriate statistical considerations are made.
In summary, statistical methods play a critical role in clinical research. A vast array of statistical methods are currently available to handle a breath of data scenarios. Proper application of these techniques requires intimate knowledge of the study design and data collected. A working knowledge of common statistical methodologies and their similarities and differences is vital for producers and consumers of clinical research.
Author’ Contributions: All authors participated in the design, interpretation of the studies, writing and review of the manuscript.
Declaration of conflicting interests: The author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.
Funding: The author(s) received no financial support for the research, authorship, and/or publication of this article.
Supplemental material: Supplemental material for this article is available online.
Statistics By Jim
Making statistics intuitive
By Jim Frost 4 Comments
The mean in math and statistics summarizes an entire dataset with a single number representing the data’s center point or typical value. It is also known as the arithmetic mean, and it is the most common measure of central tendency. It is frequently called the “average.”
Learn how to find the mean and know when it is and is not a good statistic to use!
Finding the mean is very simple. Just add all the values and divide by the number of observations. The mean formula is below:
For example, if the heights of five people are 48, 51, 52, 54, and 56 inches. Here’s how to find the mean:
48 + 51 + 52 + 54 + 56 / 5 = 52.2
Their average height is 52.2 inches.
There are two versions of the mean formula in math—the sample and population formulas. In each case, the process for how to find the mean mathematically does not change. Add the values and divide by the number of values. However, the formula notation differs between the two types.
The sample mean formula is the following:
Typically, the sample formula notation uses lowercase letters.
The population mean formula is the following:
Typically, the population mean formula notation uses Greek and uppercase letters.
Learn more in depth about Sample Mean vs. Population Mean .
Ideally, the mean in math (aka the average) indicates the region where most values in a distribution fall. Statisticians refer to it as the central location of a distribution. You can think of it as the tendency of data to cluster around a middle value. The histogram below illustrates the average accurately finding the center of the data’s distribution.
However, the average does not always find the center of the data. It is sensitive to skewed data and extreme values. For example, when the data are skewed, it can miss the mark. In the histogram below, the average is outside the area with the most common values.
This problem occurs because outliers have a substantial impact on the mean. Extreme values in an extended tail pull it away from the center. As the distribution becomes more skewed, the average is drawn further away from the center.
In these cases, the average can be misleading because it might not be near the most common values. Consequently, it’s best to use the average to measure the central tendency when you have a symmetric distribution.
For skewed distributions , it’s often better to use the median or trimmed mean , which use different methods to find the central location. Note that the average provides no information about the variability present in a distribution. To evaluate that characteristic, assess the standard deviation .
Relate post : Measures of Central Tendency
In statistics, analysts often use a sample average to estimate a population mean. For small samples, the sample can differ greatly from the population. However, as the sample size grows, the law of large numbers states that the sample average is likely to be close to the population value.
Hypothesis tests, such as t-tests and ANOVA , use samples to determine whether population means are different. Statisticians refer to this process of using samples to estimate the properties of entire populations as inferential statistics .
Related post : Descriptive Statistics Vs. Inferential Statistics
In statistics, we usually use the arithmetic average, which is the type I focus on this post. However, there are other types of averages, including the geometric version. Read my post about the geometric mean to learn more . There is also a weighted mean .
Now that you know about statistical mean, learn about regression to the mean . That’s the tendency for extreme events to be followed by more typical occurrences.
December 6, 2023 at 9:12 am
What is name of the, that write this books?
December 4, 2023 at 1:34 am
When was this published ?
December 4, 2023 at 1:38 am
When citing online resources, you typically use an “Accessed” date rather than a publication date because online content can change over time. For more information, read Purdue University’s Citing Electronic Resources .
January 29, 2023 at 12:49 am
Great explanation, Jim!
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Methodology
Published on September 19, 2022 by Rebecca Bevans . Revised on June 21, 2023.
In statistical research , a variable is defined as an attribute of an object of study. Choosing which variables to measure is central to good experimental design .
If you want to test whether some plant species are more salt-tolerant than others, some key variables you might measure include the amount of salt you add to the water, the species of plants being studied, and variables related to plant health like growth and wilting .
You need to know which types of variables you are working with in order to choose appropriate statistical tests and interpret the results of your study.
You can usually identify the type of variable by asking two questions:
Types of data: quantitative vs categorical variables, parts of the experiment: independent vs dependent variables, other common types of variables, other interesting articles, frequently asked questions about variables.
Data is a specific measurement of a variable – it is the value you record in your data sheet. Data is generally divided into two categories:
A variable that contains quantitative data is a quantitative variable ; a variable that contains categorical data is a categorical variable . Each of these types of variables can be broken down into further types.
When you collect quantitative data, the numbers you record represent real amounts that can be added, subtracted, divided, etc. There are two types of quantitative variables: discrete and continuous .
Type of variable | What does the data represent? | Examples |
---|---|---|
Discrete variables (aka integer variables) | Counts of individual items or values. | |
Continuous variables (aka ratio variables) | Measurements of continuous or non-finite values. |
Categorical variables represent groupings of some kind. They are sometimes recorded as numbers, but the numbers represent categories rather than actual amounts of things.
There are three types of categorical variables: binary , nominal , and ordinal variables .
Type of variable | What does the data represent? | Examples |
---|---|---|
Binary variables (aka dichotomous variables) | Yes or no outcomes. | |
Nominal variables | Groups with no rank or order between them. | |
Ordinal variables | Groups that are ranked in a specific order. | * |
*Note that sometimes a variable can work as more than one type! An ordinal variable can also be used as a quantitative variable if the scale is numeric and doesn’t need to be kept as discrete integers. For example, star ratings on product reviews are ordinal (1 to 5 stars), but the average star rating is quantitative.
To keep track of your salt-tolerance experiment, you make a data sheet where you record information about the variables in the experiment, like salt addition and plant health.
To gather information about plant responses over time, you can fill out the same data sheet every few days until the end of the experiment. This example sheet is color-coded according to the type of variable: nominal , continuous , ordinal , and binary .
Experiments are usually designed to find out what effect one variable has on another – in our example, the effect of salt addition on plant growth.
You manipulate the independent variable (the one you think might be the cause ) and then measure the dependent variable (the one you think might be the effect ) to find out what this effect might be.
You will probably also have variables that you hold constant ( control variables ) in order to focus on your experimental treatment.
Type of variable | Definition | Example (salt tolerance experiment) |
---|---|---|
Independent variables (aka treatment variables) | Variables you manipulate in order to affect the outcome of an experiment. | The amount of salt added to each plant’s water. |
Dependent variables (aka ) | Variables that represent the outcome of the experiment. | Any measurement of plant health and growth: in this case, plant height and wilting. |
Control variables | Variables that are held constant throughout the experiment. | The temperature and light in the room the plants are kept in, and the volume of water given to each plant. |
In this experiment, we have one independent and three dependent variables.
The other variables in the sheet can’t be classified as independent or dependent, but they do contain data that you will need in order to interpret your dependent and independent variables.
When you do correlational research , the terms “dependent” and “independent” don’t apply, because you are not trying to establish a cause and effect relationship ( causation ).
However, there might be cases where one variable clearly precedes the other (for example, rainfall leads to mud, rather than the other way around). In these cases you may call the preceding variable (i.e., the rainfall) the predictor variable and the following variable (i.e. the mud) the outcome variable .
Once you have defined your independent and dependent variables and determined whether they are categorical or quantitative, you will be able to choose the correct statistical test .
But there are many other ways of describing variables that help with interpreting your results. Some useful types of variables are listed below.
Type of variable | Definition | Example (salt tolerance experiment) |
---|---|---|
A variable that hides the true effect of another variable in your experiment. This can happen when another variable is closely related to a variable you are interested in, but you haven’t controlled it in your experiment. Be careful with these, because confounding variables run a high risk of introducing a variety of to your work, particularly . | Pot size and soil type might affect plant survival as much or more than salt additions. In an experiment you would control these potential confounders by holding them constant. | |
Latent variables | A variable that can’t be directly measured, but that you represent via a proxy. | Salt tolerance in plants cannot be measured directly, but can be inferred from measurements of plant health in our salt-addition experiment. |
Composite variables | A variable that is made by combining multiple variables in an experiment. These variables are created when you analyze data, not when you measure it. | The three plant health variables could be combined into a single plant-health score to make it easier to present your findings. |
If you want to know more about statistics , methodology , or research bias , make sure to check out some of our other articles with explanations and examples.
Research bias
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You can think of independent and dependent variables in terms of cause and effect: an independent variable is the variable you think is the cause , while a dependent variable is the effect .
In an experiment, you manipulate the independent variable and measure the outcome in the dependent variable. For example, in an experiment about the effect of nutrients on crop growth:
Defining your variables, and deciding how you will manipulate and measure them, is an important part of experimental design .
A confounding variable , also called a confounder or confounding factor, is a third variable in a study examining a potential cause-and-effect relationship.
A confounding variable is related to both the supposed cause and the supposed effect of the study. It can be difficult to separate the true effect of the independent variable from the effect of the confounding variable.
In your research design , it’s important to identify potential confounding variables and plan how you will reduce their impact.
Quantitative variables are any variables where the data represent amounts (e.g. height, weight, or age).
Categorical variables are any variables where the data represent groups. This includes rankings (e.g. finishing places in a race), classifications (e.g. brands of cereal), and binary outcomes (e.g. coin flips).
You need to know what type of variables you are working with to choose the right statistical test for your data and interpret your results .
Discrete and continuous variables are two types of quantitative variables :
If you want to cite this source, you can copy and paste the citation or click the “Cite this Scribbr article” button to automatically add the citation to our free Citation Generator.
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Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa. 2,3 Although there are fewer studies on comorbidity among youth, research suggests that adolescents with substance use disorders also have high rates of co-occurring mental illness; over 60 percent of adolescents in community-based substance use disorder treatment programs also meet diagnostic criteria for another mental illness. 4
Data show high rates of comorbid substance use disorders and anxiety disorders—which include generalized anxiety disorder, panic disorder, and post-traumatic stress disorder. 5–9 Substance use disorders also co-occur at high prevalence with mental disorders, such as depression and bipolar disorder, 6,9–11 attention-deficit hyperactivity disorder (ADHD), 12,13 psychotic illness, 14,15 borderline personality disorder, 16 and antisocial personality disorder. 10,15 Patients with schizophrenia have higher rates of alcohol, tobacco, and drug use disorders than the general population. 17 As Figure 1 shows, the overlap is especially pronounced with serious mental illness (SMI). Serious mental illness among people ages 18 and older is defined at the federal level as having, at any time during the past year, a diagnosable mental, behavior, or emotional disorder that causes serious functional impairment that substantially interferes with or limits one or more major life activities. Serious mental illnesses include major depression, schizophrenia, and bipolar disorder, and other mental disorders that cause serious impairment. 18 Around 1 in 4 individuals with SMI also have an SUD.
Data from a large nationally representative sample suggested that people with mental, personality, and substance use disorders were at increased risk for nonmedical use of prescription opioids. 19 Research indicates that 43 percent of people in SUD treatment for nonmedical use of prescription painkillers have a diagnosis or symptoms of mental health disorders, particularly depression and anxiety. 20
Although drug use and addiction can happen at any time during a person’s life, drug use typically starts in adolescence, a period when the first signs of mental illness commonly appear. Comorbid disorders can also be seen among youth. 21–23 During the transition to young adulthood (age 18 to 25 years), people with comorbid disorders need coordinated support to help them navigate potentially stressful changes in education, work, and relationships. 21
Drug Use and Mental Health Disorders in Childhood or Adolescence Increases Later Risk
The brain continues to develop through adolescence. Circuits that control executive functions such as decision making and impulse control are among the last to mature, which enhances vulnerability to drug use and the development of a substance use disorder. 3,24 Early drug use is a strong risk factor for later development of substance use disorders, 24 and it may also be a risk factor for the later occurrence of other mental illnesses. 25,26 However, this link is not necessarily causative and may reflect shared risk factors including genetic vulnerability, psychosocial experiences, and/or general environmental influences. For example, frequent marijuana use during adolescence can increase the risk of psychosis in adulthood, specifically in individuals who carry a particular gene variant. 26,27
It is also true that having a mental disorder in childhood or adolescence can increase the risk of later drug use and the development of a substance use disorder. Some research has found that mental illness may precede a substance use disorder, suggesting that better diagnosis of youth mental illness may help reduce comorbidity. One study found that adolescent-onset bipolar disorder confers a greater risk of subsequent substance use disorder compared to adult-onset bipolar disorder. 28 Similarly, other research suggests that youth develop internalizing disorders, including depression and anxiety, prior to developing substance use disorders. 29
Untreated Childhood ADHD Can Increase Later Risk of Drug Problems
Numerous studies have documented an increased risk for substance use disorders in youth with untreated ADHD, 13,30 although some studies suggest that only those with comorbid conduct disorders have greater odds of later developing a substance use disorder. 30,31 Given this linkage, it is important to determine whether effective treatment of ADHD could prevent subsequent drug use and addiction. Treatment of childhood ADHD with stimulant medications such as methylphenidate or amphetamine reduces the impulsive behavior, fidgeting, and inability to concentrate that characterize ADHD. 32
That risk presents a challenge when treating children with ADHD, since effective treatment often involves prescribing stimulant medications with addictive potential. Although the research is not yet conclusive, many studies suggest that ADHD medications do not increase the risk of substance use disorder among children with this condition. 31,32 It is important to combine stimulant medication for ADHD with appropriate family and child education and behavioral interventions, including counseling on the chronic nature of ADHD and risk for substance use disorder. 13,32
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Prevalence of overweight and obesity, trends in obesity among adults and youth in the united states.
A person whose weight is higher than what is considered to be a normal weight for a given height is described as being overweight or having obesity. 1
According to 2017–2018 data from the National Health and Nutrition Examination Survey (NHANES)
According to 2017–2018 NHANES data
BMI is a tool to estimate and screen for overweight and obesity in adults and children. BMI is defined as weight in kilograms divided by height in meters squared. BMI is related to the amount of fat in the body. A high amount of fat can raise the risk of many health problems. A health care professional can determine if a person’s health may be at risk because of his or her weight.
The table below shows BMI ranges for overweight and obesity in adults 20 and older.
BMI | Classification |
---|---|
18.5 to 24.9 | Normal, or healthy, weight |
25 to 29.9 | Overweight |
30+ | Obesity (including severe obesity) |
40+ | Severe obesity |
Use this online tool from the Centers for Disease Control and Prevention (CDC) to gauge BMI for adults.
A child’s body composition changes during growth from infancy into adulthood, and it differs by sex. Therefore, a young person’s weight status is calculated based on a comparison with other same-age and same-sex children or teens using CDC’s age- and sex-specific growth charts. The comparison results in a percentile placement. For example, a boy whose weight in relation to his height is greater than 75% of other same-aged boys places in the 75th percentile for BMI and is considered to be of normal or healthy weight.
Children grow at different rates at different times, so it is not always easy to tell if a child is overweight. A child’s health care professional should evaluate the child’s BMI, growth, and potential health risks due to excess body weight.
Weight Status Category | Percentile Range |
---|---|
Underweight | Less than 5th percentile |
Normal or healthy weight | 5th percentile to less than 85th percentile |
Overweight | 85th to less than 95th percentile |
Obesity | 95th percentile or greater |
Severe obesity | 120% of the 95th percentile |
Use this online tool from the CDC to calculate BMI and the corresponding BMI-for-age percentile based on CDC growth charts, for children and teens.
Factors that may contribute to excess weight gain among adults and youth include genetics; types and amounts of food and drinks consumed; level of physical activity; degree of time spent on sedentary behaviors, such as watching TV, engaging with a computer, or talking and texting on the phone; sleep habits; medical conditions or medicines; and where and how people live, including their access to and ability to afford healthy foods and safe places to be active. 4,5
Overweight and obesity increase the risk for many health problems, such as type 2 diabetes, high blood pressure, heart disease, stroke, joint problems, liver disease, gallstones, some types of cancer, and sleep and breathing problems, among other conditions. 5,6 Learn more about the causes and health consequences of overweight and obesity .
Age-adjusted percentage of US adults with overweight, obesity, and severe obesity by sex, 2017–2018 NHANES Data 2
All (Men and Women) | Men | Women | |
---|---|---|---|
Overweight | 30.7 | 34.1 | 27.5 |
Obesity (including severe obesity) | 42.4 | 43.0 | 41.9 |
Severe obesity | 9.2 | 6.9 | 11.5 |
As shown in the above table
Age-adjusted prevalence of obesity among adults ages 20 and over, by sex and age: United States, 2017–2018 7
As shown in the above bar graph
Age-adjusted prevalence of obesity among adults ages 20 and over, by sex, race, and Hispanic origin: United States, 2017–2018 7
Age-adjusted prevalence of severe obesity among adults ages 20 and over, by sex, age, and race and Hispanic origin: United States, 2017–2018 7
Prevalence of overweight, obesity, and severe obesity among children and adolescents ages 2 to 19 years: United States, 2017–2018 NHANES data 3
Prevalence of obesity among children and adolescents ages 2 to 19 years: United States, 2017–2018 NHANES data 3
Prevalence of obesity among children and adolescents ages 2 to 19 years, by sex and race and Hispanic origin: United States, 2017–2018 NHANES data 3
* See asterisked note in the figure above.
Trends in age-adjusted (PDF, 97.2 KB) obesity and severe obesity prevalence among adults ages 20 and over: United States, 1999–2000 through 2017–2018 7
Trends in obesity among children and adolescents ages 2–19 years, by age: United States, 1963–1965 through 2017–2018 3
As shown in the above line graph
This content is provided as a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), part of the National Institutes of Health. NIDDK translates and disseminates research findings to increase knowledge and understanding about health and disease among patients, health professionals, and the public. Content produced by NIDDK is carefully reviewed by NIDDK scientists and other experts.
The NIDDK would like to thank: Sohyun Park, Ph.D., Centers for Disease Control and Prevention, and Cheryl D. Fryar, M.S.P.H., National Center for Health Statistics, Centers for Disease Control and Prevention
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Introduction to Statistical Treatment in Research. Statistical analysis is a crucial component of both quantitative and qualitative research. Properly treating data enables researchers to draw valid conclusions from their studies. This primer provides an introductory guide to fundamental statistical concepts and methods for manuscripts.
Statistical Treatment Example - Quantitative Research. For a statistical treatment of data example, consider a medical study that is investigating the effect of a drug on the human population. As the drug can affect different people in different ways based on parameters such as gender, age and race, the researchers would want to group the ...
This article is a practical introduction to statistical analysis for students and researchers. We'll walk you through the steps using two research examples. The first investigates a potential cause-and-effect relationship, while the second investigates a potential correlation between variables. Example: Causal research question.
Introduction. Statistical analysis is necessary for any research project seeking to make quantitative conclusions. The following is a primer for research-based statistical analysis. It is intended to be a high-level overview of appropriate statistical testing, while not diving too deep into any specific methodology.
The term "statistical treatment" is a catch all term which means to apply any statistical method to your data. Treatments are divided into two groups: descriptive statistics, which summarize your data as a graph or summary statistic and inferential statistics, which make predictions and test hypotheses about your data. Treatments could include:
Statistical methods involved in carrying out a study include planning, designing, collecting data, analysing, drawing meaningful interpretation and reporting of the research findings. The statistical analysis gives meaning to the meaningless numbers, thereby breathing life into a lifeless data. The results and inferences are precise only if ...
Now, if we divide the frequency with which a given mean was obtained by the total number of sample means (36), we obtain the probability of selecting that mean (last column in Table 10.5). Thus, eight different samples of n = 2 would yield a mean equal to 3.0. The probability of selecting that mean is 8/36 = 0.222.
Practice of wrong or inappropriate statistical method is a common phenomenon in the published articles in biomedical research. Incorrect statistical methods can be seen in many conditions like use of ... Minimum Sample Size Required for Statistical Methods ... of the control (126.45 ± 8.85, n 1 =20) and treatment (121.85 ± 5.96, n 2 =20 ...
When to perform a statistical test. You can perform statistical tests on data that have been collected in a statistically valid manner - either through an experiment, or through observations made using probability sampling methods.. For a statistical test to be valid, your sample size needs to be large enough to approximate the true distribution of the population being studied.
For example, in a survey regarding the election of a Mayor, parameters like age, gender, occupation, etc. would be important in influencing the person's decision to vote for a particular candidate. Therefore the data needs to be treated in these reference frames. An important aspect of statistical treatment of data is the handling of errors.
Research Design and Methodology. Chapter 3 consists of three parts: (1) Purpose of the. study and research design, (2) Methods, and (3) Statistical. Data analysis procedure. Part one, Purpose of ...
For example, centralized facilities or collaborative efforts can provide a cost-effective way of providing research materials or information from large databases. Examples include repositories established to maintain and distribute astronomical images, protein sequences, archaeological data, cell lines, reagents, and transgenic animals.
The standard deviation, σ, measures how closely values are clustered about the mean. The standard deviation for small samples is defined by: σ = ∑N i=1(xi −x¯)2 N− −−−−−−−−−−−√ σ = ∑ i = 1 N ( x i − x ¯) 2 N. The smaller the value of σ, the more closely packed the data are about the mean, and we say that ...
Statistical treatment of data is a process used to convert raw data into something interpretable. This process is essential because it allows businesses to make better decisions based on customer feedback. This blog post will give a short overview of the statistical treatment of data and how it can be used to improve your business.
Jun 1992. POLYM COMPOSITE. A. Cervenka. P. Sheard. PDF | On Nov 1, 1979, James W. Dally published Statistical Treatment of Experimental Data | Find, read and cite all the research you need on ...
Example: Causal research question Can meditation improve exam performance in teenagers? ... Example: Statistical hypotheses to test a correlation. ... These may be the means of different groups within a sample (e.g., a treatment and control group), the means of one sample group taken at different times (e.g., pretest and posttest scores), or a ...
In a previous article in this series, we looked at different types of data and ways to summarise them. 1 At the end of the research study, statistical analyses are performed to test the hypothesis and either prove or disprove it. The choice of statistical test needs to be carefully performed since the use of incorrect tests could lead to misleading conclusions.
Types of descriptive statistics. There are 3 main types of descriptive statistics: The distribution concerns the frequency of each value.; The central tendency concerns the averages of the values.; The variability or dispersion concerns how spread out the values are.; You can apply these to assess only one variable at a time, in univariate analysis, or to compare two or more, in bivariate and ...
Role of Statistics in Biological Research. Statistics is a branch of science that deals with collection, organization and analysis of data from the sample to the whole population. Moreover, it aids in designing a study more meticulously and also give a logical reasoning in concluding the hypothesis.
A good research design provides information concerning with the selection of the sample population treatments and controls to be imposed and research work cannot be undertaken without sampling. Collecting the data and create data structure as organizing the data, analyzing the data help of different statistical method, summarizing the analysis ...
Answer: We see this question builds on this previous question. So, deciding which statistical test to use would involve considering various criteria such as whether to use parametric or non-parametric tests, your sample properties, and so on. Accordingly, based on these criteria, you may choose a t-test, a one-way or two-way ANOVA, a Wilcoxon ...
We provide a brief, yet comprehensive overview of common data types in clinical research and appropriate statistical methods for analyses. These include continuous data, binary data, count data, multinomial data, and time-to-event data. We include references for further studies and real-world examples of the application of these methods.
Finding the mean is very simple. Just add all the values and divide by the number of observations. The mean formula is below: For example, if the heights of five people are 48, 51, 52, 54, and 56 inches. Here's how to find the mean: 48 + 51 + 52 + 54 + 56 / 5 = 52.2. Their average height is 52.2 inches.
Harmonized clinical and genomic data allow for convenient cross-analysis and comparison. Clinical data, including demographics, diagnosis and treatment information, are standardized across hundreds of distinct properties. State-of-the-art bioinformatics workflows are employed to align sequencing reads, ranging from whole genome to single-cell ...
Example (salt tolerance experiment) Independent variables (aka treatment variables) Variables you manipulate in order to affect the outcome of an experiment. The amount of salt added to each plant's water. Dependent variables (aka response variables) Variables that represent the outcome of the experiment.
Many individuals who develop substance use disorders (SUD) are also diagnosed with mental disorders, and vice versa.2,3 Although there are fewer studies on comorbidity among youth, research suggests that adolescents with substance use disorders also have high rates of co-occurring mental illness; over 60 percent of adolescents in community-based substance use disorder treatment programs also ...
For example, a boy whose weight in relation to his height is greater than 75% of other same-aged boys places in the 75th percentile for BMI and is considered to be of normal or healthy weight. ... SOURCES: National Center for Health Statistics, National Health Examination Surveys II (ages 6-11) and III (ages 12-17); and National Health and ...