Statistics in medicine
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Statistics in medicine · Apr 2002
Non-parametric confidence interval estimation for competing risks analysis: application to contraceptive data.
Non-parametric maximum likelihood estimation of the cause specific failure probability, and of its standard error, in the presence of competing risks is discussed with reference to some contraceptive use dynamics data from Bangladesh. The cause specific incidence function provides an intuitively appealing summary curve for failure rates and probabilities, such as probabilities of discontinuation of different kinds of contraception, based on right-censored data of the particular event. ⋯ The accuracy of these intervals, as well as those based on the log(-log) transformation and the arcsine transformation, are compared by simulations. We find that Dinse and Larson's formula, used in conjuction with a log(-log) transform, yields reliable standard error estimates and accurate coverage in samples of small and large size, and can be recommended for use in this situation.
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Statistics in medicine · Apr 2002
Medical students' perspective on the teaching of medical statistics in the undergraduate medical curriculum.
Two undergraduate medical students at the University of Bristol commented on their experiences of learning medical statistics. In general, medical students' focus is on acquiring skills needed to practice clinical medicine, and great care must be taken to explain why disciplines such as statistics and epidemiology are relevant to this. Use of real examples and an emphasis on the need for evidence has meant that medical students are increasingly aware of the pressure on clinicians to justify their treatment decisions, and the associated need to be able to understand and critically appraise medical research. ⋯ Medical statistics should be taught early in the curriculum, but there is a need to reinforce such skills throughout the course. Teaching and assessment methods should recognize that what is being taught is a practical skill of clinical relevance. This means that problem based small groups, data interpretation exercises and objective structured clinical examinations will be more productive than traditional teaching and examination methods.