Book reviews -- Basic and Clinical Biostatistics by Beth Dawson-Saunders and Robert G. Trapp / Statistical First Aid by Robert P. Hirsch and Richard K. Riegelman

Human Biology, Apr 1994 by Sattenspiel, Lisa

Basic and Clinical Biostatistics, by Beth Dawson-Saunders and Robert G. Trapp. Norwalk, CT: Appleton and Lange, 1990. 329 pp. $29.95 (paper).

Statistical First Aid, by Robert P. Hirsch and Richard K. Riegelman. Boston, MA: Blackwell Scientific Publications, 1992. 409 pp. $29.95 (paper).

Most US anthropology departments with graduate programs require of their students and usually offer courses in basic statistical analysis. Given the diversity of interests and expertise of graduate students, finding suitable textbooks for these courses is not a straightforward task. Both Basic and Clinical Biostatistics and Statistical First Aid focus on the use of statistics in epidemiology and medicine and thus are of potential interest to human biologists.

The format of Basic and Clinical Biostatistics is one of the most interesting to be found among statistics textbooks for the social and natural sciences. It includes several chapters that are not commonly found in such books but that are important for students to gain an effective understanding of statistical techniques. These chapters include information on how to design studies in medical research, effective ways to explore and present data, and tips for reading the medical literature. One may be inclined to think that these chapters are relatively trivial and unimportant, given all the essential statistical procedures to learn, but my experience with anthropology students indicates that they don't usually understand this kind of material well at the beginning of a course. Providing them with a firm grounding in the subject early in a statistics course prevents many difficulties later on. In addition to these chapters and chapters on standard statistical procedures, the book includes a chapter on survival analysis, a technique that is of increasing importance to human biologists but that is not normally covered in other basic statistics textbooks. The book also includes two chapters that are important for clinical medicine but of more limited utility for nonclinical researchers--evaluating diagnostic procedures and clinical decision making. However, because familiarity with these procedures and with the basic principles of clinical study design can help nonclinicians to understand the cognate literature in the medical sciences, exposure of students to this material is welcome.

One of the most interesting features of Basic and Clinical Biostatistics is the inclusion at the beginning of most chapters of from two to six "Presenting Problems." These problems are drawn from the published medical literature and illustrate the use of techniques described in the chapter. The problems are drawn on throughout the chapter to emphasize uses, misuses, advantages, and disadvantages of particular techniques.

The major drawback of Basic and Clinical Biostatistics for human biologists is that it too strongly emphasizes clinical methods and procedures in medicine. Although some human biologists work in this area, most of us work under conditions with much less control over the nature of the samples and the data derived from the studies. Because of its focus on clinical medicine, Basic and Clinical Biostatistics does not address many of the kinds of problems that are most commonly found by human biologists working in nonclinical settings. In addition, the presenting problems and their discussions include technical medical language that may be unfamiliar to human biologists with a background in the biological sciences rather than in medicine, and the content of many of the problems may be of limited interest. Consequently, students may find it harder to make the necessary connections between what is described in the text and their own data set than they would with traditional texts such as Biometry by Sokal and Rohlf (1981) or Refiguring Anthropology by Thomas (1986).

Although Statistical First Aid is also written for students undertaking health research, it does not concentrate as exclusively on clinical medicine as Basic and Clinical Biostatistics does. Statistical First Aid also has a fairly unusual structure. Rather than centering on particular statistical techniques, as in most textbooks, the focus is on the kinds of variables encountered when undertaking statistical analysis. The text is divided into four sections. Part 1 considers basic principles of statistics, including probability theory, populations and samples, and estimation and inference. Parts 2 through 4 each have a similar structure with separate chapters on continuous, ordinal, and nominal dependent variables. The parts themselves are distinguished by the number of independent variables involved in a statistical procedure. Part 2 considers univariable analysis, part 3 addresses bivariable analysis, and part 4 covers multivariable analysis. Multivariable analysis, with one dependent variable and more than one independent variable, is distinguished by the authors from multivariate analysis, which deals with more than one dependent variable. Techniques of multivariate analysis are not considered in this textbook.