Martin Bland’s Text Book:

An Introduction to Medical Statistics

Cover of the fourth edition of An Introduction to Medical Statistics

Contents of this page

Overview of An Introduction to Medical Statistics

An Introduction to Medical Statistics, now in its fourth edition, is a book for medical students, doctors, medical researchers, and all who want an introduction to statistics in a medical or health context. The book has 445 pages with 236 figures.

The approach is firmly embedded in medical research, all the methods described being illustrated with the use of real data, either from my own research or from the medical literature. Equations and formulae are given where appropriate and manual calculation is described, but the use of computers for calculations is emphasised, together with the graphical methods which computers make easy. For those who do not like to take things on trust, mathematical appendices are included which explain the derivation of the various statistical formulae, and graphical simulations are used to illustrate some of the more surprising statistical principles.

The book begins with the design of clinical and epidemiological studies, then describes methods for summarising and presenting the data collected. Next probability is introduced, and the ways in which it can be used to interpret data. The most commonly used statistical methods are described, their assumptions and how these can be checked, their interpretation, and how to choose the appropriate method for the analysis of different types of data in various circumstances.

The book goes on to describe the analysis of data where there is more than one predictor or explanatory variable, for continuous measurements, for yes or no variables, for counts, and for time to event data. Meta-analysis is described for different tyes of data, including checking for possible publicatiion bias and network metanalysis for studies which include several treatments. This is followed by the estimation of required sample size for different kinds of study.

A chapter on measurement in medicine discusses measurement error and observer variation, for quantitative measurements and for categories. The limits of agreement method for agreement between different methods of measuring the same quantity is described. The chaper goes on to describe the analysis of diagnostic methods and the estimation of reference ranges and centile charts and the creation and validation of composite questionnaire scales.

The last two chapters cover large-scale mortality statistics, expectation of life, and population structure and we finish with a new chapter on the Bayesian approach to statistics. This may have been rather rash on my part, but we see these methods more often now in the medical literature, so I thought I should try an introduction.

Two types of exercises are included: 122 multiple choice questions of the five branch True/False type, and long exercises involving interpretation of analyses and critical reading of research. No exercises requing calculations are included in this edition. Full solutions are given for all exercises.

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Fourth edition

The fourth edition was published in July 2015. Due to the adoption of a larger page format, the page count of the fourth edition is similar to that of the third edition, but several new topics have been added and others extended.

New topics in the fourth edition include:

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Contents of An Introduction to Medical Statistics

High-lighted sections can be read on the Web. Sections which are new in the fourth edition are indicated.

  1. Introduction

  2. The design of experiments
  3. Sampling and observational studies
  4. Summarizing data
  5. Presenting data
  6. Probability
  7. The Normal distribution
  8. Estimation
  9. Significance tests
  10. Comparing the means of small samples
  11. Regression and correlation
  12. Methods based on rank order
  13. The analysis of cross-tabulations
  14. Choosing the statistical method
  15. Multifactorial methods
  16. Time to event data — NEW CHAPTER — includes expanded material
  17. Meta-analysis — NEW CHAPTER — includes greatly expanded material
  18. Determination of sample size
  19. Missing data — NEW CHAPTER — all new material
  20. Clinical measurement
  21. Mortality statistics and population structure
  22. The Bayesian approach — NEW CHAPTER — all new material

Appendix 1: Suggested answers to multiple choice questions and exercises



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Extracts from reviews of the first edition

The first edition was well reviewed, e.g.:
At last I have a book on medical statistics that I can safely recommend to my students. --- Journal of the Royal Statistical Society.
It is a book which I think anyone teaching an introductory course in medical statistics should seriously consider as the main text. --- Statistics in Medicine.
If you want understand some of the statistical ideas important to medicine but fear being overwhelmed by mathematics you will welcome “An Introduction to Medical Statistics” by M. Bland. --- British Medical Journal.

Reviews of the second edition

European Journal of Orthodontics

Martin Bland’s textbook is one of those most commonly recommended by academic medical statisticians in the UK for students and professionals in health-related disciplines. According to the British Medical Journal reviewer of the first edition, ‘If you want to understand some of the statistical ideas important to medicine but fear being overwhelmed by mathematics you will welcome this book’. And it is certainly sufficiently explicit and prescriptive for those at the research stage of their careers. The second edition is rather longer than the first, in particular sections on multifactorial methods and determination of sample size have been greatly expanded to form additional chapters. Each chapter includes several traditional multiple choice questions, and a longer question: a section at the back of the book gives full solutions to both. As in most other biostatistics texts, the clinical and epidemiological examples used are medical rather than dental, but do not presuppose specialized medical knowledge: the issues in dental specialties are fundamentally similar, and a dental reader should find the medical orientation no obstacle. The second edition is still good value at 14.95 pounds.

R. G. Newcombe. (1996) European Journal of Orthodontics 18(3) , 308.

N.B. The price is now higher, but still good value! -- MB.

Academic Orthopaedic Society Book Reviews

Title: An Introduction to Medical Statistics
Author: Martin Bland
Publisher: Oxford Medical Publications
Price: $27.95.
Comment: This paperback makes aspects of statistics and design of experiments, sampling and observational studies, data presentation, probability and other painful aspects of statistics relatively painless although it does have a lot of math.

Reviews of the third edition

The third edition was reviewed by Les Huson (The Statistician, 50, 548). The review ends:
The coverage may not be very different from that of other introductory texts, but in my view the style and content are, and they alone make this text one of the best of its kind. The approach is very data driven, and the use of real data makes this even more appealing. The concern throughout is with statistical practice -- i.e. with extracting meaningful information from real data -- and not statistical theory, although the necessary theoretical ideas are explained in a non-mathematical way. The writing style -- first person throughout -- is also attractive and makes the text easy to read and digest, although it should also be said that this book contains a large amount of material and to work through it thoroughly takes time! Using the companion volume also [Statistical Questions in Evidence-based Medicine], and working through the exercises, would mean a very thorough course of study indeed.

All in all, this is an excellent book -- it has been on my bookshelf since the first edition, and in my view it should be the first choice for any student wanting a serious introduction to the practice of medical statistics.

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An Introduction to Medical Statistics is published world-wide by Oxford University Press . See OUP web site for details.


Corrections to the second edition

Despite the combined proof-reading efforts of Doug Altman, Janet Peacock, and myself, a few errors remain. An up to date list of corrections to the second edition is maintained on this site.

Corrections to the third edition

An up to date list of corrections to the third edition is maintained on this site.

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Copies of data sets used in the book

Most of the datasets from An Introduction to Medical Statistics can be found for downloading on my download page.

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Back to Martin Bland’s Home Page.

This page maintained by Martin Bland.
Last updated: 17 August, 2015.

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