Understanding Biostatistics (Outside Of Your PSM Textbooks)

By- Tejaswini Ashok

“The PSM textbook is a must to lay the foundation of biostatistics.”

Dr. Gargi Kakani, MBBS (MPH student at Harvard T.H Chan School of Public Health)

Preventive & Social Medicine – what do you think of when you hear these three magical words?

The majority of us, medical students, share a common bittersweet relationship with this unique subject. We would have taken math instead of biology if we wanted to learn statistics, right? Having said that, as doctors who have successfully closed their chapters with the beloved textbook of Park, we would like to shed light on the real-world implications of a vital aspect of medicine – biostatistics.

Biostatistics is the application of statistical science to research in health-related fields including medicine, biology, public health, nursing, and pharmacy. This field intends to use statistical methods to find the solution to problems encountered in public health and medicine. Biostatisticians play a pivotal role in formulating the scientific questions to be answered, determine appropriate sampling techniques, coordinate data collection procedures, conduct statistical analyses to answer those scientific questions, and lastly in the preparation of research material for publication. (1) The interdisciplinary nature of the field is one of its biggest perks.

To elucidate this further, we interviewed Dr. Gargi Kakani, MBBS who is currently pursuing her Masters in Public Health in Clinical Effectiveness from the world-renowned Harvard T.H Chan School of Public Health. Dr. Gargi Kakani worked as a frontline healthcare professional in the COVID-19 pandemic for over a year. Her experiences on the frontline motivated her to seek a master’s degree in public health. She aspires to be a pediatrician after graduating with the MPH degree from Harvard T. H. Chan School of Public Health. Let us learn about the importance of biostatistics from Dr. Gargi, in addition to some tips & tricks on how to contribute to the field as a medical student.

1. What is the role of biostatistics in Global medicine?

“Biostatistics is important to give meaning to the findings of clinical research. It can help answer questions like, “what is the risk of…?”, “is this a confounding factor or an effect modifier?”, “are these two variables associated?” and so on. Once a research question is answered at a hospital level, larger studies with tools like prediction models and machine learning are used to have a more meaningful impact. These advanced biostatistics are now being used in low- and middle-income countries for various purposes.”

2. How can medical students get involved and dive into biostatistics beyond the PSM textbook?

“The PSM textbook is a must to lay the foundation of biostatistics. It will help orient the students to common terminology and definitions. For students who are keen on designing the clinical projects and performing the analyses by themselves, I would recommend taking a course called Principles and Practice of Clinical Research offered by Executive and Continuing Professional Education at Harvard T.H. Chan. I was a student of the course in 2020 and now I am a teaching assistant. This course will solidify the core concepts of biostatistics. It is a 9-month course and can be done online.”

3. What advice would you give to somebody considering medical research as a career?

“You must pursue an MS or Ph.D. degree to kick start your career solely as a researcher. However, if you want to learn how to design and implement research in the clinical setting, you can either enroll in PPCR (from the previous question) or pursue an MPH degree.”

4. To what extent can a physician get involved in biostatistics while practicing medicine/ treating a disease?

“To whatever extent the physician deems fit. I am a physician learning how to build prediction models and propensity scores that will strengthen case-control and cohort studies, which have been historically deemed inferior to randomized controlled trials. I am fluent in three software packages of biostatistics – SAS, STATA, and R. Additionally, the Bayesian methods are extremely useful if you are considering medical decision analysis as a future.”

5. How much has public health benefitted from biostatistics?

“This is a very broad question. Public health is not exclusive to biostatistics and can never be. You could pursue a degree in just epidemiology, sure, however, a combination of epidemiology and biostatistics forms the core of public health. Any benefit in the realm of public health stems from the principles learned in both subjects.”

We thank Dr. Gargi Kakani for her detailed and informative response. The scope and role of biostatistics in evidence-based medicine are truly indispensable. We hope after reading this article, at least one of you is inspired to look beyond the dreary pages of a textbook and discover an opportunity to make a global impact.