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ORIGINAL ARTICLE
Year : 2017  |  Volume : 15  |  Issue : 1  |  Page : 68-72

Knowledge, Attitude and Perception Regarding Biostatistics Among Postgraduate Students in Dental Institutions of Andhra Pradesh


1 Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India
2 Public Health Dentistry, Vishnu Dental College, Bhimavaram, Andhra Pradesh, India

Date of Web Publication14-Mar-2017

Correspondence Address:
Gautami S Penmetsa
Department of Periodontics and Implantology, Vishnu Dental College, Bhimavaram 534202, West Godavari, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jiaphd.jiaphd_165_16

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  Abstract 

Introduction: Biostatistics is a discipline concerned with how we ought to make decisions when analysing biomedical data. As statistics is desirable at every stage of research to obtain scientifically important information and reliable results, the importance of biostatistics should definitely be informed to the researchers in health sciences. Aim: To evaluate the knowledge, attitude and perception of dental professionals towards biostatistics. Materials and Methods: A cross-sectional study was conducted to assess the knowledge, attitude and perception regarding biostatistics among 721 postgraduate students in dental institutions of Andhra Pradesh. All the participants were provided with a pre-structured questionnaire comprising 21 questions, and answering was completely self-paced. Results: Among the respondents, 86% were aware of the importance of biostatistics in research. Forty-five percent of the respondents attempted to perform statistical analysis on their own. Of all the students, 53% were unable to identify the commonly used parametric tests in clinical trials. Conclusion: Majority of the participants were aware of the importance of biostatistics, but only a few of them attempted to perform statistical analysis. Therefore, dental institutions should take initiatives in organising workshops and training programmes for learning and application of biostatistics, concomitantly encourage research activity to conduct valuable research and add up evidence to literature.

Keywords: Biostatistics knowledge, dental postgraduate, research methods, students


How to cite this article:
Penmetsa GS, Dubba K, Mohammad Z. Knowledge, Attitude and Perception Regarding Biostatistics Among Postgraduate Students in Dental Institutions of Andhra Pradesh. J Indian Assoc Public Health Dent 2017;15:68-72

How to cite this URL:
Penmetsa GS, Dubba K, Mohammad Z. Knowledge, Attitude and Perception Regarding Biostatistics Among Postgraduate Students in Dental Institutions of Andhra Pradesh. J Indian Assoc Public Health Dent [serial online] 2017 [cited 2019 Dec 15];15:68-72. Available from: http://www.jiaphd.org/text.asp?2017/15/1/68/201935


  Introduction Top


In this current era of evidence-based practice, it has become mandatory for clinicians and academicians to face a plethora of studies that might have an impact on patient care, as well as those describing changes in the philosophy of dental health care provision and new vistas in dental research and education.[1],[2] The dental practitioners in the 21st century will need an inordinate skill to assess new information to be update with the research advances, as reviewing literature has become a part and parcel of their work.[3] For this, they must adequately understand statistics emphasizing the need for application of mathematics to biological processes.[4] As statistics is desirable at every stage of research to obtain scientifically important information and reliable results, the importance of biostatistics should definitely be informed to the researchers in health sciences.[5]

Biostatistics plays a crucial role in health science research, as it aids in assessing treatment effects, comparing different treatment options, understanding treatment interactions and properly implementing the new innovations in diagnostic and therapeutic methodologies.[6] Therefore, the proper use and understanding of statistics is necessary to differentiate between the ‘gold’ and the ‘dross’ and to figure out the associated dilemmas in concluding the statistical data.[7]

It has become mandatory for researchers to apply some basic concepts of biostatistics into their work if they need to share their results with the scientific community. In consequence, biostatistics comes into action in the form of significance tests, confidence intervals and so on, as the scientific community needs to be convinced that the experimental outcome is not just a matter of chance.

The objective of this study was to evaluate the knowledge, attitude and perception of dental professionals towards biostatistics, as it would help to understand the basic knowledge of the subject and aid in improving its teaching methods by enabling dental professionals understand its importance in interpreting research outcomes. This understanding and knowledge regarding the basics of biostatistics would help dental professionals enhance their appraisal and interpretation towards advanced methods frequently encountered in clinical research and further help them in adding valuable evidence to the literature.


  Materials and Methods Top


This cross-sectional study was conducted between February 2016 and March 2016 in all the 11 dental institutions of Andhra Pradesh offering a Master of Dental Surgery (MDS) course. The postgraduate students who had taken admission into a MDS course in various specialities during 2013, 2014 and 2015 were recruited for the study. Those postgraduate students who were present on the day of conducting the study in the respective institution were included in the study. The questionnaire was distributed among the students and data collected. This study was approved by the Institutional Review Board. Necessary permissions were obtained from all the institutions regarding the execution of the study.

Prior to the start of the main study, a pilot study was executed on a set of 80 students for knowing the feasibility and validating the questionnaire. The observed Cronbach’s alpha is 0.75, which is acceptable. A pre-structured questionnaire comprising a total of 21 questions, of which 14 were related to attitude and perception towards biostatistics and seven were based on basic knowledge in biostatistics, was prepared. The questionnaire was adopted from previously published studies[1],[8] and modified taking care that it covered the basic topics in biostatistics.

The inclusion criteria were that students should have taken admission into a MDS course in Andhra Pradesh between the academic years 2013–14, 2014–15 and 2015–16. The participants were explained in brief about the study and the questionnaire and were also assured of the confidentiality of their details. Only those who were willing to participate and had given their consent were included. All the participants were provided with a questionnaire, and answering was completely self-based. The data collected were entered in MS EXCEL spreadsheet and analysed through the Statistical Package for the Social Sciences package v.21 software (SPSS Inc., Chicago, IL, USA).


  Results Top


Among the 865 postgraduate students approached, 721 participated in the study. The response rate was 83.4%. [Table 1] shows distribution of the study participants based on gender and year of study. The study population had high percentage of female students (67%), and the distribution was statistically significant in all the 3 years (P < 0.05).
Table 1: Distribution of the survey’s respondents

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Seven hundred and three (98%) students agreed that they required a programme-based learning on biostatistics. Six hundred and nineteen students were aware of the importance of biostatistics, and 693 (96%) thought that knowledge of biostatistics was needed both during and after pursuing a MDS course for a better career. Among all the respondents, 489 (68%) had biostatistics as a part of their curriculum, and 307 (43%) of them had attended a course or workshop related to biostatistics. Biostatistics was believed to be more difficult than other subjects in dental training by 61% of the students, whereas 39% of the students disagreed with the same [Table 2].
Table 2: Response for attitude and perception-based questions

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Of all the respondents, 591 (82%) were aware that research was of different types, whereas 18% were unaware. Among all, 362 (50%) students reported that they had knowledge of various statistical software packages available on the Internet, and 337 (47%) students were familiar with the use of MS Excel spreadsheet. The majority of respondents (77%) felt that knowledge of biostatistics was necessary during the search of literature; however, 169 (23%) of them disagreed. Among the participants, 390 (54%) students conducted studies requiring statistical analysis, and 321 (45%) of them attempted to perform statistical analysis on their own. Among the study population, 351 (49%) students were willing to participate in the statistical analysis of their study along with the statistician.

Responses to knowledge-based questions are presented in [Figure 1]. Only 8.6% of the respondents had knowledge of software packages available for statistical analysis, and 91.4% were unable to identify the wrong software package. Among the study population, 65.4% of the respondents had knowledge regarding the types of bias in randomized, controlled trial. Forty-seven percent of the respondents were able to identify the commonly used parametric test in randomized, clinical trials, whereas 53% could not. Sixty-one percent of the students were aware of the purpose of randomization in a randomized, controlled trial.
Figure 1: Correct response to knowledge-based questions

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[Figure 2] depicts the opinion of the respondents regarding the stage in which a statistician has to be consulted in research. Forty-eight percent of the respondents preferred consulting a statistician while designing the study, 2.7% during research, 42.3% for statistical analysis and 6.6% thought the statistician should be consulted when the study was not accepted for publication because of error in statistical analysis.
Figure 2: Response to the question ’Which is the first preferred stage for consulting a statistician in a research?’

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Of the study population, 346 (48%) of the students had knowledge regarding the different types of random sampling methods. Only 15% of the respondents were able to correctly interpret the meaning of ‘P ≤ 0.05’. Among the participants, 289 (40%) had knowledge related to double blind trials.


  Discussion Top


Biostatistics plays a very important role in the field of research, helping with description, organization, data analysis and interpretation, and, therefore, it is an esteemed tool in evidence-based dentistry. Biostatistics, when used wisely, helps to clearly understand the subject under study, as its accurate use helps in obtaining evidence regarding the assumptions of research. On the contrary, its altered application can lead to misperceptions.

Though some studies have been conducted to record the awareness and knowledge of health care professionals regarding biostatistics, they are primarily directed towards physicians and academicians. They showed that even those who had more acquaintance with research literature had restricted knowledge of the basics of biostatistics. Hence, this study was undertaken to assess the knowledge, attitude and perception of dental postgraduate students of Andhra Pradesh regarding biostatistics.

A total of 721 students were included in the study. The results of our study suggested that 86% of the respondents were aware of the importance of biostatistics in research, whereas 61% of the respondents felt that biostatistics was a difficult subject when compared to other dental subjects. This was in line with the results of a study conducted by Batra et al.,[1] in which biostatistics was believed to be a difficult subject by 64.3% of the respondents.

In this study, 68% of the students revealed that biostatistics was a part of their curriculum, but only half of the respondents had familiarity with MS Excel spreadsheet and statistical software packages on the Internet. This is in line with the results of a study conducted by Swetha et al.[8] on 391 postgraduate students of periodontics. Therefore, every student should be obliged to obtain a certificate in computer education, so that they could have acquaintance with the use of softwares. Sundefeld et al.[9] concluded that emphasis should be placed on teaching of biostatistics in all dental schools. According to Sharma et al.,[10] research component should be made an essential requirement in undergraduate curriculum, and postgraduates should be encouraged to participate in workshops on research methodology to provide a better perspective of the same.

In this study, 96% of the postgraduate students thought that biostatistical knowledge is beneficial to a dentist’s career, and only 43% of the students had been a part of a course or workshop related to biostatistics. This is in support with the results of a study conducted by Batra et al.[1] regarding perception of dental professionals towards biostatistics, in which 69.8% agreed that knowing biostatistics would benefit their career. Therefore, institutions should take an active step in conducting continuing dental education programmes, short courses, training programmes, workshops, etc. related to biostatistics to build up better career for the students. Windish et al.[11] suggested the inclusion of biostatistics training programmes in their curriculum to prepare residents for learning skills of biostatistics.

Hood and Neumann[12] showed that a brief and cost-effective group workshop delivered at the start of the semester could produce identifiable improvements in statistics self-efficacy and attitudes. Furthermore, a study done by Chima et al.[13] highlighted the potential benefits of a short-course in biostatistics in improving the knowledge and performance of biostatistical analysis by biomedical researchers in Africa and other resource-poor settings.Though 54% of the respondents conducted various studies requiring statistical analysis, less than 50% attempted to perform the statistical analysis on their own. This is in turn supported by the study conducted by Swetha et al.[8] This ascertainment also simulates with another study conducted by West and Ficalora,[14] in which they showed that only a small percentage (17.6%) of medical students, internal medicine residents and internal teaching faculties believed that they had adequate training in biostatistics, and even fewer (14.6%) felt adequately prepared to conduct a statistical analysis. This indicated the lack of self-application of statistics among students. Best and Laskin[15] concluded that the residents were unprepared to interpret the results of clinical research because they lacked knowledge of biostatistics.

In this study, only 48% of the students preferred to consult a statistician at the time of designing the study, 2.07% during research, 42% for performing statistical analysis and interpretation and 6.6% in case the study was not accepted for publication. This implied that most of the respondents did not know the appropriate stage of approaching a statistician.

Though 65.4% of the students had some knowledge regarding bias in randomized, clinical trials, 61% of the respondents knew the purpose of randomisation, and only 48% of the students had knowledge regarding random sampling methods. Only 40% of the students had knowledge related to double blind trials. It was found that far less than half of the study population had limited knowledge regarding the parametric tests that were commonly used in randomized, clinical trials. In addition to this very, few respondents had true knowledge regarding the software packages available for statistical analysis. Very few participants had interpreted the meaning of P ≤ 0.05. This indicated the limited knowledge of the participants regarding probability and level of significance.

Most of the students were in a predicament stage to decide an appropriate method for execution of research, to select research topics and anticipate the errors when conducting the research, warrants learning and application of biostatistics as a part of their curriculum. This can be achieved through planned efforts by the institutes in opening new vistas to conduct good research through thorough understanding of biostatistics.

The limitations of our study are the following: there may be insufficiency in so-framed knowledge testing questions to evaluate the true knowledge of the participants; and there is less command on conception of questions by the participants.


  Conclusion Top


Though majority of the participants were aware of the importance of biostatistics, only a few of them could attempt to perform statistical analysis, which implied lack of knowledge and confidence in conducting research. Therefore, dental institutions should take an initiative in conducting continuing dental education programs, workshops and training programmes for learning and application of biostatistics with periodic update and revision. In addition, students should aim to learn basic and specific statistical analysis such as performing descriptive analysis of data, testing the significance between groups and testing the variance between the groups. Institutions should take interest in availing experts’ guidance to postgraduate students throughout their research activity to conduct valuable research and add up evidence to literature and decision-making.

Acknowledgements

We acknowledge Dr. C. D. Dwarakanath, Professor and HOD, Department of Periodontics and Implantology and Dr. Gadde Praveen, Senior Lecturer, Department of Public Health Dentistry, Vishnu Dental College for their support and guidance for our study.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Batra M, Gupta M, Dany SS, Rajput P. Perception of dental professionals towards biostatistics. Int Sch Res Notices 2014;2014:1-6.  Back to cited text no. 1
    
2.
Polychronopoulou A, Eliades T, Taoufik K, Papadopoulos MA, Athanasiou AE. Knowledge of European orthodontic postgraduate students on biostatistics. Eur J Orthod 2011;33:434-40.  Back to cited text no. 2
    
3.
Mostert P. Changing approaches and perceptions: Biostatistics and its role in teaching the Stellenbosch doctor. ICOTS 2006;7:1-6.  Back to cited text no. 3
    
4.
Heinzmann D. Biostatistics − Where mathematics meets biology. Newsl YEBN 2006.  Back to cited text no. 4
    
5.
Ocakoglu G, Ercan I, Gunelkaradeniz P. Knowledge of dentists about biostatistics: A worldwide survey. e-J Dent 2013;3:318-27.  Back to cited text no. 5
    
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Vivekanand SK. Manual of Community Dentistry. New Delhi: Jaypee Brothers Medical Publishers; 2004.  Back to cited text no. 6
    
7.
Moskowitz E. Statistics in dentistry. Who needs them? Editorial NYSDJ 2007;August/September:4.  Back to cited text no. 7
    
8.
Swetha JL, Arpita R, Srikanth C, Nutalapati R. Cognition, comprehension and application of biostatistics in research by Indian postgraduate students in periodontics. J Indian Soc Periodontol 2014;18:65-8.  Back to cited text no. 8
[PUBMED]  [Full text]  
9.
Sundefeld, Mazza ML, Amália M, Santo E, Regina M. Assessing the inclusion of biostatistics in schools of dentistry in Brazil. Int Assoc Stat Edu/ISI Satellite 2007;1-7.  Back to cited text no. 9
    
10.
Sharma N, Pramila M, Krishnamurthy A, Umashankar GK, Ranganath XX, Ahuja N. Knowledge, attitude, and practices in research among postgraduate students in dental institutions in Bengaluru city, India. J Indian Assoc Public Health Dent 2014;12:189-93.  Back to cited text no. 10
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11.
Windish DM, Hout SJ, Green ML. Medicine residents’ understanding of the biostatistics and results in the medical literature. JAMA 2007;298:1010-22.  Back to cited text no. 11
    
12.
Hood M, Neumann DL. Evaluation of a workshop to reduce negative perceptions of statistics in undergraduate psychology students. Psychol Learn Teach 2013;12:115-25.  Back to cited text no. 12
    
13.
Chima SC, Nkwanyana NM, Esterhuizen TM. Impact of a short biostatistics course on knowledge and performance of postgraduate scholars: Implications for training of African doctors and biomedical researchers. Niger J Clin Pract 2015;18:S62-70.  Back to cited text no. 13
    
14.
West CP, Ficalora RD. Clinician attitudes toward biostatistics. Mayo Clin Proc 2007;82:939-43.  Back to cited text no. 14
    
15.
Best AM, Laskin DM. Oral and maxillofacial surgery residents have poor understanding of biostatistics. J Oral Maxillofac Surg 2013;71:227-34.  Back to cited text no. 15
    


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