Key concepts in biostatistics: using statistics to answer the question "is there a difference?"

Biostatistics seeks to answer the question "Is there a difference?" in the rate of a disease or characteristic among subgroups of patients. The goal of this article is to introduce and define measures used in epidemiology and discuss different types of analyses in clinical research with an emphasis on the concepts and implications of the analyses rather than the mathematics. The implications of the use of measures such as incidence and prevalence, as well as odds, risk, and hazards ratios may affect study conclusions. An understanding of the distinction between these summary measures is essential. The concepts of univariate and multivariate analyses, a discussion of what it means to control for potential confounders, and a description of statistical power and significance are also presented. These concepts are integral to the design and analysis of clinical studies. An understanding of their advantages and applications will enhance the reader's ability to understand and evaluate the literature.