13 December 2011, Vol. 3, No. 2 AJHPE
Introduction
According to publications in the UK and USA1-3 there is a lack or limi-
tation in the knowledge of research methodology, statistics, and criti-
cal appraisal skills of medical literature evaluation among registrars
and clinicians. As a consequence, utilisation of biostatistical consulta-
tion services became necessary and is provided in the most prestigious
academic hospitals and medical schools of the world.4-6 In South Africa
(SA) as a result of rules changes by the Health Professional Council
of SA (HPCSA) to become a specialist, a compulsory qualification in
research was added. Therefore courses in research methodology, applied
statistics and scientific writing were implemented since 2007 at the Uni-
versity of the Witwatersrand and from 2009 biostatistical consultations
were conducted.
In order to evaluate the utilisation of biostatistical services at the aca-
demic medical platform of the Faculty of Health Sciences, a review of
one-on-one consultations was undertaken. Thus the purpose of this study
was to determine the extent and the utilisation of the one-on-one biosta-
tistical consultations during the year 2010 at the Medical School of the
University of the Witwatersrand.
Methods
Consultations were performed by one research methodologist and sta-
tistical expert at two academic medical institutions of the University of
the Witwatersrand (Medical School and at Chris Hani Baragwanath Aca-
demic Hospital) between January and December 2010. Every consulta-
tion was counted separately regardless of the number of times needed to
address the same project. Each session was booked in advance and the
duration ranged between 40 and 60 minutes. The results presented in this
study were completed and compiled by the expert from data collection
sheets which included consultees’ position and field, date, nature and/
or purpose of the consultation and type of project. Data were reported
as frequencies and percentages with the correspondent 95% confidence
interval (CI95%) for each institution as well as for the combined sites.
Results
In total 235 one-on-one biostatistical consultations were performed
at two academic medical institutions of the University of the Witwa-
tersrand between January and December 2010. A total of 144 consulta-
tions, 61%, CI95% (55 - 67%) and 39 %, CI95% (49 - 61%) were completed
at Medical School and Chris Hani Baragwanath Academic Hospital.
Biostatistical consultations were divided into two wide topics: research
protocol development (study design, sample size calculation, etc.) and
statistical analysis (data entry, data coding, appropriate statistical tests
and results interpretation) which represented 35%, CI95% (29 - 41%) and
65%, CI95% (59 - 71%) of the consultations respectively.
Fig. 1 shows the distribution of biostatistical consultations per site, ac-
cording to consultees and purpose of the consultation. The majority of
the consultees were medical doctors seeking advice to get degrees such
as Master in Medicine and PhD; 55% (129/235) and 19% (45/235) re-
spectively, rather than medical students or staff researchers working for
the University of the Witwatersrand with non-degree purpose.
The median and range of consultations per month at Medical School and
at Chris Hani Baragwanath Academic hospital were 12 (8 - 17) and 7
(0 - 20), respectively.
The more frequent medical fields of the consultees were psychiatry
(30%) followed by emergency medicine/family medicine (16%) and an-
aesthetics (15%) at the medical school site. However, at the Chris Hani
Baragwanath academic site internal medicine was the department with
more bookings (34%), followed by anaesthetics (18%) and psychiatry
(12%).
Conclusions
The results of this study were similar to those found in several academic
research institutions between 1999 and 2005 in the USA.4 Changes in
critical legislation provided the catalyst for many clinicians training to
be specialists to embark on research which they may not have done,
given their high workloads in delivering healthcare. These changes also
unveiled the previously hidden anxieties of being unable to cope with
research, in particular statistics. Courses were put in place and immedi-
ately were over-subscribed. Ultimately the success or otherwise of these
courses will be measured in throughput rates. South Africa is a country
desperately short of doctors and specialists and research requirements
should not become a limitation to qualifying.
Conflict of interest: None.
Ethics: A waiver was received from the HREC (Medical) Faculty of
Health Sciences, University of the Witwatersrand.
Short Report
One-on-one consultation on protocol development and statistics
analysis in health sciences postgraduate students
Elena N Libhaber, Merryll Vorster
School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg
Correspondence to: Elena N Libhaber (Elena.Libhaber@wits.ac.za)
Fig. 1. Biostatistical consultations per site.
14 December 2011, Vol. 3, No. 2 AJHPE
References
1. West CP, Ficalora RD. Clinician attitudes toward biostatistics. Mayo Clinic Proc
2007;82(8):939-943.
2. Miles S, Price GM, Swift L, Shepstone L, Leinster SJ. Statistics teaching in medi-
cal school: Opinions of practising doctors .BMC Medical Education 2010;10:75.
3. Rao G, Kanter SL. Physician numeracy as the basis for an evidence-based medi-
cine curriculum. Acad Med 2010;85:1794-1799.
4. Deutsch R, Hurwitz S, Janosky J, Oster R. The role of education in biostatistical
consulting. Statist Med 2007;26:709-720.
5. Parker RA. Estimating the value of an internal biostatistical consulting service.
Statist Med 2000;19:2131-2145.
6. Lesser ML, Parker RA. The biostatistician in medical research: allocating time and
effort. Statist Med 1995;14:1683-1692.
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