In one sentence Medical data are observations and measurements collected for analysis, and they arrive from patients, records, laboratory tests, surveys and surveillance.
Where medical data come from
Data are observations or measurements collected for the purpose of analysis. In medical work they are gathered from several recognisable places, and knowing which one you are holding changes how far you can trust it. The patient is the first source: a nurse measures a temperature, a pulse or a blood pressure and writes the value down. Medical records and hospital databases supply values recorded earlier, often by someone else. Laboratory tests produce measurements such as a haemoglobin concentration or a blood glucose level. Questionnaires and surveys collect what patients report about themselves, such as smoking or diet. Clinical trials and public-health surveillance collect data to a written plan, which is why they can support comparisons that a ward notebook cannot. Whichever source you use, the numbers first obtained are raw: they have not yet been counted, sorted or summarised.
A ward records the ages of ten patients admitted overnight, in the order they arrived: 22, 35, 18, 41, 22, 29, 35, 18, 25, 22.
Name three different sources from which a nurse might obtain patient data, and say what kind of value each one gives.
Show the answer
Any three of these: the patient, giving a measured value such as temperature or pulse; medical records and hospital databases, holding values recorded earlier by other staff; laboratory tests, giving measured concentrations such as haemoglobin; questionnaires, giving what the patient reports; clinical trials and public-health surveillance, which collect data to a written plan.
Read detailed explanations
- Choosing a class width without guessing
Choosing the number of classes and their width is a judgement, not a fact hidden in the data, so the judgement should be made in two visible moves. First decide roughly how many classes you want. For a beginner, aim between five and twenty. A widely used formula, Sturges’ rule, estimates the number as 1 + 3.322 × log10(n), so for n = 50 it gives 1 + 3.322 × 1.699 ≈ 6.6, that is about seven classes. Second, divide the range by that number and round the answer up to a convenient value. For ages running from 10 to 59 years the range is 59 − 10 = 49 years, and 49 ÷ 7 = 7 years exactly, so seven classes of width 7 begin 10–16, 17–23, 24–30, 31–37, 38–44, 45–51 and 52–58. The last class ends at 58 and the value 59 has nowhere to go: the arithmetic looked perfect and the table still fails. Rounding the width up to 8 repairs it, giving classes from 10–17 through 58–65, in which the final class is partly empty. A partly empty end class is harmless; a missing observation is not. The supplied example makes the opposite choice and is equally valid: five classes of width 10, namely 10–19, 20–29, 30–39, 40–49 and 50–59, cover 10 to 59 exactly. Both tables can be defended, which is why a careful writer states how many classes were wanted and what width was chosen before showing the result. Two technical terms make the width meaningful when the table is used for further work. The midpoint, also called the class mark, is the average of the two limits: for 20–29 it is (20 + 29) ÷ 2 = 24.5 years, and it stands in for every value in the class when a mean is later estimated from grouped data. The boundary method matters when the variable is continuous rather than a whole-number count. If weight is recorded to the nearest kilogram, the class written 10–19 really stretches from 9.5 kg to 19.5 kg, a width of 10 kg, because a patient weighing 19.4 kg is rounded into it. For a discrete count such as the number of children, the class 2–3 means exactly 2 or 3 children and no adjustment is needed. Never change the width part way down a table, because unequal widths make the bars of a histogram misleading, and avoid an open-ended class such as 70 and over, whose midpoint cannot be fixed. Finish by checking that every observation falls in exactly one class and that the class frequencies add to n.
- Reading a frequency table forwards and backwards
A frequency table is read forwards for one value and backwards for a group, and the two readings use different columns. Forwards is the frequency column: it answers how many patients had exactly this value. Backwards is the cumulative frequency column: it answers how many had this value or less, and the answer never shrinks as you move down the table. The cumulative relative frequency is the running total of the proportions, and it behaves in the same way. In a complete table its last value is exactly 1, or 100 %. Here is a worked reading. A ward reviews the length of stay of 40 patients, and the cumulative relative frequency after 5 days is 0.85. So 85 % of patients stayed five days or fewer. The remaining share is found by subtraction, not by a new count: 1 − 0.85 = 0.15, so 15 % stayed longer than five days, and 0.15 × 40 = 6 patients. That subtraction is called the complement, and it is valid because every patient belongs to one of the two groups and to only one. Two checks keep the table honest, and they catch different faults. First, the frequencies must add to n, and the relative frequencies must add to 1. When percentages are rounded to one decimal place they may total 99.9 % or 100.1 %; that is a rounding artefact rather than a mistake, but the unrounded proportions add to exactly 1. Second, the cumulative column must never decrease and must finish at n. If it finishes at 39 when 40 patients were measured, one observation has been lost somewhere above that row, and the fault lies not in the last addition but in the frequency that was written wrongly earlier. Reading the table backwards also gives the beginner a first, informal idea of probability: if 30 % of ten patients were aged 22, you may estimate that about 30 % of similar patients will be. A proportion built on ten patients is fragile, because adding or removing one patient moves it by ten percentage points, while the same proportion built on a thousand patients barely moves. The arithmetic looks identical; the reliability does not.
- From a grouped table to a clinical summary
Grouping buys a readable pattern and pays for it with precision, and knowing the price is what makes the summary honest. Once ages are written as 20–29, the individual values are gone: the table no longer records that one patient was 22 and another 29. What survives is the shape of the distribution — how many patients are young, how many are old, and where the bulk of them sits. The standard way to recover a usable number is to treat every value in a class as if it equalled the midpoint, then compute an estimated mean as the sum of each class frequency multiplied by its midpoint, divided by n. For the supplied grouped ages: 10–19 has 8 patients and midpoint 14.5, giving 8 × 14.5 = 116; 20–29 has 15 and midpoint 24.5, giving 15 × 24.5 = 367.5; 30–39 has 12 and midpoint 34.5, giving 12 × 34.5 = 414; 40–49 has 10 and midpoint 44.5, giving 10 × 44.5 = 445; 50–59 has 5 and midpoint 54.5, giving 5 × 54.5 = 272.5. The total is 116 + 367.5 + 414 + 445 + 272.5 = 1,615, and 1,615 ÷ 50 = 32.3 years. That mean is an estimate, not the true mean, because each midpoint stands in for values that were never exactly there; with narrow classes it is close, and with very wide classes it drifts. The same table answers resource questions without any new arithmetic. How many patients were at least 40 years old? Add the last two class frequencies: 10 + 5 = 15 patients, which is 15 ÷ 50 = 0.30, or 30 % of the group. Reading upwards from the bottom of the table gives an at-or-above count, and it is the mirror image of the cumulative column read downwards. The width you chose becomes the width of each bar when the same grouped counts are drawn as a histogram, so unequal widths make a bar look important merely because it is wide, not because it holds more patients. Equal widths avoid that trap, which is why the width rule and the graph rule are really one rule. Finally, when a class is open-ended, such as 70 and over, no midpoint can be fixed and no grouped mean can be trusted; if the summary is meant for calculation, avoid open-ended classes even when they make the table look tidier.