13 Research methods, statistics, critical review and evidence-based practice13.9 Differential and analytic statistics

13.9.3 Parametric and non parametric inference

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Written by Resident Doctor Committee · Published

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Shape of a distribution

Interactive

Histogram and box plot of a symptom score200 scores with a mean of 14.54 and a median of 14.44. Right-skewed: the long tail drags the mean above the median, so the median describes the typical person better.02040Mean 14.57.524.2Symptom score
Count of people in each bandMean (solid line)Median (dashed line, and the bar in the box)
Mean
14.54
Median
14.44
Mean minus median
0.10Right-skewed: the long tail drags the mean above the median, so the median describes the typical person better.
Standard deviation
2.87Interquartile range 3.36.
Sample skewness
0.20Zero for a symmetric sample.
Outliers
7Beyond 1.5 interquartile ranges from the nearer quartile.

The scores are scores on an imagined scale that cannot go below zero, which is itself a reason real clinical measures skew to the right: there is a floor but no ceiling.

Start with positive skew and watch the mean sit right of the median, then drag skew to 0 to see them meet. Set n to 30 to see how ragged even a symmetrical small sample looks.

Describing a distribution

  • The normal distribution is symmetrical and bell-shaped, with mean, median and mode equal. Parametric tests such as the t-test assume this shape.

  • Negative skew has a tail stretching to the left, as with a ceiling effect, and pulls the mean below the median.

In the symmetrical distribution the mean, median and mode coincide, while in negative skew the tail stretches to the left and pulls the mean below the median. Diva Jain, CC BY-SA 4.0, via Wikimedia Commons

Measure

Definition

Note

Variance

Average of the squared deviations from the mean

Its units are squared

Standard deviation

Square root of the variance

Same units as the data

Standard error of the mean

Standard deviation divided by the square root of the sample size

Measures the precision of a sample mean and shrinks as the sample grows

What makes a method parametric

  • Parametric methods specify a model through a finite set of parameters. They also handle non-continuous data: logistic regression models binary outcomes and Poisson regression models counts.

  • Non-parametric methods work on ranks and do not assume normally distributed data, unlike t-tests, analysis of variance, least-squares models and Pearson's correlation.

  • Non-parametric methods still need an independent or paired structure and an outcome that can be ordered.

Assumptions of parametric tests

Parametric tests assume independent observations, normally distributed populations and similar variances.

Test

Assumptions

Not an assumption

Student's t-test

Outcome normally distributed in the population sampled

Unpaired groups, unequal group sizes and small samples do not bar it

Analysis of variance

Normal groups, equal variances, independent observations, interval or ratio outcome

Equal population means, which is the null hypothesis under test

  • Welch's t-test drops the equal-variance assumption of the classical pooled t-test.

  • Parametric tests are not specially suited to very small samples whose distribution cannot be verified.

  • Rank tests are not automatically better in tiny samples: with three patients per group, an exact two-sided Mann-Whitney test cannot give a p value below 0.10.

  • A rank test does not remove dependence from repeated measures, matching or clustering.

Checking normality

  • Formal normality tests check whether data follow a normal distribution before a parametric test is used, with normality as the null hypothesis. They include Lilliefors, Shapiro-Wilk, Kolmogorov-Smirnov, Jarque-Bera and Anderson-Darling.

  • Small samples can miss important departures and large samples flag trivial ones, so inspect plots and influential values as well.

Transforming skewed data

  • Logarithmic, cube root, arcsine square root and Box-Cox transformations can pull skewed data towards normality before a parametric test.

  • The log-rank test is a hypothesis test, not a transformation.

  • A log transformation linearises an exponential relationship, so exponential growth becomes a straight line when the logarithm of the variable is plotted against time.

Compare the two panels: raw length of stay is positively skewed with a long right tail, but after a log transformation the same values are roughly symmetrical and bell shaped, suitable for a parametric test. Drawn for MRCPsychiatrist

Rank-based tests

  • The Mann-Whitney U test is the rank-based counterpart of the unpaired, independent-samples t-test. It compares how the two groups are ordered (probability of superiority) and is not generally a test of medians.

  • The Wilcoxon signed rank test uses paired differences and assumes they are symmetrical.

  • The Kruskal-Wallis test compares rank distributions across groups but does not say which pair differs.