The development of a statistical computer software resource for medical research
Medical research is often weakened by poor statistical practice, and inappropriate use of statistical computer software is part of this problem. The statistical knowledge that medical researchers require has traditionally been gained in both dedicated and ad hoc learning time, often separate from the research processes in which the statistical methods are applied. Computer software, however, can be written to flexibly support statistical practice. The work of this thesis was to explore the possibility of, and if possible, to create, a resource supporting medical researchers in statistical knowledge and calculation at the point of need. The work was carried out over eleven years, and was directed towards the medical research community in general. Statistical and Software Engineering methods were used to produce a unified statistical computational and knowledge support resource. Mathematically and computationally robust approaches to statistical methods were continually sought from current literature. The type of evaluation undertaken was formative; this included monitoring uptake of the software and feedback from its users, comparisons with other software, reviews in peer reviewed publications, and testing of results against classical and reference data. Large-scale opportunistic feedback from users of this resource was employed in its continuous improvement. The software resulting from the work of this thesis is provided herein as supportive evidence. Results of applying the software to classical reference data are shown in the written thesis. The scope and presentation of statistical methods are considered in a comparison of the software with common statistical software resources. This comparison showed that the software written for this thesis more closely matched statistical methods commonly used in medical research, and contained more statistical knowledge support materials. Up to October 31st 2000, uptake of the software was recorded for 5621 separate instances by individuals or institutions. The development has been self-sustaining. Medical researchers need to have sufficient statistical understanding, just as statistical researchers need to sufficiently understand the nature of data. Statistical software tools may damage statistical practice if they distract attention from statistical goals and tasks, onto the tools themselves. The work of this thesis provides a practical computing framework supporting statistical knowledge and calculation in medical research. This work has shown that sustainable software can be engineered to improve statistical appreciation and practice in ways that are beyond the reach of traditional medical statistical education.