Skip to main content
Log in

Sample Size Matters: A Guide for Surgeons

  • Published:
World Journal of Surgery Aims and scope Submit manuscript

Abstract

Considerations of sample size computations in the medical literature have gained increasing importance over the past decade and are now often mandatory for scientific grant proposals, protocols, and publications. However, many surgeons are ill-prepared to understand the parameters on which the appropriate sample size is based. The present article has several objectives: first, to review the need for sample size considerations; second, to explain the ingredients necessary for sample size computations in simple, nonmathematic language; third, to provide options for reducing the sample size if it seems impracticably large; and fourth, to help avoid some of the more common mistakes encountered when computing sample sizes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. J Lerman (1996) ArticleTitleStudy design in clinical research: sample size estimation and power analysis Can. J. Anaesth 43 184–191 Occurrence Handle8825545

    PubMed  Google Scholar 

  2. D Moher CS Dulberg GA Wells (1994) ArticleTitleStatistical power, sample size, and their reporting in randomized controlled trials JAMA 272 122–124 Occurrence Handle10.1001/jama.272.2.122 Occurrence Handle8015121

    Article  PubMed  Google Scholar 

  3. P Vandekerckhove PA O’Donovan RJ Lilford et al. (1993) ArticleTitleInfertility treatment: from cookery to science: The epidemiology of randomised controlled trials Br. J. Obstet. Gynaecol 100 1005–1036 Occurrence Handle8251450

    PubMed  Google Scholar 

  4. HC Williams P Seed (1993) ArticleTitleInadequate size of ‘negative’ clinical trials in dermatology Br. J. Dermatol 128 317–326 Occurrence Handle8471517

    PubMed  Google Scholar 

  5. S Sheps (1993) ArticleTitleSample size and power J. Invest. Surg 6 469–475 Occurrence Handle8123607

    PubMed  Google Scholar 

  6. Guller, U, Delong, ER (2004) “Interpreting statistics in medical Literature: A vade mecum for surgeons.” J Am Coll Surgeons 198: 441

    Google Scholar 

  7. JM Bland DG Altman (1994) ArticleTitleOne and two sided tests of significance B.M.J. . 309–248

    Google Scholar 

  8. PC O’Brien MA Shampo (1981) ArticleTitleStatistics for clinicians. 8. Comparing two proportions: the relative deviate test and chi-square equivalent Mayo. Clin. Proc. 56 513–515 Occurrence Handle7266061

    PubMed  Google Scholar 

  9. DM Berwick (1980) ArticleTitleExperimental power: the other side of the coin Pediatrics 65 1043–1045 Occurrence Handle7367119

    PubMed  Google Scholar 

  10. SN Goodman (1999) ArticleTitleToward evidence-based medical statistics 1. The P value fallacy. Ann. Intern. Med 130 995–1004

    Google Scholar 

  11. G Guyatt R Jaeschke N Heddle et al. (1995) ArticleTitleBasic statistics for clinicians. 1. Hypothesis testing Csan. Med. Assac. J. Grasi 152 27–32

    Google Scholar 

  12. JA Freiman TC Chalmers H Smith SuffixJr et al. (1978) ArticleTitleThe importance of beta, the type II error and sample size in the desigrand interpretation of the randomized control trial: survey of 71 “negative” trials N. Engl. J. Med 299 690–694 Occurrence Handle355881

    PubMed  Google Scholar 

  13. TV Perneger (1998) ArticleTitleWhat’s wrong with Bonferroni adjustments B. M. J. 316 1236–1238

    Google Scholar 

  14. JM Pascoe (1981) ArticleTitleWas it a type II error? Pediatrics 68 149–150

    Google Scholar 

  15. PM Fayers D Machin (1995) ArticleTitleSample size: how many patients are necessary? Br J. Cancer 72 1–9 Occurrence Handle7599035

    PubMed  Google Scholar 

  16. DG Altman (1998) ArticleTitleStatistical reviewing for medical journals Stat. Med. 17 2661–2674 Occurrence Handle10.1002/(SICI)1097-0258(19981215)17:23<2661::AID-SIM33>3.3.CO;2-2 Occurrence Handle9881413

    Article  PubMed  Google Scholar 

  17. SN Goodman JA Berlin (1994) ArticleTitleThe use of predicted confidence intervals when planning experiments and the misuse of power when interpreting results Ann. Intem. Med. 121 200–206

    Google Scholar 

  18. R Lilford D Braunholtz J Harris et al. (2004) ArticleTitleTrials in surgery Br. J. Surg. 91 6–16 Occurrence Handle10.1002/bjs.4418 Occurrence Handle14716788

    Article  PubMed  Google Scholar 

  19. J Wittes E Brittain (1990) ArticleTitleThe role of internal pilot studies in increasing the efficiency of clinical trials Stat. Med. 9 65–72 Occurrence Handle2345839

    PubMed  Google Scholar 

  20. PC O’Brien MA Shampo (1981) ArticleTitleStatistics for clinicians. 5. One sample of paired observations (paired t test) Mayo Clin-Proc. 56 324–326 Occurrence Handle7015027

    PubMed  Google Scholar 

  21. R Peto MC Pike P Armitage et al. (1976) ArticleTitleDesign and analysis of randomized clinical trials requiring prolonged observation of each patient. I. Introduction and design Br. J. Cancer 34 585–612 Occurrence Handle795448

    PubMed  Google Scholar 

  22. TR Church JS Ederer F.andel et al. (1993) ArticleTitleEstimating the duration of ongoing prevention trials Am. J. Epidemiol 137 797–810 Occurrence Handle8484371

    PubMed  Google Scholar 

  23. F Ederer TR Church JS Mandel (1993) ArticleTitleSample sizes for prevention trials have been too small Am. J. Epidemiol 137 787–796 Occurrence Handle8484370

    PubMed  Google Scholar 

  24. R Simon DG Altman (1994) ArticleTitleStatistical aspects of prognostic factor studies in oncology Br. J. Cancer 69 979–985 Occurrence Handle8198989

    PubMed  Google Scholar 

  25. SJ Pocock MD Hughes RJ Lee (1987) ArticleTitleStatistical problems in the reporting of clinical trials: a survey of three medical journals N. Engl. J. Med 317 426–432 Occurrence Handle3614286

    PubMed  Google Scholar 

Download references

Acknowledgments

The authors thank Jonathan McCall for carefully reading the manuscript and making many valuable suggestions.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ulrich Guller M.D., M.H.S..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Guller, U., Oertli, D. Sample Size Matters: A Guide for Surgeons . World J. Surg. 29, 601–605 (2005). https://doi.org/10.1007/s00268-005-7921-y

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00268-005-7921-y

Keywords

Navigation