Attach importance of the bootstrap t test against Student's t test in clinical epidemiology: a demonstrative comparison using COVID-19 as an example

S Zhao, Z Yang, SS Musa, J Ran… - Epidemiology & …, 2021 - cambridge.org
S Zhao, Z Yang, SS Musa, J Ran, MKC Chong, M Javanbakht, D He, MH Wang
Epidemiology & Infection, 2021cambridge.org
Student's t test is valid for statistical inference under the normality assumption or
asymptotically. By contrast, although the bootstrap t test was proposed in 1993, it is seldom
adopted in medical research. We aim to demonstrate that the bootstrap t test outperforms
Student's t test under normality in data. Using random data samples from normal
distributions, we evaluated the testing performance, in terms of true-positive rate (TPR) and
false-positive rate and diagnostic abilities, in terms of the area under the curve (AUC), of the …
Student's t test is valid for statistical inference under the normality assumption or asymptotically. By contrast, although the bootstrap t test was proposed in 1993, it is seldom adopted in medical research. We aim to demonstrate that the bootstrap t test outperforms Student's t test under normality in data. Using random data samples from normal distributions, we evaluated the testing performance, in terms of true-positive rate (TPR) and false-positive rate and diagnostic abilities, in terms of the area under the curve (AUC), of the bootstrap t test and Student's t test. We explore the AUC of both tests with varying sample size and coefficient of variation. We compare the testing outcomes using the COVID-19 serial interval (SI) data in Shenzhen and Hong Kong, China, for demonstration. With fixed TPR, the bootstrap t test maintained the equivalent accuracy in TPR, but significantly improved the true-negative rate from the Student's t test. With varying TPR, the diagnostic ability of bootstrap t test outperformed or equivalently performed as Student's t test in terms of the AUC. The equivalent performances are possible but rarely occur in practice. We find that the bootstrap t test outperforms by successfully detecting the difference in COVID-19 SI, which is defined as the time interval between consecutive transmission generations, due to sex and non-pharmaceutical interventions against the Student's t test. We demonstrated that the bootstrap t test outperforms Student's t test, and it is recommended to replace Student's t test in medical data analysis regardless of sample size.
Cambridge University Press
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