Sample size determination: Principles and applications for health research

Authors

DOI:

https://doi.org/10.71357/hsij.v3i1.63

Keywords:

Sample size determination, Statistical power, Confidence levels, WHO guidelines, Research methodology

Abstract

Background: Determining an appropriate sample size is a crucial aspect of research design, ensuring validity, reliability, and generalizability of findings. An inadequate sample size increases the risk of Type II errors, while an excessively large sample may lead to resource inefficiencies and a higher likelihood of Type I errors. Understanding the principles of sample size determination, including statistical power, confidence levels, and margin of error, is essential for producing accurate and meaningful research outcomes.

Objective: This review explores the principles of sample size determination, calculation methods for various research designs, and practical applications. It also discusses challenges in determining the optimal sample size and examines international guidelines, such as those issued by the World Health Organization (WHO), to enhance the accuracy and credibility of research findings.

Discussion: Sample size determination varies depending on research design, including surveys, experiments, and clinical trials. This review highlights key statistical considerations such as confidence intervals, statistical power, and the role of design effects. Additionally, practical challenges such as resource constraints, parameter misestimation, and population diversity are discussed. Technological advancements, including statistical software, are also examined for their role in improving sample size calculations and research efficiency.

Conclusion: Adhering to established principles and leveraging modern tools for sample size determination enables researchers to optimize study designs and enhance the validity of findings. Implementing international guidelines minimizes bias and ensures the robustness of results. Ultimately, accurate sample size estimation contributes to high-quality scientific studies that support evidence-based decision-making and progress across various disciplines.

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References

Biau, D. J., Kernéis, S., & Porcher, R. (2008). Statistics in brief: The importance of sample size in the planning and interpretation of medical research. Clinical Orthopaedics and Related Research, 466(9), 2282–2288. https://doi.org/10.1007/s11999-008-0346-9

Celentano, D. D., & Szklo, M. (2018). Gordis Epidemiology (6th ed.). Elsevier.

Charan, J., & Biswas, T. (2013). How to calculate sample size for different study designs in medical research? Indian Journal of Psychological Medicine, 35(2), 121–126. https://doi.org/10.4103/0253-7176.116232

Cochran, W. G. (1977). Sampling techniques. John Wiley & Sons.

Cohen, J. (2013). Statistical power analysis for the behavioral sciences. Routledge. https://doi.org/10.4324/9780203771587

Conroy, R. (n.d.). Sample Size - A rough Guide. NDI. Retrieved February 15, 2025, from https://www.ndi.org/sites/default/files/samplesizecalculation.pdf?utm_source=chatgpt.com

Daniel, W. W., & Cross, C. L. (2013). Biostatistics: A foundation for analysis in the health sciences (10th edition). John Wiley & Sons.

Desachy, T., Thevenet, M., Garcia, S., Lightning, A., Didier, A., Mandairon, N., & Kuczewski, N. (2024). Enhancing statistical power while maintaining small sample sizes in behavioral neuroscience experiments evaluating success rates. https://doi.org/10.1101/2024.07.25.605060

Faul, F., Erdfelder, E., Lang, A.-G., & Buchner, A. (2007). G*Power 3: A flexible statistical power analysis program for the social, behavioral, and biomedical sciences. Behavior Research Methods, 39(2), 175–191. https://doi.org/10.3758/BF03193146

Friedman, L. M., Furberg, C. D., DeMets, D. L., Reboussin, D. M., & Granger, C. B. (2015). Fundamentals of clinical trials. Springer International Publishing. https://doi.org/10.1007/978-3-319-18539-2

Hoshaw-Woodard, S. (2001). Description and comparison of the methods of cluster sampling and lot quality assurance sampling to assess immunization coverage. Department of Vaccones and Biologicals - WHO.

Kim, H.-Y. (2016). Statistical notes for clinical researchers: Sample size calculation 1. comparison of two independent sample means. Restorative Dentistry & Endodontics, 41(1), 74. https://doi.org/10.5395/rde.2016.41.1.74

Kraemer, H. C., & Blasey, C. (2016). How many subjects?: Statistical power analysis in research. SAGE Publications, Ltd. https://doi.org/10.4135/9781483398761

Lakens, D. (2022). Sample size justification. Collabra: Psychology, 8(1). https://doi.org/10.1525/collabra.33267

Lohr, S. L. (2019). Sampling. Chapman and Hall/CRC. https://doi.org/10.1201/9780429296284

Lohr, S. L. (2021). Sampling - Design and analysis. Chapman and Hall/CRC. https://doi.org/10.1201/9780429298899

Lwanga, S. K., Lemeshow, S., & World Health Organization. (1991). Sample size determination in health studies: A practical manual. World Health Organization.

Maxwell, S. E., Kelley, K., & Rausch, J. R. (2008). Sample size planning for statistical power and accuracy in parameter estimation. Annual Review of Psychology, 59(1), 537–563. https://doi.org/10.1146/annurev.psych.59.103006.093735

Moser, C. A., & Kalton, G. (2017). Survey methods in social investigation. Routledge. https://doi.org/10.4324/9781315241999

Parsaeian, M., Mahdavi, M., Saadati, M., Mehdipour, P., Sheidaei, A., Khatibzadeh, S., Farzadfar, F., & Shahraz, S. (2021). Introducing an efficient sampling method for national surveys with limited sample sizes: application to a national study to determine quality and cost of healthcare. BMC Public Health, 21(1), 1414. https://doi.org/10.1186/s12889-021-11441-0

Patel, D. (2024). Sample size estimation in clinical trials. National Journal of Community Medicine, 15(06), 503–508. https://doi.org/10.55489/njcm.150620243815

Schober, P., & Vetter, T. R. (2019). Sample size and power in clinical research. Anesthesia & Analgesia, 129(2), 323–323. https://doi.org/10.1213/ANE.0000000000004316

Shreffler, J., & Huecker, M. R. (2025). Type I and type II errors and statistical power. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing

Sivasamy, S. (2023). Sample size considerations in research. Endodontology, 35(4), 304–308. https://doi.org/10.4103/endo.endo_235_23

Sullivan, G. M., & Feinn, R. (2012). Using effect size—or why the p value is not enough. Journal of Graduate Medical Education, 4(3), 279–282. https://doi.org/10.4300/JGME-D-12-00156.1

Vasudevan, S. (2024). Sample size calculation in various medical research. International Journal of Medical Sciences and Nursing Research, 4(3), 22–29. https://doi.org/10.55349/ijmsnr.2024432229

Wang, X., & Ji, X. (2020). Sample size estimation in clinical research. Chest, 158(1), S12–S20. https://doi.org/10.1016/j.chest.2020.03.010

Weissgerber, T. L., Garovic, V. D., Milin-Lazovic, J. S., Winham, S. J., Obradovic, Z., Trzeciakowski, J. P., & Milic, N. M. (2016). Reinventing biostatistics education for basic scientists. PLOS Biology, 14(4), e1002430. https://doi.org/10.1371/journal.pbio.1002430

WHO. (2008). WHO child growth standards : Training course on child growth assessment. WHO.

Yin, G., Li, A., & Verger, A. (2017). Spatiotemporally representative and cost-efficient sampling design for validation activities in wanglang experimental site. Remote Sensing, 9(12), 1217. https://doi.org/10.3390/rs9121217

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Published

2025-02-28

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How to Cite

Mukti, B. H. . (2025). Sample size determination: Principles and applications for health research. Health Sciences International Journal, 3(1), 127-143. https://doi.org/10.71357/hsij.v3i1.63

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