Adrian Esterman

Please keep media enquiries between 8am and 8pm ACT.

Welcome to my home page. I hope you enjoy your visit.

My favourite quotations/poem

"Together we can achieve more than we ever could alone"

Unknown

My latest article in The Conversation 

A (hopefully) amusing article about statistical errors

A little bit about me

I attended Beal Grammar School for Boys in Essex, UK, and left to start work at the age of 16. After several years working as a junior clerk, I enrolled in an Honours degree in Statistics at the University of Bath, graduating in 1972.  This was followed by a Masters degree in Medical Statistics at the London School of Hygiene and Tropical Medicine in 1973, supervised by Professor Peter Armitage. I then took up a Junior Research Fellowship at the University of Aberdeen medical school in late 1973 before joining the World Health Organization in 1974. I worked for 5 years at the WHO head office in Geneva, followed by 2 years at the WHO European Regional Office in Copenhagen.

In 1981 I moved to Australia and worked for many years in the South Australian Department of Health as Principal Epidemiologist. In the mid-1990’s, I took a break from epidemiology, and became Managing Director of a market research company. This gave me great experience in survey research, and qualitative research, as well as HR management and sales. However, I eventually moved back into academic life, and in 2002 I received my PhD in epidemiology from Flinders University.

At the University of South Australia, one of my main roles is to provide advice on biostatistics and epidemiology to researchers in the health and medical areas. I am also a Chief Investigator on several research grants. I am the author of over 400 publications and have an h-index of 78. I am experienced at mentoring Research Fellows and junior staff, and of course PhD students. I am ranked by ScholarGPS in the top 0.5% of all scholars worlwide. In 2023 I was awarded Life Membership of the Australasian Epidemiological Association for my services to the AEA and epidemiology in Australia and New Zealand.

I really enjoy writing, and have written a number of articles about epidemiology and COVID-19 on the Medium  website. I have also written over 30 articles for The Conversation about COVID-19 and other topics, with over 2.5 million reads.  I have published a book on PhD supervision. I used to be an an avid tweeter with over 38,000 followers, but have now left X and joined BueSky, a more pleasant alternative, with the handle @profesterman. I also give presentations on the current COVID-19 situation to community, business, academic and professional groups.

If you wish to visit me in person (post-COVID-19), it is worth your time checking this link:

How to read a Professor's door

Favourite Music

Barber Violin Concerto

Korngold Violin Concerto

Shostakovic Second Piano Conecto

Anything by Rachmaninov

Anything by Elgar

Favourite Movies 

Blade Runner (1982) 

Never Let Me Go (2010)

The Silence of the Lambs (1991)

Favourite Reading

Any good fantasy series.

PhD Supervision

My supervision philosophy is based on a wonderful poem by William Butler Yates:

I would spread the cloths under your feet

But I, being poor, have only my dreams

I have spread my dreams under your feet

Tread softly because you tread on my dreams.

My students have come from all areas of health, dentistry, or medicine - usually with an interest in evidence-based practice. I have so far had 38 PhD students successfuly complete, two of them winning the Ian Davies university prize for best thesis, and several now full professors. I have been nominated by the University of South Australia for a national award for my PhD supervison. 

Current PhD students as Principal Supervisor

2019   Milina Crevar   Nutrition, contents and health warning labels on alcohol containers

Current PhD students as Co-supervisor

2021   Ethel Osazuwa   Rebuilding Life After Migration: Settlement Experiences of Refugee and Migrant Youth

2022  Tirani Kodippili   Examining the acculturation process of South Asian migrant youth and their parents in Australia

Current masters by Research as Co-supervisor

2022  Thomas Gleeson-Hammerton   Point-of-care ultrasound (POCUS) assessment of pre-hospital patients with suspected or confirmed COVID-19

A little bit about biostatistics

Biostatistics is somewhat different to the discipline of statistics in that biostatisticians are usually trained in university departments of public health, whereas statisticians are trained in university schools of mathematics and statistics. As well as standard statistical procedures, biostatisticians are experts in the design and analysis of clinical trials, the analysis of rates of disease, measures of the association between exposures and outcome, survival analysis, diagnostic testing, disease clustering and surveillance, disease screening, reliability and method comparison studies and biological assays. The statistical analysis of genetic studies has formed its own discipline called bioinformatics, which is somewhat different. The University of Adelaide is part of the Biostatistics Collaboration of Australia (BCA), and a Master of Biostatistics through the BCA qualifies you as a professional biostatistician.

A little bit about epidemiology

Epidemiology is the study of diseases in populations. The majority of epidemiologists start with a medical degree, followed by postgraduate qualifications and training in public health and epidemiology. However, epidemiologists may also originally have started with degrees in medical statistics (like myself), psychology, nursing or many other discipline areas. Much of epidemiology is about the association between an exposure factor (which might be a risk factor like smoking, or an intervention) and an outcome (usually a disease).

This wonderful cartoon is definitely worth viewing:

How exposures are related to outcomes

Textbooks

I am often asked to recommend a good textbook. So here are my current thoughts:

• Basic biostatistics: Essential medical statistics by Kirkwood and Sterne
• Advanced biostatistics: Statistical methods in medical research by Armitage, Berry and Mathews
• Basic epidemiology: Epidemiology by Petra Buttner and Reinhold Muller
• Advanced epidemiology: Epidemiology: Study design and data analysis by Mark Woodward 

For those looking for free statistical software. I can highly recommend jamovi, which including addons which you can download, has a surprising number of features, and can directly import from Excel, SPSS and Stata. You can download it here:

https://www.jamovi.org/

Current grants

Berryman C, Moseley L, Bernardo C, Burke A, Leake H, Ferencz N, De Morgan S, Lord S, Gwilt I, Hibbert P, Wallwork S, Mumford V, Jennings A, Esterman A. INcorporating co-design and sysTEms thinking to GeneRate, implement and evaluATE an improved model of care for youth with chronic pain (INTEGRATE). 2023 MRFF Multidisciplinary Models of Primary Care Stream 4 (ID 204082). $2,604,235. 2025-2029.

Shekhawat R, Shoushtarian M, Lopez-Escamez A, Datta A, Esterman A, Battersby M, Pope K.  Novel Tinnitus Management Combining Brain Stimulation and Hearing Aids with Genetic and Epigenetic Biomarkers. NHMRC Ideas Grant (ID 2037740). $2,237,869.40 2025-2029. Through Flinders University.

Carson-Chahhoud KV, Tai A, Sandford D, Shah S, Mayer W, Segal L, Perveen S, O’Connor A, Tingey-Holyoak J, Sharrad K, Esterman A, Crutzen R, Hamari J, Cao J, Smith R, Gwilt I, Chong A, Henderson M. Clinical trial to evaluate a digital self-management and mental health intervention for young people with asthma and their families. WCH Foundation 2023 Bloom Grant Round. App ID: BRP18. $1,395,044.00; 3-years

Mikocka-Walus A, McCaffrey N, Evans S, Knowles S, Andrews J, Esterman A, Fuller- Tyszkiewicz M. Grant Opportunity: 2021 MRFF Clinical Trials Activity: Randomized E-hypnotherapy for Chronic Pelvic Pain Syndrome Trial (REST). $1,300,459 2023 – 2028. (Application ID: 2022322). Through Deakin University.

Maher C, Bogomolva S, Esterman A, Curtis R. Improving physical activity and screen time in Outside School Hours Care through evidence-based guidelines: an effectiveness-implementation hybrid trial. NHMRC Partnership Grant.  $1,398,57. 2022-2026 (App 1105454).

Maher C, Christian H, Esterman A, Nathan N, Rosenkranz R, Lewis L, Cliff D, Milte R, Curtis R. A multi-site guideline implementation randomised controlled trial to improve physical activity and screen time in Out of School Hours Care. MRFF - PPHR Initiative - 2020 Maternal First 2000 Days and Childhood Health. $1,499,840 2022-2025 (APP 2007395).

Nguyen T, Brodaty H, Xiao L, Brijnath B, Schofield P, Esterman A, Crotty M, Andrade A, Bhar S, Kurrle S. e-DiVA (empowering Dementia Carers with an iSupport Virtual Assistant). NHMRC e-Asia. $1,857,364 2021 – 2025 (APP 105614).

Hillier S, Olds T, Maher C, Gill T, Esterman A, Khadka J, Adams R, Hill C, Keogh J.   Healthy Choices: Co-designed community programs to enhance healthy lifestyle choices for people with chronic conditions Medical Research Future Fund (MRFF) – Preventive and Public Health Research Initiative. $780,670. 2020 – 2025. (APP 105492).

2025 Publications

1. Simpson N, Vernon R, Briley A, Esterman A, Steen M. Evaluating the effectiveness of a conflict resolution and resilience building bespoke educational workshop for South Australia midwifery students: A pre-post measure education study. Midwifery (2025), doi: https://doi.org/10.1016/j.midw.2025.104436.
2. Nguyen P, Indelicato D, Esterman A, Paulino A, Ermoian R, Laack N, Perkins S, Mangona V, Mihalcik S, Lee J, Hill-Kayser C, Kwok Y, Han-Chih Chang J, Perentesis J, MacEwan I, Le H, Yock T. Acute Toxicities of Proton Craniospinal Irradiation in Pediatric Medulloblastoma: A Pediatric Proton/Photon Consortium Registry (PPCR) Study. International Journal of Particle Therapy (2025) ISSN 2331-5180, https://doi.org/10.1016/j.ijpt.2025.100747.
3. Kodippili T, Ziaian T, Puvimanasinghe, Esterman A, Clark Y. Family dynamics and psychological wellbeing of South Asian migrant youth in Australia. Journal of Family Studies, 1–25. https://doi.org/10.1080/13229400.2025.2469064.
4. Bahrami B, Macri C, Esterman A, Goggin M. Increasing intraocular lens exchange rates in Australia 2003-2022. Clinical and Experimental Ophthalmology (Accepted for publication 17 February 2025).
5. Askew CD, Windsor M, Feka K, Russell FD, Schaumberg M, Walker MA, Neal B, Esterman A, Litewka L, Golledge J; Foot-PAD Trial Group. Single-centre, double-blinded, randomised placebo-controlled trial to determine the effect of a 12-week home-based programme of footplate neuromuscular electrical stimulation on walking capacity in people with peripheral artery disease: a protocol for the Foot-PAD trial. BMJ Open. 2025 Jan 25;15(1):e093162. doi: 10.1136/bmjopen-2024-093162. PMID: 39863411.
6. Gleeson-Hammerton T, Pearce J, Eckert M, Esterman A, Peters MD. Paramedic assessment of suspected or confirmed COVID-19 patients in the out-of-hospital environment: a scoping review protocol. JBI Evid Synth. 2025 Jan 7. doi: 10.11124/JBIES-24-00069. Online ahead of print. PMID: 39763382
7. Gibson K, Smith A, Sharp R, Ullman A, Morris S, Esterman A. Adverse events associated with umbilical vascular catheters in the neonatal intensive care unit: a retrospective cohort study. Australian Critical Care 2025 Jan 18;38(3):101146. doi: 10.1016/j.aucc.2024.101146. Online ahead of print.PMID: 39827575.

STATISTICAL TIPS

Multiple testing

The concern when testing m hypotheses simultaneously is to control the familywise error rate, the probability of making any false discovery.  For example, if you undertake 10 hypothesis tests, each at the p=0.05 level, then the chance of any one not being statistically significant is 0.95. The probability of all 10 not being statistically is 0.95^10 = 0.60. Hence the probability of at least one being statistically significant by chance is 0.40. In other words, there is a 40% chance of a false positive.

To avoid this, we adjust the p-values to take into account multiple testing. For example, suppose you conducted 5 hypothesis tests, and obtained the following p-values.

Hypothesis                    3                4              1                    2                  5

Original p-values        0.003        0.008       0.013        0.048       0.233 

Without any adjustment, we would reject the null hypothesis of no difference for hypotheses 3, 4, 1 and 2.

The simplest adjustment that can be made is that attributed to Bonferroni. Here you simply divide the nominal p-value (0.05) by the number of tests and use that as the criterion. In our case, since there were 5 tests, we would compare the result of each test to 0.05/5=0.01, and that would be our new criterion.  In that case, only hypotheses 3 and 4 would be stataistically significant.

However, Bonferroni has been shown to be overly conservative, and a better adjustment called the Holme-Bonferroni can be used. First sort the m p-values into size order as above. Then compare the most significant against 0.05/m, the next against 0.05/(m-1), the next 0.05/(m-2) etc. Now hypotheses 3, 4 and 1 are statistically significant. 

 Finally, we can use a technique that controls the false discovery rate (FDR). There are many methods for doing this, but the one I recommend is by Benjamani, Krieger and Yekutieli (2006). There is a Stata do file for obtaining these adjusted p-values called fdr_sharpened_qvalues.do which I can supply if you contact me. It uses a method called sharpened q-values.

Hypothesis                    3                4              1                    2                5

Original p-values        0.003        0.008       0.013        0.048       0.233 

Sharpened q-values   0.016        0.017       0.018        0.025       0.064

The conclusions are the same as when using the unadjusted p-values.  So, you can see that the sharpened q-value method is the most powerful of adjustments for multiple testing.

Australasian Epidemiology Association (AEA)

Clinical Oncological Society of Australia (COSA)

Australian Vascular Access Society

Qualifications

• Doctor of Philosophy Flinders University

• Master of Science (Medical Statistics) University of London

• Postgraduate Diploma London School of Hygiene and Tropical Medicine

• Bachelor of Science (Honours) University of Bath