The sample size is the number of observational units included in a study or assigned to a specified study arm.
For equal independent binomial samples, the displayed normal-approximation size per group targets a two-sided significance level and power at specified alternative rates, with . Its first variance term sets the null critical value and its second the alternative distribution. A numerical sample size is not determined by an effect ratio alone; power, sidedness, allocation and baseline rates must also be specified. Rare-event discreteness and clustered designs can materially change the achieved power.
Suppose each collaborating centre contributes independently randomized participants per arm with specified event probabilities. At 50% statistical power, the usual normal-approximation alternative quantile is zero. The required size per arm is , with for a two-sided test or for a one-sided test. Divide by the per-centre arm size and round up. Endpoints must use the same time origin and follow-up window, and cluster dependence requires an additional adjustment.
A sample size calculation for a binary endpoint requires its own baseline probability, not merely the rate of a related outcome. A fatal-event probability equals the probability of the underlying event times its conditional fatality probability; knowing only that product does not identify the incidence of all events. Thus a mortality rate can size a mortality trial but cannot determine the size for all fatal and nonfatal events without further assumptions. The significance level, allocation, target statistical power and effect definition must also be specified.
For a one-sided normal-mean test of size with known standard deviation , a positive alternative and target statistical power , the required sample size is the ceiling of . This follows by shifting the standard normal quantile in the alternative rejection probability.

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