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2018 ; 126
(3
): 1068-1072
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gab.com Text
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English Wikipedia
Statistical Significance Versus Clinical Importance of Observed Effect Sizes:
What Do P Values and Confidence Intervals Really Represent?
#MMPMID29337724
Schober P
; Bossers SM
; Schwarte LA
Anesth Analg
2018[Mar]; 126
(3
): 1068-1072
PMID29337724
show ga
Effect size measures are used to quantify treatment effects or associations
between variables. Such measures, of which >70 have been described in the
literature, include unstandardized and standardized differences in means, risk
differences, risk ratios, odds ratios, or correlations. While null hypothesis
significance testing is the predominant approach to statistical inference on
effect sizes, results of such tests are often misinterpreted, provide no
information on the magnitude of the estimate, and tell us nothing about the
clinically importance of an effect. Hence, researchers should not merely focus on
statistical significance but should also report the observed effect size.
However, all samples are to some degree affected by randomness, such that there
is a certain uncertainty on how well the observed effect size represents the
actual magnitude and direction of the effect in the population. Therefore, point
estimates of effect sizes should be accompanied by the entire range of plausible
values to quantify this uncertainty. This facilitates assessment of how large or
small the observed effect could actually be in the population of interest, and
hence how clinically important it could be. This tutorial reviews different
effect size measures and describes how confidence intervals can be used to
address not only the statistical significance but also the clinical significance
of the observed effect or association. Moreover, we discuss what P values
actually represent, and how they provide supplemental information about the
significant versus nonsignificant dichotomy. This tutorial intentionally focuses
on an intuitive explanation of concepts and interpretation of results, rather
than on the underlying mathematical theory or concepts.