Alternatives to the P value: connotations of significance.

Junyong In, Dong Kyu Lee
Author Information
  1. Junyong In: Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.
  2. Dong Kyu Lee: Department of Anesthesiology and Pain Medicine, Dongguk University Ilsan Hospital, Goyang, Korea.

Abstract

The statistical significance of a clinical trial analysis result is determined by a mathematical calculation and probability based on null hypothesis significance testing. However, statistical significance does not always align with meaningful clinical effects; thus, assigning clinical relevance to statistical significance is unreasonable. A statistical result incorporating a clinically meaningful difference is a better approach to present statistical significance. Thus, the minimal clinically important difference (MCID), which requires integrating minimum clinically relevant changes from the early stages of research design, has been introduced. As a follow-up to the previous statistical round article on P values, confidence intervals, and effect sizes, in this article, we present hands-on examples of MCID and various effect sizes and discuss the terms statistical significance and clinical relevance, including cautions regarding their use.

Keywords

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MeSH Term

Humans
Minimal Clinically Important Difference
Probability
Research Design
Clinical Trials as Topic
Data Interpretation, Statistical
Confidence Intervals

Word Cloud

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