Evaluation of the Use of P Values in Neurosurgical Literature: from Statistical Significance to Clinical Irrelevance

Iris S.C. Verploegh, Nicole A. Lazar, Ronald H.M.A. Bartels, Victor Volovici

Research output: Contribution to journalArticlepeer-review

3 Scopus citations

Abstract

The application and interpretation of P values have caused debate for several decades, and this debate has become particularly relevant in the past few years. The P value represents the probability of seeing results as extreme or more extreme than those observed in a data analysis, were the null hypothesis and other underlying assumptions to be true. While P values are useful in pointing out where an effect may be present, they have often been misused in an attempt to oversell “statistically significant” findings. As P values rely on the spread and number of measurements, a smaller P value does not necessarily imply a larger effect size, which is better assessed via an effect estimate and confidence interval interpreted in the context of the study. The clinical relevance of a computed P value is context dependent. We investigated the current use of P values in a small sample of recent neurosurgical literature. Only a minority of manuscripts that reported statistical significance described confounder adjustment, or effect sizes. A common, incorrect assumption often observed was that statistical significance equals clinical relevance. To enable correct interpretation of clinical significance, it is crucial that authors describe the clinical implications of their findings.

Original languageEnglish (US)
Pages (from-to)280-283.e3
JournalWorld neurosurgery
Volume161
DOIs
StatePublished - May 2022

All Science Journal Classification (ASJC) codes

  • Surgery
  • Clinical Neurology

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