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Article . 2009
License: CC BY
Data sources: Datacite
ZENODO
Article . 2009
License: CC BY
Data sources: Datacite
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How often are statistically significant results clinically relevant? Not often

Authors: Heston, Thomas F; Wahl, Richard L;

How often are statistically significant results clinically relevant? Not often

Abstract

Objectives. Statistical significance does not equal clinical significance. This study looked at how frequently statistically significant results in the nuclear medicine literature are clinically relevant. Methods. A Medline search was performed with results limited to clinical trials or randomized controlled trials published in one of the major nuclear medicine journals. Articles analyzed were limited to those reporting continuous variables where a mean (X) and standard deviation (SD) were reported and determined to be statistically significant (p < 0.05). A total of 32 test results were evaluated. Clinical relevance was determined in a two-step fashion. First, the crossover point between groups 1 (normal) and 2 (abnormal) was determined. At this point, a variable is just as likely to fall in the normal distribution as the abnormal distribution. Jacobson's test for clinically significant change was used: crossover point = (SD1 * X2 + SD2 * X1) / (SD1 + SD2). How many SDs from the mean this crossover point fell was then determined. For example, 13.9 +/- 4.5 compared to 9.2 +/- 2.1 was reported as statistically significant (p < 0.05). The crossover point is 10.7, which equals 0.71 std from the mean: 13.9 - (0.71*4.5) = 9.2 + (0.71*2.1). Results. The average crossover point was 0.66 SDs from the mean. The crossover point was within 1 SD from the mean in 26/32 cases and in these cases, averaged 0.45 SD. Thus, for 4 out of 5 statistically significant results, when applied to an individual patient, the cut-off between normal and abnormal was 0.45 SD from the mean. This results in a third of normal patients falling into an abnormal category. Conclusions. Statistically significant results frequently are not clinically significant. Statistical significance alone does not ensure clinical relevance. Citation: Heston TF, Wahl RL. "How Often Are Statistically Significant Results Clinically Relevant? Not Often." Journal of Nuclear Medicine 50, no. supplement 2 (2009): 1370–1370.

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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