![]() ![]() This brings attention to the need to consider, and specify, a priori what is and what is not a result that is of value for guiding practice. What measures would we use instead for making causal inferences and for managing bias-what are the alternatives? There have long been discussions among the editors and editorial board members of the Journal of Neurologic Physical Therapy ( JNPT) (and many other journals) about the difference between the concepts of clinical importance versus statistical significance. While the viewpoint that P values should be abandoned is certainly not universally shared among statisticians, and the idea has drawn criticism from a thought leader in evidence-based practice, 2 imagine if we did take to heart the recommendation that we not depend on P values. The recommendation is to provide the precise P value (eg, P = 0.13 as opposed to P > 0.05) to allow readers to gauge the relationship for themselves. More generally, and more importantly, treating significant/nonsignificant as dichotomous outcomes has resulted in a distortion of the evidence. 1 The authors argue that overreliance on P values has led to the misleading conclusion that there are conflicts between studies when one study achieves the conventional threshold P value of 0.05 and a similar study does not. It may be surprising to learn that, in fact, statisticians themselves are concerned about the overinterpretation of statistically significant versus nonsignificant P values Earlier this year the American Statistical Association published a 19-page editorial and a special issue on this topic, calling for an end to use of the phrase “nonsignificant results” as the equivalent of “no effect” or “no difference.” In fact, there is a call for an end to the use of the phrase “statistically significant” altogether. Conversely, the outcomes of a study may be important, while the P value does not reach the level of statistical significance. While, according to the thesaurus, “importance” and “significance” can often be used interchangeably, in research a finding may be statistically significant but not necessarily important. If you're like me, you find joy in identifying the “just right” word to make a point, and so the thesaurus (ok, digital thesaurus these days) is a dear and familiar companion. For many of us, writing is a large part of our professional roles. ![]()
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