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Confidence Intervals Assess Both Clinical Significance and Statistical Significance

1991; American College of Physicians; Volume: 114; Issue: 6 Linguagem: Inglês

10.7326/0003-4819-114-6-515

1539-3704

Leonard E. Brahman,

Health Systems, Economic Evaluations, Quality of Life

Editorials15 March 1991Confidence Intervals Assess Both Clinical Significance and Statistical SignificanceLeonard E. Brahman, PhDLeonard E. Brahman, PhDAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-114-6-515 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptInvestigators sometimes base their claim of superiority for a new treatment over older treatments on statistical significance (Pvalues) without stressing whether there is a real clinical advantage. Not all statistically significant differences are clinically significant (1-3). Fortunately, confidence intervals can address both clinical and statistical significance (1).Annals(4-6) and other journals (1, 7-11) recommend using confidence intervals in reporting the main results of studies. In this editorial, I use hypothetical examples to illustrate point estimates and confidence intervals of the difference between the percentages of patients responding to two treatments for a cancer. These examples show how confidence...References1. Berry G. Statistical significance and confidence intervals [Editorial]. Med J Austr. 1986;144:618-9. CrossrefMedlineGoogle Scholar2. Sackett D, Haynes R, and Tugwell P. Clinical Epidemiology—A Basic Science for Clinical Medicine. Boston: Little, Brown & Co.; 1985. Google Scholar3. Levitt S, Boen J, and Potish R. Rebuttal to letter entitled "Clinical trials: statistical significance and clinical importance." Int J Radiation Oncology Biol Phys. 1981;7:1741-2. CrossrefMedlineGoogle Scholar4. Simon R. Confidence intervals for reporting results of clinical trials. Ann Intern Med. 1986;105:429-35. LinkGoogle Scholar5. Rothman K. Significance questing. Ann Intern Med. 1986;105:445-7. LinkGoogle Scholar6. Braitman L. 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Ann Intern Med. 1991;114:437-44. LinkGoogle Scholar13. Freedman D, Pisano R, and Purves R. Statistics. New York: Norton; 1978. Google Scholar14. Armitage P and Berry G. Statistical Methods in Medical Research. 2d ed. Boston: Blackwell Scientific Publications; 1987. Google Scholar15. Wonnacott R and Wonnacott T. Introductory Statistics. 4th ed. New York: John Wiley & Sons; 1985. Google Scholar16. Rothman K. Modern Epidemiology. Boston: Little, Brown & Co.; 1986. Google Scholar17. Fletcher R, Fletcher S, and Wagner E. Clinical Epidemiology: The Essentials. 2d ed. Baltimore: Williams & Wilkins; 1988. Google Scholar18. Anscombe F. The summarizing of clinical experiments by significance levels. Statistics in Medicine. 1990;9:707. CrossrefGoogle Scholar19. Shott S. Statistics for Health Professionals. Philadelphia: W.B. Saunders Company; 1990:73-4. Google Scholar20. Box G, Hunter W, and Hunter J. Statistics for Experimenters: An Introduction to Design, Data Analysis and Model Building. 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