Title
The undue influence of significant p-values on the perceived importance of study results
Date Issued
01 June 2005
Access level
open access
Resource Type
journal article
Author(s)
Bhandari M.
Schemitsch E.H.
Mayo Clinic College of Medicine and Science
Abstract
Background: Statistically significant differences between treatments (i.e., results typically associated with p < 0.05) may not always correspond to important differences upon which to base orthopedic practice. If the hypothesis that p < 0.05 unduly influences the perception of importance of study results were true, we would expect that presenting such a p-value would lead to 1) greater agreement among clinicians about the importance of a study result, and 2) greater perceived importance of a study result, when compared with presenting the same results omitting the p-value. Methods: The participants were 3 orthopedics residents, 5 fellows, and 4 attending orthopedic surgeons at a university hospital. We constructed a 40-item questionnaire with the comparison groups, primary outcome of interest, and the results from each of 40 studies. These studies represent a variety of interventions across orthopedic surgery assessed in 2-group comparative intervention studies (randomized trials, observational studies) and were published between 2000 and 2002 in the Journal of Bone and Joint Surgery-American Volume. For each question, respondents were asked to rate the importance of the study results. Participants answered the questionnaire first without p-values and then, 8 weeks later, with p-values (and a random sample of items without p-values). An intra-class correlation quantified agreement between clinicians when answering items with and without p-values. The difference in mean importance scores between the two presentations was also estimated. Results: Of 40 eligible clinical comparative studies, 30 reported p < 0.05 for their primary comparison. Without presenting p-values, overall agreement regarding clinical significance among reviewers was fair (ICC = 0.35, 95% CI: 0.25-0.49). In the 30 studies with p < 0.05, mean importance scores (1 = low; 3 = high) were greater when p-values were presented (difference 0.6, CI 0.1-1.1). 10 of 12 reviewers perceived results to be more important when presented with significant p-values. Interpretation When significant, p-values unduly influence the perception of clinicians regarding the importance of study results. Copyright © Taylor & Francis 2005.
Start page
291
End page
295
Volume
76
Issue
3
Language
English
OCDE Knowledge area
Salud pública, Salud ambiental Ortopedía
Scopus EID
2-s2.0-22844445223
PubMed ID
Source
Acta Orthopaedica
ISSN of the container
17453674
Sources of information: Directorio de Producción Científica Scopus