Statistical and Clinical Significance Essay

The primary goal of analytical quantitative research is to generate valid results from representative samples that can be generalized to target populations. Such generalizations are based on statistical inferences that researchers make about the nature of the relationship(s) that they examine. While one can’t deny the invaluable role of statistical inference in research reporting, nurse researchers - particularly novice nurse researchers – need to be cautious not to overplay the statistical significance of research findings while ignoring the clinical significance of such findings. This is important because, after all, the ultimate goal of nursing research is to generate findings that are of clinical or real life value to nursing theory and practice. Statistical and Clinical Significance Essay.

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In this short article, I will briefly explain the concepts of statistical and clinical significance in nursing research in an attempt to highlight the equal importance of both concepts when making conclusions about research findings. Doing so is extremely important because a statistically significant finding that has a limited clinical significance has little if any benefit to nursing practice. Likewise, a clinically significant finding that is not statistically significant is a function of chance and its observed size is essentially zero. Statistical and Clinical Significance Essay.

Statistical significance refers to one’s decision to reject the null hypothesis based on a predetermined criterion (e.g., a 2-tailed alpha of 0.05 or 95% confidence interval). It allows researchers to make statistical inference from the study findings about the true parameter or population value. A statistically significant result simply indicates that the observed effect is not likely due to chance. For instance, when one makes statistical inference based on p values, he/she will report a statistically significant result if the reported p value is equal or less than the study’s predetermined alpha level. A p value greater than the alpha level are not statistically significant; indicating that the observed results (e.g., difference or correlation) are likely due to chance. Statistical and Clinical Significance Essay.

Clinical significance pertains to the practical real life importance or benefits of research findings. It often measures the magnitude of the relationship between the independent variable and the outcome variable. It answers whether or not the change one may observe in the outcome as a result of the proposed intervention or exposure is big enough to warrant real life implications. Judgement of clinical significance depends on the nature of the research outcome under investigation. Common indicators of clinical significance may include - but are not limited to - correlation coefficients, amount of shared variance, mean difference, odds ratio, relative risk, risk reduction, and hazard ratio. Other indicators of clinical significance may include cost, patient values, and quality of life associated with the outcome. Statistical and Clinical Significance Essay.

To illustrate the important link between statistical and clinical significance in nursing research, let us consider a fictitious scenario in which a nurse researcher studies the impact of administering a one-on-one post-operative educational program on the risk of developing post-operative complications. In this scenario, our nurse randomly assigns patients to a standard post-operative education group (control group) and one-on-one post-operative education group (treatment group); assuming that the outcome variable is measured on a binary scale as post-operative complication versus no post-operative complication. At the end of the study, our nurse researcher reports a significant difference in the rate of post-operative complications between the two groups (p = 0.035). While this result leads one to infer that the observed difference in post-operative complications between the study groups in not likely due to chance, it only tells part of the story. What is the clinical implication of this finding from a practical point view; one shall ask! It is important therefore to look into whether or not this statistically significant finding was of any clinical value. Statistical and Clinical Significance Essay.

Let us now assume that the study findings above indicated that the rate of post-operative complications was 30% in the control group as opposed to 27% in the treatment group. Given the relatively high rate of complications in the control group, this modest reduction of 3% may carry little if any clinical significance to the practicing nurse or hospital administrator. This will be especially true if the cost and time associated with the proposed one-on-one education program was considerably high. Therefore, a reasoned nurse researcher will likely discuss this statistically significant finding with caution highlighting its modest clinical significance. Statistical and Clinical Significance Essay.

Now let us assume that the rate of complications in the above scenario went down from 30% in the control group to 20% in the treatment group (p = 0.035). One will agree that this would be a statistically significant result that is associated with an impressive reduction in the complication rate by one third; making it also a clinically significant one. Such finding will probably be of interest to nurses and hospital administrators. It is important however to keep in mind that clinical significance shall not be solely judged by the observed effect size. In fact, sometimes an impressive reduction in the risk may not be of a real clinical value if such reduction is associated with prohibitive increase in other health risks and/or cost. Thus, clinical significance of research is best evaluated by making an informed expert judgement of the benefits and risks associated with research findings. If the benefits clearly outweigh the risks and the effect size is large enough, then a statistically significant finding is also clinically significant. Statistical and Clinical Significance Essay.

This discussion demonstrates that while statistical significance allows one make inferences about the study results, it is not enough to make sound recommendations concerning the clinical benefits of these results. Thus, researchers are encouraged to always consider the clinical significance of their findings and to discuss statistically significant results within the context of their clinical significance. Statistical and Clinical Significance Essay.