Literature DB >> 25328834

Beyond statistical significance: clinical interpretation of rehabilitation research literature.

Phil Page1.   

Abstract

UNLABELLED: Evidence-based practice requires clinicians to stay current with the scientific literature. Unfortunately, rehabilitation professionals are often faced with research literature that is difficult to interpret clinically. Clinical research data is often analyzed with traditional statistical probability (p-values), which may not give rehabilitation professionals enough information to make clinical decisions. Statistically significant differences or outcomes simply address whether to accept or reject a null or directional hypothesis, without providing information on the magnitude or direction of the difference (treatment effect). To improve the interpretation of clinical significance in the rehabilitation literature, researchers commonly include more clinically-relevant information such as confidence intervals and effect sizes. It is important for clinicians to be able to interpret confidence intervals using effect sizes, minimal clinically important differences, and magnitude-based inferences. The purpose of this commentary is to discuss the different aspects of statistical analysis and determinations of clinical relevance in the literature, including validity, significance, effect, and confidence. Understanding these aspects of research will help practitioners better utilize the evidence to improve their clinical decision-making skills. LEVEL OF EVIDENCE: 5.

Keywords:  Clinical significance; evidence based practice; statistical significance

Year:  2014        PMID: 25328834      PMCID: PMC4197528     

Source DB:  PubMed          Journal:  Int J Sports Phys Ther        ISSN: 2159-2896


  16 in total

1.  Design and analysis of research on sport performance enhancement.

Authors:  W G Hopkins; J A Hawley; L M Burke
Journal:  Med Sci Sports Exerc       Date:  1999-03       Impact factor: 5.411

Review 2.  Understanding the minimum clinically important difference: a review of concepts and methods.

Authors:  Anne G Copay; Brian R Subach; Steven D Glassman; David W Polly; Thomas C Schuler
Journal:  Spine J       Date:  2007-04-02       Impact factor: 4.166

3.  The PEDro scale is a valid measure of the methodological quality of clinical trials: a demographic study.

Authors:  Natalie A de Morton
Journal:  Aust J Physiother       Date:  2009

Review 4.  Progressive statistics for studies in sports medicine and exercise science.

Authors:  William G Hopkins; Stephen W Marshall; Alan M Batterham; Juri Hanin
Journal:  Med Sci Sports Exerc       Date:  2009-01       Impact factor: 5.411

5.  Making meaningful inferences about magnitudes.

Authors:  Alan M Batterham; William G Hopkins
Journal:  Int J Sports Physiol Perform       Date:  2006-03       Impact factor: 4.010

Review 6.  Putting P values in perspective.

Authors:  Kristin L Sainani
Journal:  PM R       Date:  2009-09       Impact factor: 2.298

7.  A statistics primer. Confidence intervals.

Authors:  M L Greenfield; J E Kuhn; E M Wojtys
Journal:  Am J Sports Med       Date:  1998 Jan-Feb       Impact factor: 6.202

8.  Research designs in sports physical therapy.

Authors:  Phil Page
Journal:  Int J Sports Phys Ther       Date:  2012-10

Review 9.  Methods to explain the clinical significance of health status measures.

Authors:  Gordon H Guyatt; David Osoba; Albert W Wu; Kathleen W Wyrwich; Geoffrey R Norman
Journal:  Mayo Clin Proc       Date:  2002-04       Impact factor: 7.616

10.  Minimal important difference thresholds and the standard error of measurement: is there a connection?

Authors:  Kathleen W Wyrwich
Journal:  J Biopharm Stat       Date:  2004-02       Impact factor: 1.051

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  96 in total

1.  Home-based isometric exercise training induced reductions resting blood pressure.

Authors:  Jonathan D Wiles; Natalie Goldring; Damian Coleman
Journal:  Eur J Appl Physiol       Date:  2016-11-16       Impact factor: 3.078

2.  Instrument-assisted soft tissue mobilization and proprioceptive neuromuscular facilitation techniques improve hamstring flexibility better than static stretching alone: a randomized clinical trial.

Authors:  Leanna J Gunn; Jill Campbell Stewart; Brittany Morgan; Steven T Metts; Justin M Magnuson; Nicholas J Iglowski; Stacy L Fritz; Catherine Arnot
Journal:  J Man Manip Ther       Date:  2018-08-01

Review 3.  Evidence-based statistical analysis and methods in biomedical research (SAMBR) checklists according to design features.

Authors:  Alok Kumar Dwivedi; Rakesh Shukla
Journal:  Cancer Rep (Hoboken)       Date:  2019-08-22

4.  Ways of coping and perceived HIV-related stigma among people living with HIV: moderation by sex and sexual orientation.

Authors:  Monique J Brown; Julianne M Serovich; Tanja C Laschober; Judy A Kimberly; Celia M Lescano
Journal:  Psychol Health Med       Date:  2019-10-21       Impact factor: 2.423

5.  The effect of prior knowledge of test endpoint on non-local muscle fatigue.

Authors:  Alan R Hamilton; David G Behm
Journal:  Eur J Appl Physiol       Date:  2017-02-27       Impact factor: 3.078

6.  The Addition of Transcutaneous Electrical Nerve Stimulation with Roller Massage Alone or in Combination Did Not Increase Pain Tolerance or Range of Motion.

Authors:  James D Young; Alyssa-Joy Spence; Gerard Power; David G Behm
Journal:  J Sports Sci Med       Date:  2018-11-20       Impact factor: 2.988

7.  Maintaining Interrater Agreement of Core Assessment Instruments in a Multisite Randomized Controlled Clinical Trial: The Randomized Evaluation of Sedation Titration for Respiratory Failure (RESTORE) Trial.

Authors:  Ruth Lebet; Jennifer Hayakawa; Tracy B Chamblee; Joana A Tala; Nakul Singh; David Wypij; Martha A Q Curley
Journal:  Nurs Res       Date:  2017 Jul/Aug       Impact factor: 2.381

8.  Machine learning and modeling: Data, validation, communication challenges.

Authors:  Issam El Naqa; Dan Ruan; Gilmer Valdes; Andre Dekker; Todd McNutt; Yaorong Ge; Q Jackie Wu; Jung Hun Oh; Maria Thor; Wade Smith; Arvind Rao; Clifton Fuller; Ying Xiao; Frank Manion; Matthew Schipper; Charles Mayo; Jean M Moran; Randall Ten Haken
Journal:  Med Phys       Date:  2018-08-24       Impact factor: 4.071

9.  Differences in Rural and Urban Health Information Access and Use.

Authors:  Xuewei Chen; Heather Orom; Jennifer L Hay; Erika A Waters; Elizabeth Schofield; Yuelin Li; Marc T Kiviniemi
Journal:  J Rural Health       Date:  2018-11-16       Impact factor: 4.333

10.  General and Domain-Specific Effectiveness of Cognitive Remediation after Stroke: Systematic Literature Review and Meta-Analysis.

Authors:  Jeffrey M Rogers; Rachael Foord; Renerus J Stolwyk; Dana Wong; Peter H Wilson
Journal:  Neuropsychol Rev       Date:  2018-07-13       Impact factor: 7.444

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