The p-value: A clinician's disease?

  • F.R. Rosendaal
    Clinical Epidemiology, C7-P, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
    Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
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Published:August 26, 2016DOI:
      It is remarkable that in the interpretation of scientific evidence, be it as reviewer for a medical journal or as reader, clinicians appear to be the ones most impressed by p-values and statistical significance, or the absence thereof. They attach in their reviews and presentations more importance to it than epidemiologists and statisticians. In fact, the latter groups often actively discourage the use, and certainly the overinterpretation of significance testing, as reflected also in reporting guidelines such as STROBE, which see the presentation of p-values in a scientific article as an option, not an obligation. Since the first authoritative publications forcefully arguing against the use of statistical significance testing appeared in the 1980s and 1990s, it is worthwhile to wonder why p-values are still used, and why especially clinicians are so enamoured with them. In this opinion piece I will explain why relying on statistical testing is philosophically erroneous, how it will often lead to the wrong conclusions, and I will give my layman's psychological explanation why this p-disease has a strong predilection for clinicians.


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