Advertisement

The p-value: A clinician's disease?

  • F.R. Rosendaal
    Correspondence
    Clinical Epidemiology, C7-P, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
    Affiliations
    Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
    Search for articles by this author
Published:August 26, 2016DOI:https://doi.org/10.1016/j.ejim.2016.08.015
      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.

      Keywords

      To read this article in full you will need to make a payment

      Purchase one-time access:

      Academic & Personal: 24 hour online accessCorporate R&D Professionals: 24 hour online access
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'

      Subscribe:

      Subscribe to European Journal of Internal Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect

      Suggested reading

        • Boland P.J.
        A biographical glimpse of William Sealy Gosset.
        Am Stat. 1984; 38: 179-183
        • Rothman K.J.
        Significance questing.
        Ann Intern Med. 1986; 105: 445-447
        • Simon R.
        Confidence intervals for reporting results of clinical trials.
        Ann Intern Med. 1986; 105: 429-435
        • Goodman S.N.
        Toward evidence-based medical statistics. 1: the P value fallacy.
        Ann Intern Med. 1999; 130: 995-1004