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超越统计学意义:康复研究文献的临床解读

Beyond statistical significance: clinical interpretation of rehabilitation research literature.

作者信息

Page Phil

机构信息

Louisiana State University, Baton Rouge, Louisiana, USA.

出版信息

Int J Sports Phys Ther. 2014 Oct;9(5):726-36.

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

摘要

未标注

循证实践要求临床医生紧跟科学文献的前沿。不幸的是,康复专业人员常常面对难以进行临床解读的研究文献。临床研究数据通常采用传统统计概率(p值)进行分析,这可能无法为康复专业人员提供足够信息来做出临床决策。具有统计学意义的差异或结果仅仅涉及是否接受或拒绝零假设或方向性假设,而没有提供差异(治疗效果)的大小或方向方面的信息。为了改进康复文献中临床意义的解读,研究人员通常会纳入更多与临床相关的信息,如置信区间和效应量。临床医生能够使用效应量、最小临床重要差异和基于大小的推断来解读置信区间非常重要。本述评的目的是讨论文献中统计分析和临床相关性判定的不同方面,包括效度、显著性、效应和置信度。理解研究的这些方面将有助于从业者更好地利用证据来提高他们的临床决策技能。

证据级别

5级。

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