Answer for HCA 699 What is the difference between statistically significant evidence and clinically significant evidence

Answer 2 for HCA 699 What is the difference between statistically significant evidence and clinically significant evidence? 

It appears that people often misinterpret these two types of evidence as being one and the same. Mainly because there is a confusion that stems from the word significant as meaning it is literally important (Ranganathan, Pramesh, Buyse, 2015). For statistics specifically, it has a completely different implication than with clinically applicable findings (Ranganathan et al., 2015). So statistically significant is about “quantifying the probability of a study’s results being due to chance. Clinical significance, on the other hand, refers to the magnitude of the actual treatment effect” (Ranganathan et al., 2015, p.169).

When it comes to advancing an evidenced-based project it appears that clinical significance is more of what is being sought. Because it is about the findings that are related to the control groups and receiving the intervention being researched (Ranganathan et al., 2015). If the results are strong enough within their trial than it can greatly impact best practice (Ranganathan et al., 2015). If an intervention produces the results in favor of the hypothesis then it can be applied to real-life medical care. This strongly helps advance any evidenced-based project because of its established applications to care.

Now statistical significance is still important however it is far more dependent on several variables one of which is the sample size of the study (Ranganathan et al., 2015). The larger the sample size the more the findings can appear to be statistically significant even if the treatment effects are inconsequential (Ranganathan et al., 2015). There is more responsibility put on the readers evaluating the study to determine if the statistically significant findings are clinically applicable (Ranganathan et al., 2015). One such example of this was a study done on patients with advanced pancreatic cancer who received treatment with erlotinib plus gemcitabine versus a group who only received gemcitabine alone in their treatment (Ranganathan et al., 2015). The survival rates were found to be prolonged in the groups that received both treatments with a p-value being about 0.038 (Ranganathan et al., 2015). This translates to there being “only a 3.8% chance that this observed difference between the groups occurred by chance…and therefore, [is] statistically significant” (Ranganathan et al., 2015, p.170). Despite being statistically significant it shows the treatment effect did not produce enough of the median survival rate and is therefore clinically irrelevant when it comes to measuring the outcomes of this suggested combination (Ranganathan et al., 2015).

Overall for statistical significance, context is everything and is not as easily applied for EBP as the findings that are considered clinically significant. The best way to differentiate between the two is through the way that Melnyk & Fineout-Overholt explain it which is that clinical significance is how the impact the findings will have on clinical practice, and statistical significance is that the results did not occur by happenstance (2019). Thus, as a reader of these studies, it is important to be cognizant of these two types of findings and be able to infer them correctly when considering an application to practice. Each does offer something to advance an EBP but may not be applicable in every situation. This has to be decided once the variables are considered and ruled out.

Ranganathan, P., Pramesh, C., & Buyse, M. (2015). Common pitfalls in statistical analysis: Clinical versus statistical significance. Perspectives in Clinical Research, 6(3), 169-170. Retrieved from http://www.picronline.org/article.asp?issn=2229-3485;year=2015;volume=6;issue=3;spage=169;epage=170;aulast=Ranganathan

Melnyk, B., & Fineout-Overholt, E. (2019). Evidence-based practice in nursing & healthcare a guide to best practice 4th edition [Ebook Version]. Retrieved from https://www.gcumedia.com/digital-resources/wolters-kluwer/2018/evidence-based-practice-in-nursing-and-healthcare_a-guide-to-best-practice_4e.php