• Iris S C Verploegh, Nicole A Lazar, BartelsRonald H M ARHMARadboud University Medical Center, Nijmegen, the Netherlands., and Victor Volovici.
• Department of Neurosurgery, Erasmus Medical Center, Rotterdam, the Netherlands. Electronic address: i.verploegh@erasmusmc.nl.
• World Neurosurg. 2022 May 1; 161: 280-283.e3.

AbstractThe application and interpretation of P values have caused debate for several decades, and this debate has become particularly relevant in the past few years. The P value represents the probability of seeing results as extreme or more extreme than those observed in a data analysis, were the null hypothesis and other underlying assumptions to be true. While P values are useful in pointing out where an effect may be present, they have often been misused in an attempt to oversell "statistically significant" findings. As P values rely on the spread and number of measurements, a smaller P value does not necessarily imply a larger effect size, which is better assessed via an effect estimate and confidence interval interpreted in the context of the study. The clinical relevance of a computed P value is context dependent. We investigated the current use of P values in a small sample of recent neurosurgical literature. Only a minority of manuscripts that reported statistical significance described confounder adjustment, or effect sizes. A common, incorrect assumption often observed was that statistical significance equals clinical relevance. To enable correct interpretation of clinical significance, it is crucial that authors describe the clinical implications of their findings.Copyright © 2022 The Author(s). Published by Elsevier Inc. All rights reserved.

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