European journal of clinical investigation
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Eur. J. Clin. Invest. · May 2020
EditorialRedefining significance and reproducibility for medical research: A plea for higher P-value thresholds for diagnostic and prognostic models.
The role of P-values for null hypothesis testing is under debate. We aim to explore the impact of the significance threshold on estimates for the strengths of associations ("effects") and the implications for different types of epidemiological research. We consider situations with normal distribution of a true effect, while varying the effect size. ⋯ We conclude that a lower P-value threshold for declaring statistical significance implies more exaggeration in an estimated effect. This implies that if a low threshold is used, effect size estimation should not be attempted, for example in the context of selecting promising discoveries that need further validation. Confirmatory studies, such as randomized controlled trials, might stick to the 0.05 threshold if adequately powered, while prediction modelling studies should use an even higher threshold, such as 0.2, to avoid strongly biased effect estimates.