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The hidden charm of clinical significance: Why do treatment effects affect daily life?
In medicine and psychology, clinical relevance refers to the practical importance of a treatment effect—in short, whether it has a real, measurable impact on daily life. However, in the discussion of clinical significance, the distinction between statistical significance and practical significance is often encountered. The difference between the two is an important key to understanding the effectiveness of clinical treatment.
Overview of Statistical Significance
Statistical significance is used in hypothesis testing to test the validity of the null hypothesis that there is no relationship between two variables.
When researchers set a significance level (usually α = 0.05 or 0.01), if there is a significant difference between the two groups, it means that the probability of obtaining the observed result is only 5% if the difference is completely due to chance. . However, this does not represent the clinical importance of this difference or the size of the effect.
Discussion on practical significance
The practical clinical significance answers the question of how effective an intervention or treatment is, or the extent of change that results from the treatment.
For example, in clinical research, practical significance quantifies the importance of findings using metrics such as effect size and number needed to treat (NNT). Effect size quantifies the degree to which a sample deviates from expectations, which plays a pivotal role in the interpretation of research results.
Specific applications of clinical significance
Clinical relevance provides information about whether the treatment was effective enough to change the patient's diagnostic label.
This raises a key question in clinical treatment research: Is a treatment effective enough that a patient no longer meets the diagnostic criteria? For example, one treatment significantly improved depressive symptoms and resulted in 40% of patients no longer meeting diagnostic criteria for depression.
Calculation of clinical significance
There are many methods for calculating clinical significance, including but not limited to the Jacobson-Truax method and the Gulliksen-Lord-Novick method. These methods are important in measuring the effects of medical treatment in research.
The Jacobson-Truax method was used to evaluate clinical significance by calculating the reliability change index (RCI).
This index takes into account the participant's pre- and post-test scores and categorizes them according to standard errors, classifying participants as recovered, improved, unchanged, or worsened. In contrast, the Gulliksen-Lord-Novick method makes adjustments to account for regression to the mean.
ConclusionAs clinical psychology and medicine continue to advance, it becomes increasingly important to understand the differences between statistical significance, practical significance, and clinical significance. This not only relates to the design and data analysis of the study, but also directly affects the interpretation of patients' treatment outcomes and the impact on their daily lives. In this case, how can we evaluate the true significance of treatment outcomes in order to better serve patients?
