<?xml version="1.0"?>
<Articles JournalTitle="Journal of Biostatistics and Epidemiology">
  <Article>
    <Journal>
      <PublisherName>Tehran University of Medical Sciences</PublisherName>
      <JournalTitle>Journal of Biostatistics and Epidemiology</JournalTitle>
      <Issn>2383-4196</Issn>
      <Volume>5</Volume>
      <Issue>4</Issue>
      <PubDate PubStatus="epublish">
        <Year>2020</Year>
        <Month>07</Month>
        <Day>22</Day>
      </PubDate>
    </Journal>
    <title locale="en_US">The Conundrum of P-Values: Statistical Significance is Unavoidable but Need Medical Significance Too</title>
    <FirstPage>259</FirstPage>
    <LastPage>267</LastPage>
    <AuthorList>
      <Author>
        <FirstName>Abhaya</FirstName>
        <LastName>Indrayan</LastName>
        <affiliation locale="en_US">Department of Clinical Research, Max Healthcare Institute, New Delhi, India.</affiliation>
      </Author>
    </AuthorList>
    <History>
      <PubDate PubStatus="received">
        <Year>2019</Year>
        <Month>10</Month>
        <Day>23</Day>
      </PubDate>
      <PubDate PubStatus="accepted">
        <Year>2020</Year>
        <Month>06</Month>
        <Day>20</Day>
      </PubDate>
    </History>
    <abstract locale="en_US">Background: Small P-values have been conventionally considered as evidence to reject a null hypothesis in empirical studies. However, there is widespread criticism of P-values now and the threshold we use for statistical significance is questioned. 
Methods: This communication is on contrarian view and explains why P-value and its threshold are still useful for ruling out sampling fluctuation as a source of the findings. 
Results: The problem is not with P-values themselves but it is with their misuse, abuse, and over-use, including the dominant role they have assumed in empirical results. False results may be mostly because of errors in design, invalid data, inadequate analysis, inappropriate interpretation, accumulation of Type-I error, and selective reporting, and not because of P-values per se.
Conclusion: A threshold of P-values such as 0.05 for statistical significance is helpful in making a binary inference for practical application of the result. However, a lower threshold can be suggested to reduce the chance of false results. Also, the emphasis should be on detecting a medically significant effect and not zero effect.
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    <web_url>https://jbe.tums.ac.ir/index.php/jbe/article/view/310</web_url>
    <pdf_url>https://jbe.tums.ac.ir/index.php/jbe/article/download/310/240</pdf_url>
  </Article>
</Articles>
