Absence of evidence is not evidence of absence

Abstract

We need to report uncertain results and do it clearly The title of this editorial is not new. For example, it was used nearly a decade ago for an article in the BMJ 's Statistics Notes series.1 Altman and Bland considered the dangers of misinterpreting differences that do not reach significance, criticising use of the term “negative” to describe studies that had not found statistically significant differences. Such studies may not have been large enough to exclude important differences. To leave the impression that they have proved that no effect or no difference exists is misleading. As an example, a randomised trial of behavioural and specific sexually transmitted infection interventions for reducing transmission of HIV-1 was published in the Lancet. 2 The incidence rate ratios for the outcome of HIV-1 infection were 0.94 (95% confidence interval 0.60 to 1.45) and 1.00 (0.63 to 1.58) for two intervention groups compared with control. In …