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Toward Evidence-Based Medical Statistics. 1: The P Value Fallacy
Abstract
An important problem exists in the interpretation of modern medical research data: Biological understanding and previous research play little formal role in the interpretation of quantitative results. This phenomenon is manifest in the discussion sections of research articles and ultimately can affect the reliability of conclusions. The standard statistical approach has created this situation by promoting the illusion that conclusions can be produced with certain "error rates," without consideration of information from outside the experiment. This statistical approach, the key components of which are P values and hypothesis tests, is widely perceived as a mathematically coherent approach to inference. There is little appreciation in the medical community that the methodology is an amalgam of incompatible elements, whose utility for scientific inference has been the subject of intense debate among statisticians for almost 70 years. This article introduces some of the key elements of that debate and traces the appeal and adverse impact of this methodology to the P value fallacy, the mistaken idea that a single number can capture both the long-run outcomes of an experiment and the evidential meaning of a single result. This argument is made as a prelude to the suggestion that another measure of evidence should be used--the Bayes factor, which properly separates issues of long-run behavior from evidential strength and allows the integration of background knowledge with statistical findings.
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Cites
Linde, K., Clausius, N., Ramirez, G., Melchart, D., Eitel, F., Hedges, L. V., & Jonas, W. B. (1997) · The Lancet · doi:10.1016/s0140-6736(97)02293-9 · Cited by 979
Bayesian approaches to randomized trials
Spiegelhalter, D. J., Freedman, L. S., & Parmar, M. K. B. (1994) · Journal of the Royal Statistical Society. Series A (Statistics in Society) · doi:10.2307/2983527 · Cited by 720
Problems in the “Evidence” of “Evidence-Based Medicine”
Feinstein, A. R., & Horwitz, R. I. (1997) · The American Journal of Medicine · doi:10.1016/s0002-9343(97)00244-1 · Cited by 653
Testing a Point Null Hypothesis: The Irreconcilability of P Values and Evidence
Berger, J. O., & Sellke, T. (1987) · Journal of the American Statistical Association · doi:10.2307/2289131 · Cited by 548
Research works printed but not linked: 61
- 10.1038/bjc.1994.192 · DOI · Paper page
- 10.1093/jnci/88.3-4.206 · DOI
- 10.7326/0003-4819-130-12-199906150-00019 · DOI · Paper page
- 10.1001/jama.280.12.1061 · DOI
- 10.1093/oxfordjournals.aje.a116700 · DOI · Paper page
- 10.1001/jama.1987.03390180077027 · DOI
- 10.7326/0003-4819-98-3-385 · DOI
- 10.1136/bmj.313.7057.603 · DOI
- 10.1002/sim.4780121510 · DOI
- 10.1001/jama.1995.03520350053028 · DOI
- 10.1080/01621459.1942.10501760 · DOI · Paper page
- Pearson E, 1938, Biometrika, 38, 210
- 10.5694/j.1326-5377.1986.tb112339.x · DOI
- 10.7326/0003-4819-108-2-296 · DOI
- 10.7326/0003-4819-105-3-429 · DOI · Paper page
- 10.1214/aoms/1177704566 · DOI
- 10.1093/oxfordjournals.aje.a009531 · DOI
- 10.1093/oxfordjournals.aje.a117737 · DOI · Paper page
- 10.1093/oxfordjournals.aje.a114189 · DOI
- 10.1097/00001648-199107000-00002 · DOI
- 10.1080/01621459.1963.10500851 · DOI · Paper page
- 10.1016/S0197-2456(83)80003-8 · DOI
- Cornfield J, 1966, American Statistician, 20, 18, 10.1080/00031305.1966.10479786 · DOI
- 10.1093/biomet/77.3.467 · DOI
- 10.1111/j.1445-2197.1994.tb02308.x · DOI
- 10.1080/01621459.1993.10476404 · DOI · Paper page
- 10.1016/S0002-9149(96)90531-7 · DOI
- 10.1097/00001888-199812000-00011 · DOI · Paper page
- 10.1002/cpt196345580 · DOI
- 10.7326/0003-4819-105-3-445 · DOI
- 10.1037/h0042040 · DOI · Paper page
- 10.1016/0890-6238(93)90242-Y · DOI
- 10.5271/sjweh.193 · DOI
- 10.1177/00220345970760010201 · DOI
- 10.7326/0003-4819-108-2-266 · DOI · Paper page
- 10.1111/j.1365-2125.1982.tb01987.x · DOI · Paper page
- 10.2307/2528565 · DOI
- 10.1136/bmj.288.6420.841 · DOI
- 10.1136/bmj.288.6421.920 · DOI
- Salsburg D, 1985, American Statistician, 39, 220, 10.1080/00031305.1985.10479435 · DOI
- 10.1037/0022-006X.62.1.75 · DOI
- 10.2307/2983040 · DOI
- 10.1056/NEJM198708133170706 · DOI · Paper page
- 10.2307/2528899 · DOI
- 10.1001/jama.280.3.280 · DOI
- 10.1016/S0197-2456(98)00051-8 · DOI
- 10.1016/S0197-2456(98)00054-3 · DOI
- 10.1016/S0197-2456(98)00052-X · DOI
- 10.2105/AJPH.77.2.195 · DOI · Paper page
- 10.1097/00001648-199801000-00004 · DOI
- 10.1136/hrt.60.3.177 · DOI
- 10.1016/S0895-4356(97)00295-3 · DOI
- 10.1136/bmj.313.7057.569 · DOI
- 10.1146/annurev.pu.16.050195.000323 · DOI
- 10.1016/0197-2456(95)00072-0 · DOI
- 10.2105/AJPH.78.12.1568 · DOI
- 10.1002/sim.4780060103 · DOI
- 10.1016/0277-9536(82)90393-8 · DOI
- 10.7326/0003-4819-118-3-199302010-00009 · DOI · Paper page
- 10.1001/jama.1994.03520020055015 · DOI
- Hayden G, 1983, Pediatrics, 72, 84, 10.1542/peds.72.1.84 · DOI
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Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gotzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2010) · BMJ · doi:10.1136/bmj.c869 · Cited by 8,883
The ASA Statement on p -Values: Context, Process, and Purpose
Wasserstein, R. L., & Lazar, N. A. (2016) · The American Statistician · doi:10.1080/00031305.2016.1154108 · Cited by 6,306
Sensitivity analysis in observational research: Introducing the E-value
VanderWeele, T. J., & Ding, P. (2017) · Annals of Internal Medicine · doi:10.7326/m16-2607 · Cited by 6,350
The Revised CONSORT Statement for Reporting Randomized Trials: Explanation and Elaboration
Altman, D. G., Schulz, K. F., Moher, D., Egger, M., Davidoff, F., Elbourne, D., Gøtzsche, P. C., Lang, T., & for the CONSORT Group (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-8-200104170-00012 · Cited by 3,835
Bayesian t tests for accepting and rejecting the null hypothesis
Rouder, J. N., Speckman, P. L., Sun, D., Morey, R. D., & Iverson, G. (2009) · Psychonomic Bulletin & Review · doi:10.3758/pbr.16.2.225 · Cited by 3,688
Statistical tests, P values, confidence intervals, and power: a guide to misinterpretations
Greenland, S., Senn, S. J., Rothman, K. J., Carlin, J. B., Poole, C., Goodman, S. N., & Altman, D. G. (2016) · European Journal of Epidemiology · doi:10.1007/s10654-016-0149-3 · Cited by 3,200
Self-citationMoher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2012) · International Journal of Surgery · doi:10.1016/j.ijsu.2011.10.001 · Cited by 2,345
The Abuse of Power: The Pervasive Fallacy of Power Calculations for Data Analysis
Hoenig, J. M., & Heisey, D. M. (2001) · The American Statistician · doi:10.1198/000313001300339897 · Cited by 2,046
Moher, D., Hopewell, S., Schulz, K. F., Montori, V., Gøtzsche, P. C., Devereaux, P. J., Elbourne, D., Egger, M., & Altman, D. G. (2010) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.03.004 · Cited by 1,858
Scientific method: Statistical errors
Nuzzo, R. (2014) · Nature · doi:10.1038/506150a · Cited by 1,536
Why Most Discovered True Associations Are Inflated
Ioannidis, J. P. A. (2008) · Epidemiology · doi:10.1097/ede.0b013e31818131e7 · Cited by 1,495
Sterne, J. A. C. (2001) · BMJ · doi:10.1136/bmj.322.7280.226 · Cited by 1,466
The Extent and Consequences of P-Hacking in Science
Head, M. L., Holman, L., Lanfear, R., Kahn, A. T., & Jennions, M. D. (2015) · PLOS Biology · doi:10.1371/journal.pbio.1002106 · Cited by 1,388
“NHST is the most widely used data analysis method in most scientific disciplines [22,23].”
MethodWhat does research reproducibility mean?
Goodman, S. N., Fanelli, D., & Ioannidis, J. P. A. (2016) · Science Translational Medicine · doi:10.1126/scitranslmed.aaf5027 · Cited by 1,293
Self-citationβ-Blockers in Congestive Heart Failure: A Bayesian Meta-Analysis
Brophy, J. M., Joseph, L., & Rouleau, J. L. (2001) · Annals of Internal Medicine · doi:10.7326/0003-4819-134-7-200104030-00008 · Cited by 389
Evolution of Reporting P Values in the Biomedical Literature, 1990-2015
Chavalarias, D., Wallach, J. D., Li, A. H. T., & Ioannidis, J. P. A. (2016) · JAMA · doi:10.1001/jama.2016.1952 · Cited by 370
Jansen, J. P., Trikalinos, T., Cappelleri, J. C., Daw, J., Andes, S., Eldessouki, R., & Salanti, G. (2014) · Value in Health · doi:10.1016/j.jval.2014.01.004 · Cited by 319
When Null Hypothesis Significance Testing Is Unsuitable for Research: A Reassessment
Szucs, D., & Ioannidis, J. P. A. (2017) · Frontiers in Human Neuroscience · doi:10.3389/fnhum.2017.00390 · Cited by 298
Lyons, N., Cooper, C., & Lloyd-Evans, B. (2021) · BMC Psychiatry · doi:10.1186/s12888-021-03321-z · Cited by 197
Bayesian ranking of biochemical system models
Vyshemirsky, V., & Girolami, M. A. (2008) · Bioinformatics · doi:10.1093/bioinformatics/btm607 · Cited by 181
An estimate of the science-wise false discovery rate and application to the top medical literature
Jager, L. R., & Leek, J. T. (2014) · Biostatistics · doi:10.1093/biostatistics/kxt007 · Cited by 179
Pereira, T. V., & Ioannidis, J. P. A. (2011) · Journal of Clinical Epidemiology · doi:10.1016/j.jclinepi.2010.12.012 · Cited by 160
Hubbard (2004) · doi:10.1177/0959354304043638 · Cited by 114
Useem, J., Brennan, A., LaValley, M., Vickery, M., Ameli, O., Reinen, N., & Gill, C. J. (2015) · PLOS ONE · doi:10.1371/journal.pone.0144980 · Cited by 105
Even statisticians are not immune to misinterpretations of Null Hypothesis Significance Tests
Lecoutre, M., Poitevineau, J., & Lecoutre, B. (2003) · International Journal of Psychology · doi:10.1080/00207590244000250 · Cited by 86
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Metadata
- Authors
- Goodman, S. N.
- Venue
- Annals of Internal Medicine
- Publisher
- American College of Physicians
- Published
- 1999-06-15
- Volume
- 130
- Issue
- 12
- Pages
- 995-1004
- ISSN
- 0003-4819 (ISSN-L)
- 1539-3704
- OpenAlex
- W2152938409
- Cited by
- 1,185
- References
- 4
- FWCI
- 29.37
- Type
- journal article
- Language
- en
- Open access
- closed
- Licence
- www.acpjournals.org/journal/aim/text-and-data-mining (tdm)
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