Statistical significance, clinical importance and effect sizes: Enhancing understanding of a study's results.

ABSTRACT

BACKGROUND: The proper interpretation of a study's results requires both excellent understanding of good methodological practices and deep knowledge of prior results, aided by the availability of effect sizes. METHODS: This review takes the form of an expository essay exploring the complex and nuanced relationships among statistical significance, clinical importance, and effect sizes. RESULTS: Careful attention to study design and methodology will increase the likelihood of obtaining statistical significance and may enhance the ability of investigators/readers to accurately interpret results. Measures of effect size show how well the variables used in a study account for/explain the variability in the data. Studies reporting strong effects may have greater practical value/utility than studies reporting weak effects. Effect sizes need to be interpreted in context. Verbal summary characterizations of effect sizes (e.g., "weak", "strong") are fundamentally flawed and can lead to inappropriate characterization of results. Common language effect size (CLES) indicators are a relatively new approach to effect sizes that may offer a more accessible interpretation of results that can benefit providers, patients, and the public at large. CONCLUSIONS: It is important to convey research findings in ways that are clear to both the research community and to the public. At a minimum, this requires inclusion of standard effect size data in research reports. Proper selection of measures and careful design of studies are foundational to the interpretation of a study's results. The ability to draw useful conclusions from a study is increased when investigators enhance the methodological quality of their work.