Statistical Significance and Clinical Relevance

When evaluating the validity of a study, the reader must consider both the clinical and statistical significance of the findings. A study that claims clinical relevance may lack sufficient statistical significance to make a meaningful statement. Conversely, a study that shows a statistically significant difference in 2 treatment options may lack practicality. The concept of power of a clinical trial refers to the probability of detecting a difference between study groups when a true difference exists. We will discuss statistical power by examining studies too small to identify important differences, studies so large as to identify differences that are not clinically significant, difficult-to-design studies without very large patient populations, and those studies with both adequate power and clinically relevant findings. Dermatologists should not focus on small P values alone to decide whether a treatment is clinically useful; it is essential to consider the magnitude of treatment differences and the power of the study.