Carl D. Atkins, MD
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Atkins CD. Locating and Appraising Systematic Reviews. Ann Intern Med. 1998;128:323. doi: 10.7326/0003-4819-128-4-199802150-00027
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Published: Ann Intern Med. 1998;128(4):323.
TO THE EDITOR:
Hunt and McKibbon make a serious mistake in their discussion of what they call the test for homogeneity . The authors' decision to use this term rather than the more appropriate term, the test for heterogeneity, underscores their failure to account for the type II error inherent in tests of significance based on P values . The null hypothesis in the test for heterogeneity is that the different studies have underlying populations with the same mean and variance for the outcome under study. Although a P value less than 0.05 may be cause to reject this null hypothesis, a P value of 0.05 or greater is not sufficient evidence to accept the null hypothesis. A nonsignificant P value tells us only that we cannot be more than 95% sure that the underlying populations are different. Under this stringent criterion, we can say only that the differences between groups may be due to chance, not that they are due to chance. This lack of symmetry of statistical testing with P values must always be kept in mind.
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