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Confidence Intervals Assess Both Clinical Significance and Statistical Significance

Leonard E. Brahman, PhD
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Requests for Reprints: Leonard E. Braitman, PhD, Biostatistics Unit, University of Pennsylvania Cancer Center, 312 NEB/S2 6020, 420 Service Drive, Philadelphia, PA 19104.

University of Pennsylvania Cancer Center
Philadelphia, PA 19104

Ann Intern Med. 1991;114(6):515-517. doi:10.7326/0003-4819-114-6-515
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Investigators sometimes base their claim of superiority for a new treatment over older treatments on statistical significance (P values) without stressing whether there is a real clinical advantage. Not all statistically significant differences are clinically significant (1-3). Fortunately, confidence intervals can address both clinical and statistical significance (1). Annals (4-6) and other journals (1, 7-11) recommend using confidence intervals in reporting the main results of studies. In this editorial, I use hypothetical examples to illustrate point estimates and confidence intervals of the difference between the percentages of patients responding to two treatments for a cancer. These examples show how confidence


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