Frequentist, bayesian analysis and complementary statistical tools for geriatric and rehabilitation fields : are traditional null-hypothesis significance testing methods sufficient?

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Bibliographic Details
Main Author: Nascimento, Dahan da Cunha
Publication Date: 2024
Other Authors: Rolnick, Nicholas, Almeida, Isabella da Silva, Cipriano Junior, Gerson, Durigan, João Luiz Quagliotti
Format: Article
Language: eng
Source: Repositório Institucional da UnB
Download full: http://repositorio.unb.br/handle/10482/54455
https://doi.org/10.2147/CIA.S441799
http://orcid.org/0000-0002-6580-9404
http://orcid.org/0000-0001-9778-2800
http://orcid.org/0000-0001-6323-7003
Summary: Null hypothesis significant testing (NHST) is the dominant statistical approach in the geriatric and rehabilitation fields. However, NHST is routinely misunderstood or misused. In this case, the findings from clinical trials would be taken as evidence of no effect, when in fact, a clinically relevant question may have a “non-significant” p-value. Conversely, findings are considered clinically relevant when significant differences are observed between groups. To assume that p-value is not an exclusive indicator of an association or the existence of an effect, researchers should be encouraged to report other statistical analysis approaches as Bayesian analysis and complementary statistical tools alongside the p-value (eg, effect size, confidence intervals, minimal clinically important difference, and magnitude-based inference) to improve interpretation of the findings of clinical trials by presenting a more efficient and comprehensive analysis. However, the focus on Bayesian analysis and secondary statistical analyses does not mean that NHST is less important. Only that, to observe a real intervention effect, researchers should use a combination of secondary statistical analyses in conjunction with NHST or Bayesian statistical analysis to reveal what p-values cannot show in the geriatric and rehabilitation studies (eg, the clinical importance of 1kg increase in handgrip strength in the intervention group of long-lived older adults compared to a control group). This paper provides potential insights for improving the interpretation of scientific data in rehabilitation and geriatric fields by utilizing Bayesian and secondary statistical analyses to better scrutinize the results of clinical trials where a p-value alone may not be appropriate to determine the efficacy of an intervention.

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