NRS 490 Week 8 Clinical and Statistical Significance of EBP
For successful implementation of evidence based practice, understanding and interpretation of the research is essential. For this reason, it is important to understand the difference between statistical significance and clinical significance. Statistically significant result implies a relationship or a difference between the variables that was not solely caused by normal variation or chance. In this regard, statistical significance as a parameter in evidence based practice shows the extent or the likelihood that finding from research is true and does not occur by a chance (Heavey, 2015).NRS 490 Week 8 Clinical and Statistical Significance of EBP
The probability value (p value) is used to show the chance of the randomness of a particular result occurring but not the actual variance between the variables under question. In research analysis, results are statistically significant when the probability value generated during the analysis is less that the certainty level needed by a researcher. In research studies including evidence based practice, researchers normally set probability values at 0.05, which imply a chance of 5% that the result was not caused by a probability and a 95% certainty that there exist an actual relationship between the variables analyzed in the study (Heavey, 2015).
Clinical significance is essentially a subjective interpretation of research findings as meaningful for patient under care, and therefore likely to influence the behavior of healthcare provider (Heavey, 2015). A clinically significant result occurs when medical experts believe that the finding is considerable enough to be medically crucial and hence be applied as a guide in provision of care to patients.NRS 490 Week 8 Clinical and Statistical Significance of EBP
In evidence based research practice, statistical significance must always be determined before determination of clinical significance. However, clinical significance is usually a subjective evaluation and cannot be established by a single experiential test. I can use clinical significance to support positive outcomes in my project outcome by ensuring that the result is statistically significant. This is due to the fact that majority of statistically significant findings are normally have clinical significance.
What Is Clinical Significance?
Emily began mental health therapy with a number of symptoms including insomnia, intense sadness, and fatigue. Emily has been feeling this way for a few months. Emily’s psychologist diagnoses her with depression and starts treatment using cognitive-behavioral therapy (CBT). After four months of weekly therapy, Emily’s symptoms have almost diminished to the point that she no longer qualifies for a depression diagnosis. Emily’s treatment is clinically significant.
In a 1984 journal, Neil Jacobson, William Follette, and Dirk Revenstorf noted the need for a new method of determining whether or not different mental health therapies were truly effective in helping clients. In this article, they defined clinical significance within the realm of psychology and psychotherapy. NRS 490 Week 8 Clinical and Statistical Significance of EBP
Simply stated, clinical significance is the ability for a treatment or research experiment to help a client or patient so much that they are returned to normal functioning from a dysfunctional state. The cognitive-behavioral therapy was clinically significant in our example because it moved Emily from a disturbed state (depressed) to a normal level of functioning.
Statistical vs. Clinical Significance
Statistical significance was initially the only determinant of the efficacy of psychotherapy techniques. That was until scholars Jacobson, Follette, and Revenstorf decided that psychotherapy was missing something: a way to prove the treatments are really working. Although both concepts are very different, they can be easily confused.
Treatment in psychotherapy is statistically significant if the results obtained have a less than 5% likelihood of being due to chance. In other words, there is a 95% probability that the treatment was the tool that actually helped the client or patient return to a normal state of functioning. Statistical significance is often written using the variable, p. So if p < 0.05, the psychotherapy is considered statistically significant. NRS 490 Week 8 Clinical and Statistical Significance of EBP
Clinical significance, on the other hand, is determined by whether or not psychotherapy was able to accomplish the goals set at the beginning of therapy. Was it able to treat the depression, anxiety, post-traumatic stress disorder, or schizophrenia to a point that the client has returned to a normal level of functioning? Has the client moved from the ranks of mentally disturbed to normal? That is what clinical significance determines.
Clinical Significance Determined
In the case of Emily, shedding the symptoms of depression and returning to normal may have been enough for her psychologist to call the treatment clinically significant. But sometimes, clinical significance isn’t this clear. Some disorders can’t be fully eradicated, such as autism and some personality disorders. But a psychologist could still attain clinical significance in psychotherapy even though the client may never enter the normal functioning realm no matter how long they’re in therapy. So for us to fully determine if a treatment was clinically significant, there are various statistical methods that have been developed over the years. NRS 490 Week 8 Clinical and Statistical Significance of EBP
The new publication, Statistical Methods and Reasoning for the Clinical Sciences: Evidence-Based Practice, from Plural Publishing, San Diego, was written to give practitioners the scientific literacy needed to understand statistical methods in order to increase the accuracy of their diagnoses.
Written by Eiki Satake, PhD, associate professor of mathematics and statistics at Emerson College in Boston, Mass, the publication includes case studies on a companion website. The text is designed to help readers comprehend how the process of clinical research relates to the scientific method of problem solving. Readers will understand the importance of three key interrelated tasks involved in a research study: description (why it was done), explanation (what was done and to whom), and contextualization (how the results relate to other bodies of knowledge).NRS 490 Week 8 Clinical and Statistical Significance of EBP