Statistical and Clinical Significance : NR 505 Week 6 Discussion
The difference between statistically significant results and clinical significance is very interesting. For this discussion, respond to each of the following topics.
Distinguish between statistical and clinical significance of results.
Would it be possible to have research study results that supported the acceptance of the null hypothesis and demonstrate clinical significance? Provide a hypothetical example that supports your answer.
If you question the credibility of the results from a qualitative study, would the information have clinical significance for your practice area? Why or why not? Provide a hypothetical example that supports your answer.
Statistical and Clinical Significance SAMPLE APPROACH
Both statistical and clinical significance are critical in the medical profession, and both are only beneficial when they result in change
or impact in the patient population. El-Masri (2016) asserts that a statistically significant result indicates that the observed effect is not likely due to chance. For instance, the values used to reject the null hypothesis are predetermined. Statistical significance enables the researcher to determine the genuine value of the research on the patient population based on the study findings and data. Clinical significance quantifies the strength of the correlation between the independent and dependent variables (El-Masri, 2016). Clinical relevance is determined by the value added to patient care, quality of life, and cost. Healthcare practitioners must use caution to ensure that the study’s findings are reliable and that they may be applied to benefit a patient group.
To my mind, you can accept the null hypothesis and yet demonstrate clinical significance, in my judgment. Clinical importance, in my opinion, is the effect it has on the patient population based on the study data available, regardless of whether the results indicate beneficial or detrimental change. “Was the treatment plan effective?” and “Does it have clinical relevance?” are two questions that assist in determining clinical importance. For instance, if a hypothetical research study on a group of clinically depressed patients using cognitive behavior therapy as the independent variable demonstrates no statistically significant difference between the control and independent groups, the null hypothesis is accepted. However, clinical outcomes indicated that a significant proportion of patients responded well to cognitive behavior therapy and verbalized an improvement in mood, perspective, and quality of life. Confidence intervals might be used to establish whether cognitive behavior therapy had clinical significance for the depressed patient group and could result in clinical changes such as improved quality care outcomes, patient satisfaction, or a reduction in hospital stays. The term “clinical significance” refers to the practical application of research findings (El-Masri, 2016).
According to Connelly (2014) the clinical significance of a study must be determined by the clinician because they know the needs of their patient population and the practice setting in which they operate. In my opinion, if I questioned the credibility of the qualitative study I could still potentially find clinical significance in my practice area. For example, a hypothetical study on veterans’ suicide risk post deployment with in-depth interviews on a sample size of approximately 20 veterans to discuss their experience with re-integration into society and the effects on their mental health needs. The credibility of the data could be in question simply because the saturation of the data did not occur. However, as a clinician working in a rural setting with a large veteran population, I see how certain questions regarding post deployment and mental health needs could improve the quality of life and possibly reduce the suicide risk within my patient population then I have discovered clinical significance while questioning the credibility of the study.
Statistical and Clinical Significance SAMPLE RESPONSE
The question I chose this week discusses how my research on veterans could be transferred to a different population group. I found this question fascinating and I feel I have two distinct population groups that could fall into a similar situation as veterans returning from combat and reintegrating back into a civilian lifestyle. The first group would be police officers who are accustomed to putting their life on the line every day in the line of duty. I can see where police officers see many fellow officers wounded or killed because of protecting others. Meffert et.al (2014) discussed the similarities between a combat veteran and a police officer and the level of stress endured and the high rate of post traumatic stress disorder (PTSD) as a result of their career choice. Police officers are often the first line of defense and first responder in a life-threatening situation, emergency scenario, or domestic abuse where women and children are being assaulted.
The qualitative research on post war veterans could easily relate to police officers as they try to have normal lives and when they are off duty. The common thread with these two disciplines is the PTSD from work related violence that permeates their existence on and off duty. Meffert (2014) discusses how PTSD can impact work and personal relationships and effect overall mental health and the individual’s ability to relate to others. The second group I feel could relate to the qualitative study would be victims of domestic violence. In this population group there is a combat zone within the home setting thus increasing the risks for victims to experience PTSD. Victims of domestic abuse can have a difficult time relating to other individuals within the community and can feel isolated and alone and live in a constant posture of defense and fear for their personal safety. This posture of defense can impact mental well-being and a sense of belonginess similar to that of the post war veteran. All three situations could benefit from qualitative research on reintegration into community following life outside of their previous combat zone.