A Utilitarian Perspective on Risk Quantification for Clinical Significance in Binary Outcomes.

Null hypothesis significance testing (NHST) in medical research is increasingly being supplemented by estimation statistics, focusing on effect sizes (ESs) and confidence intervals (CIs). This study evaluates the expression of ESs and CIs for binary outcomes. A utilitarian framework is proposed, emp...

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Publicado en:Inquiry (00469580) pp. 1 - 13
Autor principal: Park, Junhui
Formato: equations & formulas meta analysis research tables/charts Journal Article
Publicado: Sage Publications Inc. 4/24/2024
Acceso en línea:Ver este registro en EBSCOhost
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      dt: 4/24/2024
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      pub: Sage Publications Inc.
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        10.1177/00469580241248134
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        atl: A Utilitarian Perspective on Risk Quantification for Clinical Significance in Binary Outcomes.
      aug:
        au: Park, Junhui
        affil: Pukyong National University, Busan, Korea
      sug:
        subj:
          Effect Size
          Confidence Intervals
          Risk Assessment
          Randomized Controlled Trials
          Significance Test
          Conceptual Framework
          Outcomes Research
          Human
          Meta Analysis
          Funding Source
          Clinical Effectiveness
          Data Analysis Software
          Sample Size
          Decision Making, Clinical
          Descriptive Statistics
          Odds Ratio
          Relative Risk
      ab: Null hypothesis significance testing (NHST) in medical research is increasingly being supplemented by estimation statistics, focusing on effect sizes (ESs) and confidence intervals (CIs). This study evaluates the expression of ESs and CIs for binary outcomes. A utilitarian framework is proposed, emphasizing the number of beneficiaries and the impact level. To evaluate clinical significance, minimal clinically important risk difference (MCIRD) is proposed based on event magnitude (EM). Within this framework, risk difference (RD) is introduced as the primary measure. To assess the performance of RD, we compared its statistical power against other measures (risk ratio, RR; odds ratio, OR; Cohen's h) in individual study scenarios, and visual information conveyance in meta-analysis scenarios. RDs maintain statistical power in comparison to other measures in individual studies. They provide clarity on the true impact of clinical interventions without compromising statistical integrity. Meta-analytic results indicate that using RDs directly enhances transparency, uncovers heterogeneity, and addresses misaligned assumptions. This approach, by quantifying clinical effectiveness under a utilitarian perspective, facilitates the applicability of research to patient care and encourages shared decision-making. The study advocates for reporting baseline risks (BRs) with RDs and recommends a standardized presentation of these statistics. In a utilitarian perspective, adopting RD as the preferred ES can foster a transparent, patient-focused research ethos. This aids in accurately presenting the magnitude and variability of treatment effects, offering a new direction in methodology.
      pubtype: Academic Journal
      doctype:
        equations & formulas
        meta analysis
        research
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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