ArticleBMJ open2025
Disparity between statistical significance and clinical importance in published randomised controlled trials: a methodological study.
Article in BMJ open, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
3 citing papers in PubMed.
- Financial incentives for maintaining postpartum smoking abstinence: 3-4-year follow-up of the Financial Incentives for Prevention of Postpartum Return to Smoking (FIPPS) randomised controlled trial.Addiction (Abingdon, England) · 2026Trial
- Reporting of second-generationContemporary clinical trials communications · 2026Article
- Clustering longitudinal data: comparison of model-based and distance-based approaches using simulated and real-world data in psychiatric research.BMC medical research methodology · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
Abstract
objectivesWe estimated the extent of the disparity between statistical significance and clinical importance in published randomised controlled trials (RCTs), and explored factors associated with this disparity.
designA methodological study of trials published between 2018 and 2022 and indexed in PubMed was conducted. Primary reports of two-arm, phase three, superiority trials of human health interventions were included. Pharmacokinetic studies and pilot trials were excluded. The relationship between the specified delta value or minimum clinically important difference (as specified in the sample size calculation) and the effect size determined the clinical importance of the trial results. Studies where the clinical importance was at least possible, with no statistical significance, were classified as SS-CI+ disparity, and studies which were definitely not clinically important but statistically significant were classified as SS+CI- disparity. Factors associated with each type of disparity were explored at the study level using multinomial logistic regression.
results500 trials were included. In 38.4% (n=192) of these, information was not available to classify clinical importance. Overall disparity was found in 63 of the remaining 308 studies, 20.5% (95% confidence interval (CI) 16.2% to 25.5%). SS+CI- disparity was 10.3% (15/145) (95% CI 6.1% to 16.8%) and SS-CI+ disparity was 29.5% (48/163) (95% CI 22.7% to 37.2%).Studies testing complementary or alternative medicines relative to drug trials were positively associated with SS+CI- disparity. Low journal impact factor, small sample size, unfunded or grant funding and failure to mention allocation concealment were positively associated with SS-CI+disparity.
conclusionsIn up to 20% of RCTs, there may be a disparity between statistical significance and clinical importance. Clinical importance of results should be taken into account in the interpretation of trial results, and trials should adhere stringently to reporting guidelines.
Indexed as
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What Socratic holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.