How to Get to Clinically Relevant Research

The default method to evaluate clinical research is by statistical significance

 Unfortunately is statistical significance not related to the meaningfulness of the findings in the research and thereby to its meaningfulness for patients and healthcare

If researchers stated ahead of starting the trial what they would consider clinically relevant,  the reader could relate to that and agree or disagree with the researcher

It would come from focusing on using the provided information to help patients and improve healthcare - and not just publishing a paper

We want to make it mandatory to state the researchers' clinical relevance levels ahead of the trial, mentioning what they will consider clinically relevant when they pre-register their research on the clinicaltrials.gov website or similar websites. They then need to compare their findings in both the paper and abstract when publishing data from the study.    #clinicalrelevance

LINKS:

A specific page on our website about requesting clinical relevance statement and evaluation https://www.precision-evidence.com/p/clinical-relevance/ 

The history behind the chosen level for statistical significance with Ronald Fisher's book from 1925 "Statistical Methods for Research Workers." Precision Evidence Blog: https://www.precision-evidence.com/blog/the-p-value-and-sir-ronald-fischer/ 

 96% of published studies mention a p-value at 0.05 or lower: "What Have We (Not) Learned from Millions of Scientific Papers with P Values?" https://www.tandfonline.com/doi/full/10.1080/00031305.2018.1447512 

Overview of clinical trials registers like clinicaltrials.gov: https://sites.google.com/a/york.ac.uk/yhectrialsregisters/home/clinicaltrials 

Only 15% of clinical research brings value: “Avoidable waste in the production and reporting of research evidence”  https://pubmed.ncbi.nlm.nih.gov/19525005/  

Precision Evidence #8: "Critical Appraisal of the Moderna COVID19 Vaccine Trial"

 https://www.precision-evidence.com/8 

 Precision Evidence #6: "Covid-19 Vaccines Trials: Understanding the First Published Results"  https://www.precision-evidence.com/6 

 Precision Evidence #5: "Covid-19 Vaccines Trials and Press Releases – Looking Beyond the Efficacy"  https://www.precision-evidence.com/5 

TED talk with Sir Ken Robinson where he talks about two kinds of people  https://www.ted.com/talks/sir_ken_robinson_bring_on_the_learning_revolution 

NOTES: 

• Statistical significance vs. clinical significance in clinical research
• Clinical significance, clinical relevance, clinical meaningfulness
• Should clinical significance be used instead of statistical significance, or should they be used together?
• Problems with statistical significance
• Problems with clinical significance
• Why researchers must state what they consider clinical relevant outcomes before starting a research project and refer back to that when evaluating their findings
• "Positive" vs. "negative" trials in terms of statistical significance and why all research matters
• Overrepresentation in published research of statistically significant findings with p-values at 0.05 or lower
• Efficacy measures with examples "Number Needed to Treat" (NNT) of "Number Needed to Harm" (NNH)
• The history behind the chosen level for statistical significance with Ronald Fisher's book from 1925 "Statistical Methods for Research Workers."  See also blog: 
• Peer-reviewers responsibility
• We want to make it mandatory to state clinical relevance levels by the researchers ahead of the trial, mentioning what they will consider clinically relevant and essential when they pre-register their research on the clinicaltrials.gov website or similar websites. They then need to compare their findings with that both in the paper and abstract when publishing data from the research
• ALWAYS ASK FOR A CLINICAL RELEVANCE EVALUATION OF THE RESULTS - every time, all of us, whatever relation we have to produce, read and use information from clinical research
• ASK FOR A CLINICAL RELEVANCE EVALUATION OF THE RESULTS - and let's make it just as normal as the p-value #clinicalrelevance

GET THE ABSTRACT SCREENING TOOL

It can be a challenge to screen papers for clinical relevance. As we go beyond the abstract in this podcast, we have created a screening tool you can use when reading an abstract from a clinical research paper.

Using that tool enables you to quickly screen an abstract from a medical journal for clinical relevance selecting only those you want to read. At the same time, you will know why you skipped the rest. Get it at our website https://www.precision-evidence.com 

Contact us at email: [email protected],

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Website: www.precision-evidence.com

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Hosts:

Dr. Kim Kristiansen, M.D: @KKristiansenMD

JG Staal: @HealthyEvidence

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