Abstract
Intervention research has been an essential part of medicine since the eighteenth century. Still, its application for the betterment of human conditions is contemporary, and much remained unknown. The importance of intervention research cannot be overemphasised because it forms the centrepiece of one of the three fundamental pillars of evidence-based practice. Most high- impact scientific journals now require authors of intervention studies to assess the clinical relevance of any observed statistically significant difference associated with treatment. This chapter explores the fundamentals of the clinical significance concept and provides a step-by-step illustration of how to compute and interpret Cohen-d and η2 estimates. It also examines web-based resources for calculating clinical significance estimates for different experimental research designs. Additionally, the chapter offer insights on how to assess the underlying assumptions associated with the parametric tests. Applying the concepts presented in this chapter will open the floodgate for improved evidence-based intervention studies in medicine and allied health. The more researchers take part in intervention research, the faster we can answer essential clinical questions that will help us prevent emerging diseases and find more effective treatments.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Similar content being viewed by others
References
Physiopedia. Evidence-Based Practice (EBP). n.d.. https://www.physio-pedia.com/Evidence_Based_Practice_(EBP). Accessed 12 Dec 2018.
Bixo M, Ekberg K, Poromaa IS, Hirschberg AL, Jonasson AF, Andréen L, Timby E, Wulff M, Ehrenborg A, Bäckström T. Treatment of premenstrual dysphoric disorder with the GABAA receptor modulating steroid antagonist Sepranolone (UC1010)-A randomised controlled trial. Psychoneuroendocrinology. 2017;80:46–55.
Chakhtoura M, Nassar A, Arabi A, Cooper C, Harvey N, Mahfoud Z, Nabulsi M, El-Hajj FG. Effect of vitamin D replacement on maternal and neonatal outcomes: a randomised controlled trial in pregnant women with hypovitaminosis D. A protocol. BMJ. 2016;6(3):010818.
Andersson IM, Benson L, Christensson K, Gemzell-Danielsson K. Paracervical block as pain treatment during second-trimester medical termination of pregnancy: an RCT with bupivacaine versus sodium chloride. Hum Reprod. 2016;31(1):67–74.
Whitaker AK, Endres LK, Mistretta SQ, Gilliam ML. Postplacental insertion of the levonorgestrel intrauterine device after cesarean delivery vs. delayed insertion: a randomised controlled trial. Contraception. 2014;89(6):534–9.
Monk BJ, Wang J, Stock RJ, Peters WA 3rd, Liu PY, Barrett RJ 2nd, Berek JS, Souhami L, Grigsby PW, Gordon W Jr, Alberts DS. Rethinking the use of radiation and chemotherapy after radical hysterectomy: a clinical-pathologic analysis of a Gynaecologic Oncology Group/Southwest Oncology Group/Radiation Therapy Oncology Group trial. Gynecol Oncol. 2005;96(3):721–8.
Polo-Kantola P, Rauhala E, Helenius H, Erkkola R, Irjala K, Polo O. Breathing during sleep in menopause: a randomised, controlled, crossover trial with estrogen therapy. Obstet Gynecol. 2003;102(1):68–75.
Entezami M, Heger-Mahn D, Ebert A, Halis G, Lübbert H. Short-term treatment with levonorgestrel does not antagonize the ethinyl estradiol-induced increase of uterine blood flow in postmenopausal women. Contraception. 1997;56(3):181–3.
Bofill JA, Rust OA, Devidas M, Roberts WE, Morrison JC, Martin JN Jr. Shoulder dystocia and operative vaginal delivery. J Matern Fetal Med. 1997;6(4):220–4.
Hoffman CT 3rd, Guzman ER, Richardson MJ, Vintzileos A, Houlihan C, Benito C. Effects of narcotic and non-narcotic continuous epidural anaesthesia on intrapartum fetal heart rate tracings as measured by computer analysis. J Matern Fetal Med. 1997;6(4):200–5.
Höckel M, Vorndran B, Schlenger K, Baussmann E, Knapstein PG. Tumour oxygenation: a new predictive parameter in locally advanced cancer of the uterine cervix. Gynecol Oncol. 1993;51(2):141–9.
Glujovsky D, Sueldo CE, Borghi C, Nicotra P, Andreucci S, Ciapponi A. Misleading reporting and interpretation of results in major infertility journals. Fertil Steril. 2016;105(5):1301–6.
Hay SC, Kirpalani H, Viner C, Soll R, Dukhovny D, Mao WY, Profit J, DeMauro SB, JAF Z. Do trials reduce uncertainty? Assessing impact through cumulative meta-analysis of neonatal RCTs. J Perinatol. 2017;37(11):1215–9. Available at https://www.ncbi.nlm.nih.gov/pubmed/28880258. Accessed 12 Dec 2018.
Thrower P. Eight reasons I rejected your article. 2012. Available at https://www.elsevier.com/connect/8-reasons-i-rejected-your-article. Accessed 12 Dec 2018.
Enago Academy. Learning to avoid journal rejection. 2018. Available at https://www.enago.com/academy/learning-to-avoid-journal-rejection/. Accessed 12 Dec 2018.
Oosterhaven J. Too many journals? Towards a theory of repeated rejections and ultimate acceptance. Scientometrics. 2015;103(1):261–5. Available at https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4365185/. Accessed 12 Dec 2018.
Altman DG, Bland JM. Improving doctors' understanding of statistics. J R Stat Soc A. 1991;154:223–67.
Weiss ST, Samet JM. An assessment of physician knowledge of epidemiology and biostatistics. J Med Educ. 1980;55:692–7.
Wulff HR, Andersen B, Brandenhoff P, Guttler F. What do doctors know about statistics? Stat Med. 1987;6:3–10.
Borak J, Veiullieux S. Errors of intuitive logic among physicians. Soc Sci Med. 1982;16:1939–47.
Public Health Action Support Team. Introduction to study designs – intervention studies and randomised controlled trials. 2017. Available at https://www.healthknowledge.org.uk/e-learning/epidemiology/practitioners/introduction-study-design-is-rct. Accessed 22 Dec 2018.
Friedman SB, Phillips S. What's the difference? Paediatric residents and their inaccurate concepts regarding statistics. Paediatrics. 1981;68:644–6.
Campbell DT, Julian SJ. Experimental and quasi-experimental designs for research. Boston. Available at https://www.amazon.com/Experimental-Quasi-Experimental-Designs-Research-Campbell/dp/0395307872. Accessed 22 Dec 2018.: Hougton Mifflin Company; 1963.
Cohen J. Statistical power analysis for the behavioural sciences. Hillsdale, NJ: Erlbaum; 1988.
Thompson CJ. What’s the difference between statistical significance and clinical significance? 2017. Available at https://nursingeducationexpert.com/difference-statistical-significance-clinical-significance/. Accessed 22 Dec 2018.
Cath. Intervention studies. n.d.. Available at http://www.drcath.net/toolkit/intervention-studies. Accessed 22 Dec 2018.
Effect size. Available at https://en.m.wikipedia.org/wiki/Effect_size. Accessed 22 Dec 2018.
Kraemer HC, Morgan G, Leech NL, Gliner JA, Vaske JJ, Harmon RJ. Measures of clinical significance. J Am Acad Child Adolesc Psychiatry. 2003;42(12):1524–9. Available at https://jaacap.org/article/S0890-8567(09)62138-9/fulltext. Accessed 22 Dec 2018.
Jacob ME, M. Ganguli M. Odds ratio: neuroepidemiology. In: Handbook of clinical neurology; 2016.
Schnell A. The difference between relative risk and odds ratios. 2008. Available at https://www.sciencedirect.com/topics/medicine-and-dentistry/odds-ratio. Accessed 22 Dec 2018.
Statistical Tables. n.d.. Available at https://home.ubalt.edu/ntsbarsh/Business-stat/StatistialTables.pdf. Accessed 22 Dec 2018.
Psychometrica. n.d.. Available at https://www.psychometrica.de/effect_size.html. Accessed 22 Dec 2018.
Social Science Statistics. n.d.. Available at http://www.socscistatistics.com/tests/. Accessed 22 Dec 2018.
The Practical Meta-Analysis Effect Size Calculator. n.d.. Available at https://cebcp.org/practical-meta-analysis-effect-size-calculator/. Accessed 22 Dec 2018.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2021 The Author(s), under exclusive license to Springer Nature Switzerland AG
About this chapter
Cite this chapter
Balogun, J.A. (2021). Evaluation of Clinical Significance in Intervention Research. In: Okonofua, F., Balogun, J.A., Odunsi, K., Chilaka, V.N. (eds) Contemporary Obstetrics and Gynecology for Developing Countries . Springer, Cham. https://doi.org/10.1007/978-3-030-75385-6_67
Download citation
DOI: https://doi.org/10.1007/978-3-030-75385-6_67
Published:
Publisher Name: Springer, Cham
Print ISBN: 978-3-030-75384-9
Online ISBN: 978-3-030-75385-6
eBook Packages: MedicineMedicine (R0)