The trends for the "trend toward significance" in the pediatric literature
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Updated: Aug 19, 2025

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Published on: September 20, 2024
Dimitrios Rallis1, Maria Baltogianni2, Foteini Balomenou2
1Neonatal Intensive Care Unit, University of Ioannina, Faculty of Medicine, Stavrou Niarchou Avenue, 45500, Ioannina, Greece. drallis@uoi.gr.
Abstract:
Purpose This study is to examine whether the term "trend toward statistical significance" is used to describe statistically nonsignificant results in biomedical literature. We examined articles published in five high-impact pediatric journals, including The Lancet Child & Adolescent Health, The Journal of Pediatrics, Early Human Development, Frontiers in Pediatrics, and BMC Pediatrics to identify manuscripts where a "trend" was used to describe a statistically nonsignificant result, from January 2020 to December 2021, and, furthermore, for The Journal of Pediatrics, Early Human Development, and BMC Pediatrics from January 2010 to December 2011. We detected that a "trend toward significance" was used to describe a statistically nonsignificant result at least once in 146 articles (2.7%) during the period between 2020 and 2021 and in 97 articles (4.0%) during the period between 2010 and 2011. We found no significant difference in the proportion of published articles with inappropriate use of "trend" across journals belonging to the first quartile of impact compared to the second quartile or across journals publishing under the subscription model or open access policy compared to journals publishing solely under the open access policy, in any period. The overall proportion of the inappropriate use of "trend" declined significantly between 2010 and 2011 to 2020 and 2021 (p = 0.002, RR 0.66 95% CI 0.51-0.86).
Conclusion:
"Trend" statements were sporadically used to describe statistically nonsignificant results across pediatric literature. The inappropriate use of "trend" to describe almost significant differences could be misleading, and "trend" should be reserved only when a specific statistical test for trend has been performed, or in relation to appropriate scientific definitions.
What Is Known:
•Previously, researchers have reported inappropriate use of "trend" in articles across anaesthesia or major oncology journals. •In many cases, hypothesized results that are close but not lower than the statistical significance threshold are emphasized as "almost" significant.
What Is New:
•"Trend" statements were sporadically used to describe statistically nonsignificant results across pediatric literature. •Inappropriate use of "trend" was similar in journals with a subscription model compared to those having an open access policy and decreased within a 10-year period.
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