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Evaluating the effectiveness of interventions: A comprehensive scoring system versus testing for statistical
Rav Sellahewa1, Hannah Webster1, Daniel L Rolnik2
1School of Clinical Sciences, Monash University, 246 Clayton Road, Clayton, Victoria 3168, Australia.
Summary
A context-driven causality interpretation using Bradford Hill Criteria may offer more clinical insight than strict P-value analysis in medical research. This approach better identifies treatment benefits, especially when P-values are borderline.
Area of Science:
- Medical research methodology
- Clinical trial analysis
- Epidemiological causality
Background:
- Medical practice relies on research observations, traditionally validated by P-values.
- Strict adherence to P-values may obscure genuine treatment benefits.
- Evaluating clinical trial outcomes requires robust interpretation methods.
Approach:
- Compared P-value interpretation with Bradford Hill Criteria for causality in Women's Health randomized controlled trials (RCTs).
- Scored 68 RCTs published since 2014 using the 10 Bradford Hill Criteria.
- Analyzed discordant results between P-values and Bradford Hill Criteria, referencing meta-analyses.
Key Points:
- 49% of studies showed concordance between P-values and Bradford Hill Criteria.
- 8 studies (12%) indicated effectiveness via Bradford Hill Criteria, contrary to P-value interpretation.
- Subsequent meta-analyses confirmed effectiveness in 6 of these 8 studies, often with borderline P-values (0.05-0.10).
Conclusions:
- Context-driven causality interpretation using Bradford Hill Criteria is potentially more informative than strict P-value reliance.
- This approach enhances the accurate assessment of clinical intervention benefits.
- Revisiting interpretation methods can improve clinical decision-making based on research findings.
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