The role of p-values in analysing trial results

The current widespread practice of using p-values as the main means of assessing and reporting the results of clinical trials cannot be defended. Reasons for grave concern over the present situation range from the unsatisfactory nature of p-values themselves, their very common misunderstanding by statisticians as well as by clinicians and their serious distorting influence on our perception of the very nature of clinical trials. It is argued, however, that only by fully understanding the reasons why they have become so universally popular can we hope to change opinion and introduce more sensible ways of summarizing and reporting results. Some of the ways in which this might happen are discussed.