A study reports p = 0.03 for a new antihypertensive drug's superiority. The 95% confidence interval for mean SBP reduction is 1–3 mmHg. How should clinicians interpret this finding?
- A Statistically and clinically significant; prescribe the drug
- B Statistically significant but likely not clinically meaningful due to narrow CI with small effect size ✓
- C Not statistically significant because the CI is narrow
- D The p-value should be disregarded; only CI matters
Correct answer: B. Statistically significant but likely not clinically meaningful due to narrow CI with small effect size
Explanation
Statistical significance (p<0.05) and clinical significance are distinct concepts. A narrow CI (1–3 mmHg) indicates a precisely estimated but small effect — a reduction of 1–3 mmHg in SBP is unlikely to be clinically meaningful in most patients. Large sample sizes can produce statistically significant results for trivial effects. Clinicians must assess effect size and clinical relevance alongside p-values; the Minimal Clinically Important Difference (MCID) for SBP in hypertension management is generally ≥5 mmHg.
Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.
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