Community Medicine (PSM) · Biostatistics (Measures of Central Tendency, Tests of Significance, Sampling)

A pharmaceutical trial reports a p-value of 0.03 for the primary outcome. The 95% confidence interval for the difference in means is −0.1 to 4.5 units. The MOST appropriate clinical interpretation is:

  • A Statistical significance is achieved but the confidence interval spans a wide range including near-zero differences, limiting clinical certainty
  • B The result is statistically significant and clinically meaningful because p<0.05
  • C The result is not significant because the confidence interval includes zero
  • D The confidence interval confirms that the minimum clinically important difference is exceeded
Correct answer: A. Statistical significance is achieved but the confidence interval spans a wide range including near-zero differences, limiting clinical certainty

Explanation

A p-value of 0.03 confirms statistical significance at the 0.05 level. However, the 95% CI of −0.1 to 4.5 units is wide, with the lower bound near zero (and just below zero). This means the true treatment effect could plausibly be negligible (−0.1) or substantial (4.5), providing low precision. Importantly, the CI does NOT include a clear clinically meaningful minimum threshold, so while the result achieves statistical significance, clinical relevance is uncertain. This illustrates why CI is more informative than p-value alone. Note: a CI not including zero supports statistical significance; here −0.1 to 4.5 barely excludes zero, consistent with p=0.03.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

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