A Bayesian analysis of non-significant rehabilitation findings: Evaluating the evidence in favour of truly absent treatment effects.

Bayes factor Bayesian analysis Meta-analysis Meta-research Null hypothesis significance testing Statistical power

Journal

Annals of physical and rehabilitation medicine
ISSN: 1877-0665
Titre abrégé: Ann Phys Rehabil Med
Pays: Netherlands
ID NLM: 101502773

Informations de publication

Date de publication:
Jul 2021
Historique:
received: 28 03 2020
revised: 06 05 2020
accepted: 12 07 2020
pubmed: 18 8 2020
medline: 21 10 2021
entrez: 18 8 2020
Statut: ppublish

Résumé

Relying solely on null hypothesis significance testing (NHST) to investigate rehabilitation interventions may result in researchers erroneously concluding the absence of a treatment effect. We aimed to distinguish between truly null treatment effects and data that are insensitive to detecting treatment effects by calculating Bayes factors (BF We searched the Cochrane Database of Systematic Reviews for meta-analyses with "rehabilitation" as a keyword that clearly evaluated a rehabilitation intervention. We extracted means, standard deviations, and sample sizes for treatment and comparison groups for individual findings within 175 meta-analyses. Two independent investigators classified the interventions into 4 categories using the Rehabilitation Treatment Specification System. We calculated t-statistics and associated P-values for each finding in order to extract non-significant results (P>0.05). We calculated BF Across all intervention types, most (71.9%) findings were deemed anecdotal, and this pattern remained within distinct intervention types (58.4-76.0%). Larger sample sizes tended to be associated with greater strength in favour of the null hypothesis, both across and within intervention types. Larger P-values were not associated with greater strength in favour of the null hypothesis; this finding was present both across and within intervention types. Our findings indicate that most non-significant rehabilitation findings are unable to distinguish between the true absence of a treatment effect and data that are merely insensitive to detecting a treatment effect. Findings also suggest that rehabilitation researchers may improve the strength of their statistical conclusions by increasing sample size and that Bayes factors may offer unique benefits relative to P-values.

Sections du résumé

BACKGROUND BACKGROUND
Relying solely on null hypothesis significance testing (NHST) to investigate rehabilitation interventions may result in researchers erroneously concluding the absence of a treatment effect.
OBJECTIVE OBJECTIVE
We aimed to distinguish between truly null treatment effects and data that are insensitive to detecting treatment effects by calculating Bayes factors (BF
METHOD METHODS
We searched the Cochrane Database of Systematic Reviews for meta-analyses with "rehabilitation" as a keyword that clearly evaluated a rehabilitation intervention. We extracted means, standard deviations, and sample sizes for treatment and comparison groups for individual findings within 175 meta-analyses. Two independent investigators classified the interventions into 4 categories using the Rehabilitation Treatment Specification System. We calculated t-statistics and associated P-values for each finding in order to extract non-significant results (P>0.05). We calculated BF
RESULTS RESULTS
Across all intervention types, most (71.9%) findings were deemed anecdotal, and this pattern remained within distinct intervention types (58.4-76.0%). Larger sample sizes tended to be associated with greater strength in favour of the null hypothesis, both across and within intervention types. Larger P-values were not associated with greater strength in favour of the null hypothesis; this finding was present both across and within intervention types.
CONCLUSION CONCLUSIONS
Our findings indicate that most non-significant rehabilitation findings are unable to distinguish between the true absence of a treatment effect and data that are merely insensitive to detecting a treatment effect. Findings also suggest that rehabilitation researchers may improve the strength of their statistical conclusions by increasing sample size and that Bayes factors may offer unique benefits relative to P-values.

Identifiants

pubmed: 32805456
pii: S1877-0657(20)30155-X
doi: 10.1016/j.rehab.2020.07.008
pii:
doi:

Types de publication

Journal Article Review

Langues

eng

Sous-ensembles de citation

IM

Pagination

101425

Informations de copyright

Copyright © 2020. Published by Elsevier Masson SAS.

Auteurs

Adam R Kinney (AR)

Department of Veterans Affairs, Rocky Mountain Mental Illness Research, Education and Clinical Center (MIRECC), Aurora, CO, USA; Department of Physical Medicine and Rehabilitation, University of Colorado Anschutz Medical Campus, Aurora, CO, USA. Electronic address: Adam.Kinney@va.gov.

Addie Middleton (A)

New England Geriatric Research Education and Clinical Center, VA Boston Healthcare System, Boston, MA, USA.

James E Graham (JE)

Department of Occupational Therapy, Colorado State University, Fort Collins, CO, USA.

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