DNP 801 How do statistical significance and clinical significance apply to a quality improvement initiative, like your future DPI Project?

DNP 801 How do statistical significance and clinical significance apply to a quality improvement initiative, like your future DPI Project?

DNP 801 How do statistical significance and clinical significance apply to a quality improvement initiative, like your future DPI Project?

One purpose of statistical significance is to accept or reject the null hypothesis, not focus on research hypotheses. The primary focus is to measure the strength of evidence. It may be altered by sample size, the magnitude of the relationship and error, this can cause distortion of findings.

Clinical studies are valuable and importance to clinical practice when results are appropriately interpreted. Clinically significant findings support medical care that results in improved individual physical function, mental health, and ability improve engagement in society.

The clinical point of view, the statistically significant difference among groups is not of prime importance. If a well‑conducted study shows a difference in treatment options within two groups, it is of prime importance to know whether that difference is of clinically importance or not. Sample size and measurement variability easily influences the statistical results, a nonsignificant outcome does not imply that the new therapy or treatment protocol is not beneficial (Sharma, 2021)

When reviewing articles, researchers should not only consider statistical significance and clinical significance, but take into consideration sample size, effect size of study, potential biases, the ability to reproduce the study results. (Sharma, 2021).

 

When researching what type of quality improvement initiative to implement., statistical and clinical significance of studies should be reviewed. Ensuring more balanced and less chance of biases. Answering questions re: journal articles it should be understood that variables are observed results, should be clearly identified. The study for article review of statistical and clinical significance wa a review of six databases researching literature on how the affects of transportation barriers affect those with chronic conditions. (Starbird, DiMaina, et al, 2019). The research was supportive of the need for more research in relation to transportation barriers. The article is interesting but doesn’t do a good job with statistical significance.

 

Sharma, H. (2021). Statistical significance or clinical significance? A researcher’s dilemma for appropriate interpretation of research results. Saudi Journal of Anesthesia, 15(4), 431–434. https://doi-org.lopes.idm.oclc.org/10.4103/sja.sja_158_21

 

Starbird, L. E., DiMaina, C., Sun, C.-A., & Han, H.-R. (2019). A systematic review of interventions to minimize transportation barriers among people with chronic diseases. Journal of Community Health, 44(2), 400–411. https://doi-org.lopes.idm.oclc.org/10.1007/s10900-018-0572-3

Insightful post regarding the distinction of statistical significance compared to clinical significance. It can be easy for

DNP 801 How do statistical significance and clinical significance apply to a quality improvement initiative, like your future DPI Project
DNP 801 How do statistical significance and clinical significance apply to a quality improvement initiative, like your future DPI Project

novice nurses or researchers to view a study solely in terms of statistical significance. However, as you stated in your post, clinical significance may be a pertinent finding even if it is not statistically significant. As Sharma (2021) explained, the P-value score should not preclude scientific reasoning. I suspect this is why we recently discussed the importance of critical thinking for DNP students! Critically analyzing and interpreting results helps to understand the true intention, meaning, and impact of the study, beyond statistical significance. When considering clinical significance, for those living with a chronic condition, having transportation is a significant variable that can either enhance or reduce the quality of life for patients. Progressing in your research, clinical meaning will be an important variable as you look at transportation as a component of social determinants of health.

Reference

Sharma, H. (2021). Statistical significance or clinical significance? A researcher’s dilemma for appropriate interpretation of research results. Saudi Journal of Anesthesia, 15(4), 431–434. Doi: 10.4103/sja.sja_158_21

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Clinical significance can be used for studies where relevant clinical outcomes are utilized to assess the efficacy of a treatment. In most cases, findings are those that aid in improving the patient’s wellness and quality of life (Sharma, 2021). Clinically significant results lead to but are not limited to improved mental status, physical function, social life engagement, and can deal with both subjective and objective data (Sharma, 2021). An example would be a new medication that would be considered to have clinical significance if it has a measurable positive effect on patient outcomes and treatment. On the other hand, statistical significance does not necessarily mean results lead to improved patient outcomes. Statistical significance indicates that results from a test are not likely derived from chance but rather a specific occurrence. In statistical significance, the p-value is important as it examines assumptions and how data was produced (Imbens, 2021).

Both statistical and clinical significance play a role in the future DPI Project. Statistical significance should be examined as it can aid with supportive data for the DPI project. Although p-values may be significant for studies, clinical significance should be carefully examined. The goal of the DPI project is to implement evidence-based research into practice to improve patient outcomes. With this, the clinical significance is in studies is key to ensuring the success of the DPI project. Implementing practice that is supported by high clinical statistics will lead to positive and improved outcomes. In my proposed DPI project, the goal is to decrease the delay in care of patients needing intravenous (IV) lines. Although the organization utilizes an IV team that specializes in IV insertions, there is an extended amount of time for the IV team to reach each patient, causing a delay in care. As a DNP learner, it is vital to implement a change where both statistical and clinical significance is considered. It would be pertinent to have studies that have statistical and clinically significant data to support the implementation VeinViewers and ultrasound machines to ultimately decrease delays in care.

 

References:

Imbens, G. W. (2021). Statistical significance, p-values, and the reporting of uncertainty. Journal of Economic

Perspectives35(3),

157–174. https://doi-org.lopes.idm.oclc.org/10.1257/jep.35.3.157

 

Sharma, H. (2021). Statistical significance or clinical significance? A researcher’s dilemma for appropriate interpretation of research results. Saudi Journal of Anaesthesia15(4), 431–434.

https://doi-org.lopes.idm.oclc.org/10.4103/sja.sja_158_21  

While a finding with statistical significance informs of numerical findings, clinical significance indicates a functional change or improvement. So, as you discussed, it is vital to consider not only the statistical significance during the Practice Improvement project but also clinical significance. In consideration of using a Vein Viewer for IV cannulization, there are many clinically significant considerations such as: time for insertion, number of attempts, patient satisfaction or amount of time it takes to get appropriate intravenous therapies initiated. Will your project be looking solely at a Vein Viewer? I was not aware of the different types available.

Francisco et al. (2021) found vein finders using infra-red light used less energy and were able to be manufactured at a lower cost compared to other commercially prepared vein finders. This is another example of clinical significance that should be taken into consideration. With the rising cost of healthcare, if the technology is equally effective but one is cheaper than the other, it should be taken into consideration.

References

Francisco, M. D., Chen, W. F., Pan, C. T., Lin, M. C., Wen, Z. H., Liao, C. F. & Shiue, Y. L. (2021). Competitive Real-Time Near Infrared (NIR) Vein Finder Imaging Device to Improve Peripheral Subcutaneous Vein Selection in Venipuncture for Clinical Laboratory Testing. Micromachines12(373), 373. https://doi-org.lopes.idm.oclc.org/10.3390/mi12040373