PT  - JOURNAL ARTICLE
AU  - John Concato
AU  - John A Hartigan
TI  - P values: from suggestion to superstition
AID  - 10.1136/jim-2016-000206
DP  - 2016 Oct 01
TA  - Journal of Investigative Medicine
PG  - 1166--1171
VI  - 64
IP  - 7
4099  - http://hw-f5-jim.highwire.org/content/64/7/1166.short
4100  - http://hw-f5-jim.highwire.org/content/64/7/1166.full
SO  - J Investig Med2016 Oct 01; 64
AB  - A threshold probability value of ‘p≤0.05’ is commonly used in clinical investigations to indicate statistical significance. To allow clinicians to better understand evidence generated by research studies, this review defines the p value, summarizes the historical origins of the p value approach to hypothesis testing, describes various applications of p≤0.05 in the context of clinical research and discusses the emergence of p≤5×10−8 and other values as thresholds for genomic statistical analyses. Corresponding issues include a conceptual approach of evaluating whether data do not conform to a null hypothesis (ie, no exposure–outcome association). Importantly, and in the historical context of when p≤0.05 was first proposed, the 1-in-20 chance of a false-positive inference (ie, falsely concluding the existence of an exposure–outcome association) was offered only as a suggestion. In current usage, however, p≤0.05 is often misunderstood as a rigid threshold, sometimes with a misguided ‘win’ (p≤0.05) or ‘lose’ (p>0.05) approach. Also, in contemporary genomic studies, a threshold of p≤10−8 has been endorsed as a boundary for statistical significance when analyzing numerous genetic comparisons for each participant. A value of p≤0.05, or other thresholds, should not be employed reflexively to determine whether a clinical research investigation is trustworthy from a scientific perspective. Rather, and in parallel with conceptual issues of validity and generalizability, quantitative results should be interpreted using a combined assessment of strength of association, p values, CIs, and sample size.