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Limitations of Significance Testing in Clinical Research: A Review of Multiple Comparison Corrections and Effect Size Calculations with Correlated Measures

Vasilopoulos, Terrie PhD; Morey, Timothy E. MD; Dhatariya, Ketan MD, FRCP; Rice, Mark J. MD

doi: 10.1213/ANE.0000000000001107
Economics, Education, and Policy: Statistical Grand Rounds

Modern clinical research commonly uses complex designs with multiple related outcomes, including repeated-measures designs. While multiple comparison corrections and effect size calculations are needed to more accurately assess an intervention’s significance and impact, understanding the limitations of these methods in the case of dependency and correlation is important. In this review, we outline methods for multiple comparison corrections and effect size calculations and considerations in cases of correlation and summarize relevant simulation studies to illustrate these concepts.

From the *Department of Anesthesiology, University of Florida College of Medicine, Gainesville, Florida; Elsie Bertram Diabetes Centre, Norfolk and Norwich University Hospitals, Norwich, United Kingdom; and Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, Tennessee.

Accepted for publication October 15, 2015.

Funding: None.

The authors declare no conflicts of interest.

Reprints will not be available from the authors.

Address correspondence to Mark J. Rice, MD, Department of Anesthesiology, Vanderbilt University Medical Center, 1301 Medical Center Dr., Suite 4648, The Vanderbilt Clinic, Nashville, TN 37232. Address e-mail to mark.j.rice@vanderbilt.edu.

© 2016 International Anesthesia Research Society
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