Paeds Cases · professional-practice-and-evidence
Reading a paediatric trial result for a shared decision — OSCE
OSCE on reading a paediatric statistical result — confidence interval, p-value, effect size and clinical importance — and conveying it to a family in a shared decision.
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Study tools
Target exams
MRCPCH ClinicalRACP DCERCPSC Pediatrics
Prompt
Parents of a 5-year-old with a chronic relapsing illness are deciding whether to start a daily preventive therapy; they have read online that it 'significantly shortens flare duration' with a p-value of 0.04; you have the abstract, which reports a wide 95 percent confidence interval that crosses zero around a small mean difference.
Station brief (8–10 minutes)
Help the parents decide whether to start the preventive therapy by reading the abstract result honestly and weighing it for their child. Address the online 'significantly shortens flare duration' figure, the small effect size, the confidence interval that crosses zero, the limits of a p-value on its own, and the fact that the study was small. Do not invent jurisdiction-specific thresholds or specific drug doses. [4]
References4ShowHide
- [3]Akobeng AK Understanding type I and type II errors, statistical power and sample size. Acta Paediatr, 2016.PMID 26935977
- [4]Sullivan GM, Feinn R Using Effect Size-or Why the P Value Is Not Enough. J Grad Med Educ, 2012.PMID 23997866
- [5]Nakagawa S, Cuthill IC Effect size, confidence interval and statistical significance: a practical guide for biologists. Biol Rev Camb Philos Soc, 2007.PMID 17944619
- [9]Altman DG, Bland JM How to obtain the confidence interval from a P value. BMJ, 2011.PMID 21824904