Statistical, Practical, Clinical, and Personal Significance: Definitions and Applications in Speech-Language Pathology Purpose To discuss constructs and methods related to assessing the magnitude and the meaning of clinical outcomes, with a focus on applications in speech-language pathology. Method Professionals in medicine, allied health, psychology, education, and many other fields have long been concerned with issues referred to variously as practical ... Tutorial
Tutorial  |   August 01, 2011
Statistical, Practical, Clinical, and Personal Significance: Definitions and Applications in Speech-Language Pathology
 
Author Affiliations & Notes
  • Anne K. Bothe
    University of Georgia, Athens
  • Jessica D. Richardson
    University of South Carolina, Columbia
  • Correspondence to Anne K. Bothe: abothe@uga.edu
  • Editor and Associate Editor: Laura Justice
    Editor and Associate Editor: Laura Justice×
Article Information
Speech, Voice & Prosodic Disorders / Research Issues, Methods & Evidence-Based Practice / Tutorials
Tutorial   |   August 01, 2011
Statistical, Practical, Clinical, and Personal Significance: Definitions and Applications in Speech-Language Pathology
American Journal of Speech-Language Pathology, August 2011, Vol. 20, 233-242. doi:10.1044/1058-0360(2011/10-0034)
History: Received April 15, 2010 , Revised September 22, 2010 , Accepted March 25, 2011
 
American Journal of Speech-Language Pathology, August 2011, Vol. 20, 233-242. doi:10.1044/1058-0360(2011/10-0034)
History: Received April 15, 2010; Revised September 22, 2010; Accepted March 25, 2011
Web of Science® Times Cited: 11

Purpose To discuss constructs and methods related to assessing the magnitude and the meaning of clinical outcomes, with a focus on applications in speech-language pathology.

Method Professionals in medicine, allied health, psychology, education, and many other fields have long been concerned with issues referred to variously as practical significance, clinical significance, social validity, patient satisfaction, treatment effectiveness, or the meaningfulness or importance of beyond-clinic or real-world treatment outcomes. Existing literature addressing these issues from multiple disciplines was reviewed and synthesized.

Conclusions Practical significance, an adjunct to statistical significance, refers to the magnitude of a change or a difference between groups. The appropriate existing term for the interpretation of treatment outcomes, or the attribution of meaning or value to treatment outcomes, is clinical significance. To further distinguish between important constructs, the authors suggest incorporating as definitive the existing notion that clinical significance may refer to measures selected or interpreted by professionals or with respect to groups of clients. The term personal significance is introduced to refer to goals, variables, measures, and changes that are of demonstrated value to individual clients.

Acknowledgments
An earlier version of this article was first developed while the second author was associated with the University of Georgia. Our thanks to Duska M. Franic for sharing her expertise in pharmaco-economics, quality of life measurement, and related areas, and to Patrick Finn for helpful comments about multiple versions of the manuscript.
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