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Tukur Dahiru (MBBS), FMCPH, Dip. HSM (Israel)

Dept. of Community Medicine, Ahmadu Bello University, Zaria, Nigeria.


While it’s not the intention of the founders of significance testing and hypothesis testing to have the two ideas intertwined as if they are complementary, the inconvenient marriage of the two practices into one coherent, convenient, incontrovertible and misinterpreted practice has dotted our standard statistics textbooks and medical journals. This paper examine factors contributing to this practice, traced the historical evolution of the Fisherian and Neyman-Pearsonian schools of hypothesis testing, exposed the fallacies and the uncommon ground and common grounds approach to the problem. Finally, it offers recommendations on what is to be done to remedy the situation.


The medical journals are replete with P values and tests of hypotheses. It is a common practice among medical researchers to quote whether the test of hypothesis they carried out is significant or non-significant and many researchers get very excited when they discover a “statistically significant” finding without really understanding what it means. Additionally, while medical journals are florid of statement such as: “statistical significant”, “unlikely due to chance”, “not significant,” “due to chance”, or notations such as, “P > 0.05”, “P < 0.05”, the decision on whether to decide a test of hypothesis is significant or not based on P value has generated an intense debate among statisticians. It began among founders of statistical inference more than 60 years ago1-3. One contributing factor for this is that the medical literature shows a strong tendency to accentuate the positive findings; many researchers would like to report positive findings based on previously reported researches as “non- significant results should not take up” journal space4-7

The idea of significance testing was introduced by R.A. Fisher, but over the past six decades its utility, understanding and interpretation has been misunderstood and generated so much scholarly writings to remedy the situation3. Alongside the statistical test of hypothesis is the P value, which similarly, its meaning and interpretation has been misused. To delve well into the subject matter, a short history of the evolution of statistical test of hypothesis is warranted to clear some misunderstanding.

A Brief History of P Value and Significance Testing

Significance testing evolved from the idea and practice of the eminent statistician, R.A. Fisher in the 1930's. His idea is simple: suppose we found an association between poverty level and malnutrition among children under the age of five years. This is a finding, but could it be a chance finding? Or perhaps we want to evaluate whether a new nutrition therapy improves nutritional status of malnourished children. We study a group of malnourished children treated with the new therapy and a comparable group treated with old nutritional therapy and find in the new therapy group an improvement of nutritional status by 2 units over the old therapy group. This finding will obviously, be welcomed but it is also possible that this finding is purely due to chance. Thus, Fisher saw P value as an index measuring the strength of evidence against the null hypothesis (in our examples, the hypothesis that there is no association between poverty level and malnutrition or the new therapy does not improve nutritional status). To quantify the strength of evidence against null hypothesis “he advocated P < 0.05 (5% significance) as a standard level for concluding that there is evidence against the hypothesis tested, though not as an absolute rule’’8.

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All Correspondence to:

Dr. Tukur Dahiru

MBBS, FMCPH, Dip HSM (Israel)