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PubMed · 8900794

Hypothesis testing.

Abstract

Hypothesis testing is the process of making a choice between two conflicting hypotheses. The null hypothesis, H0, is a statistical proposition stating that there is no significant difference between a hypothesized value of a population parameter and its value estimated from a sample drawn from that population. The alternative hypothesis, H1 or Ha, is a statistical proposition stating that there is a significant difference between a hypothesized value of a population parameter and its estimated value. When the null hypothesis is tested, a decision is either correct or incorrect. An incorrect decision can be made in two ways: We can reject the null hypothesis when it is true (Type I error) or we can fail to reject the null hypothesis when it is false (Type II error). The probability of making Type I and Type II errors is designated by alpha and beta, respectively. The smallest observed significance level for which the null hypothesis would be rejected is referred to as the p-value. The p-value only has meaning as a measure of confidence when the decision is to reject the null hypothesis. It has no meaning when the decision is that the null hypothesis is true.

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BibTeXRIS

H N Yarandi. 1996. Hypothesis testing.. https://doi.org/10.1097/00002800-199607000-00009

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Assessment of blinding in pharmacotherapy and noninvasive neuromodulation randomized controlled trials for neuropathic pain in adults.

In randomized controlled trials (RCTs), study participants and research personnel are often blinded to minimize biases related to knowing treatment allocation. To determine if blinding was effective, participants may be asked which treatment they believe they received ("treatment guess"). This descriptive review characterized blinding assessment (BA) reporting in pharmacotherapy and neuromodulation neuropathic pain RCTs. Of 288 papers, 36 (12.5%) reported a BA. One paper reported the results of 2 studies, so in total 37 studies with a BA were assessed. Of these, 19 were crossover, 17 parallel, and 1 partial crossover in design. All 37 studies assessed participant blinding, and 10 also assessed investigator blinding. Approximately 27% included an "unsure" answer option for treatment guess, and 38% asked the reason for the guess. There were no clear patterns in BA reporting across time nor based on treatment type. Seventeen trials provided sufficient data to calculate Bang Blinding Index (BI) to determine blinding success. Participants remained blinded (BI = 0 &#xb1; 0.2) in 10/17 placebo and 10/17 treatment arms, 6 placebo and 5 treatment arms had a BI > 0.2 suggesting possible unblinding, whereas 1 placebo and 2 treatment arms had a BI < -0.2 suggesting misinformed guessing. Overall, we found that BAs are done in a minority of published neuropathic pain trials and with variable methodology. Given the importance of minimizing risk of bias because of treatment unblinding, future studies should consider including BAs, and further consensus building is necessary to determine if and how BAs should be conducted and interpreted in analgesic clinical trials.

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