Deficiencies in Reporting Clinical Significance in Contemporary CER

Contemporary Comparative Effectiveness Research (CER) often lacks explicit specification of clinically significant differences in study outcomes, as revealed in a systematic review of 307 studies from prominent medical journals. Only 8.5% of studies specified clinical significance, with 2.3% recommending changes in clinical decision-making based on statistical significance alone. Authors frequently defined clinical significance using validated standards. The inverse correlation between sample size and effect size in statistically significant randomized controlled trials highlights the need for clearer distinctions between clinical and statistical significance in CER.