Editorial
Statistical Literacy among Foot and Ankle Surgeons
In order to understand the biomedical literature and make informed clinical decisions, foot and ankle surgeons are often required to interpret the statistical information used to describe the outcomes of clinical investigations. Statistical results are presented in essentially every published clinical report and may be used to describe the association of a risk factor or a disease in a population, which, in turn, can influence the interpretation of a clinical test or diagnostic finding or the indication to procure
additional tests. Such information, when combined with a clinician’s experience and a patient’s understanding of the options, comprises the evidence base upon which we make clinical decisions. But just how many foot and ankle surgeons understand biostatistical results, and how many have the ability to use such information for the benefit of their patients? How many foot and ankle surgeons know the definition of the p value? Is it the probability that the null hypothesis is false? Or is it the probability of getting results at least as extreme as those actually obtained if the null hypothesis were true? The correct answer is the latter, and this is precisely one of the questions posed to Ob-Gyn residents in a published survey that focused on statistical literacy (1). In that survey, respondents performed poorly on 2 statistical literacy questions, with only 26% (1222 of 4713) correctly answering a positive predictive value question and 42% (1989 of 4713) correctly defining the p value. In my opinion, it is likely that foot and ankle surgical residents would perform similarly to the way that Ob-Gyn residents performed (just as poorly) when posed with questions related to statistical literacy because the 2 groups (like most young surgeons) experience little to no formal training in biostatistics. With the exception of undergraduate statistics courses and perhaps a critical appraisal course in medical school, most surgeons get no statistical training beyond the bits and pieces discussed in journal club. I think that statistical literacy is an important prerequisite for an informed body of foot and ankle surgeons because it is necessary in order for us to understand risks and to ask the right questions. This is one of the reasons why we publish Dr. Jupiter’s Investigators’ Corner in each issue of The Journal of Foot & Ankle Surgery. It is also why I would welcome the publication of biomedical research that focuses on the association of statistical literacy and clinical outcomes. D. Scot Malay, DPM, MSCE, FACFAS Editor The Journal of Foot & Ankle SurgeryÒ
Reference 1. Anderson BL, Williams S, Schulkin J. Statistical literacy of obstetrics-gynecology residents. J Grad Med Ed 5:272–275, 2013.
1067-2516/$ - see front matter Ó 2014 by the American College of Foot and Ankle Surgeons. All rights reserved. http://dx.doi.org/10.1053/j.jfas.2014.07.001
Statistical Literacy among Foot and Ankle Surgeons
In order to understand the biomedical literature and make informed clinical decisions, foot and ankle surgeons are often required to interpret the statistical information used to describe the outcomes of clinical investigations. Statistical results are presented in essentially every published clinical report and may be used to describe the association of a risk factor or a disease in a population, which, in turn, can influence the interpretation of a clinical test or diagnostic finding or the indication to procure
additional tests. Such information, when combined with a clinician’s experience and a patient’s understanding of the options, comprises the evidence base upon which we make clinical decisions. But just how many foot and ankle surgeons understand biostatistical results, and how many have the ability to use such information for the benefit of their patients? How many foot and ankle surgeons know the definition of the p value? Is it the probability that the null hypothesis is false? Or is it the probability of getting results at least as extreme as those actually obtained if the null hypothesis were true? The correct answer is the latter, and this is precisely one of the questions posed to Ob-Gyn residents in a published survey that focused on statistical literacy (1). In that survey, respondents performed poorly on 2 statistical literacy questions, with only 26% (1222 of 4713) correctly answering a positive predictive value question and 42% (1989 of 4713) correctly defining the p value. In my opinion, it is likely that foot and ankle surgical residents would perform similarly to the way that Ob-Gyn residents performed (just as poorly) when posed with questions related to statistical literacy because the 2 groups (like most young surgeons) experience little to no formal training in biostatistics. With the exception of undergraduate statistics courses and perhaps a critical appraisal course in medical school, most surgeons get no statistical training beyond the bits and pieces discussed in journal club. I think that statistical literacy is an important prerequisite for an informed body of foot and ankle surgeons because it is necessary in order for us to understand risks and to ask the right questions. This is one of the reasons why we publish Dr. Jupiter’s Investigators’ Corner in each issue of The Journal of Foot & Ankle Surgery. It is also why I would welcome the publication of biomedical research that focuses on the association of statistical literacy and clinical outcomes. D. Scot Malay, DPM, MSCE, FACFAS Editor The Journal of Foot & Ankle SurgeryÒ
Reference 1. Anderson BL, Williams S, Schulkin J. Statistical literacy of obstetrics-gynecology residents. J Grad Med Ed 5:272–275, 2013.
1067-2516/$ - see front matter Ó 2014 by the American College of Foot and Ankle Surgeons. All rights reserved. http://dx.doi.org/10.1053/j.jfas.2014.07.001
