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Law, Probability and Risk Advance Access originally published online on March 16, 2009
Law, Probability and Risk 2009 8(2):159-170; doi:10.1093/lpr/mgp004
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© The Author [2009]. Published by Oxford University Press. All rights reserved.

Revisiting the p-value: a comparison of statistical evidence in clinical and legal medical decision making{dagger}

Kelly H. Zou*

Pfizer Inc., New York, NY, USA

Lisa M. DeTora

Lafayette College, Easton, PA, USA

Steven J. Haker

Harvard Medical School and Brigham and Women's Hospital, Boston, MA, USA

Robert V. Mulkern

Harvard Medical School and Children's Hospital Boston, Boston, MA, USA

* Email: kelly.zou{at}pfizer.com


  Abstract

While the use of p-values in evidence-based medicine (EBM) is consistent and well-defined, the application of statistical information in health law varies greatly. A comparative literature review of clinical and legal medical decision making using Medline (PubMed) and LexisNexis reveals large disparities in the mode and frequency with which statistical evidence is used in EBM when compared with health law. We present the historical background of the p-value in the statistical literature and legal case law, including several medical malpractice cases, and then compare the use of the p-value as statistical evidence in health law and clinical research. We suggest that health law may consider the establishment of statistical criteria for appropriate applications.

Keywords: p-value; significance; hypothesis testing; evidence-based medicine; probability tests; health law

{dagger} Presented at a workshop held at George Washington University, August 1st 2009, in honour of the 70th birthday of Joe Gastwirth, one of the founding editors of Law, Probability and Risk.


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