One-Sided Versus Two-Sided Testing

Lemuel A. Moyé ()
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Lemuel A. Moyé: University of Texas, Health Science Center at Houston, School of Public Health

Chapter 8 in Statistical Reasoning in Medicine, 2006, pp 167-180 from Springer

Abstract: 8.11 Conclusions I believe one-sided (benefit only) testing reflects a mindset of physicians and healthcare researchers who believe their intervention can produce no harm, a philosophy that has been shown repeatedly to be faulty, and dangerous to patients and their families. Investigators who agree to the one-sided (benefit only) approach to significance testing in a clinical experiment have closed parts of their minds to the possibility of harm entering into an avoidable flirtation with danger. In this sense, the one-sided test is not the disease, it is only a symptom. We as physicians and healthcare workers feel strongly about the treatment programs we advocate. This is required in our profession. However, these strong feelings often betray us since our day-to-day experience does not provide an objective view of the treatments. We need every tool we can find to help us gain that objective vantage point. The use of a two-sided significance test is of utmost importance. A forceful, intelligent argument for ethics will argue not only for a two-sided test, but asymmetrical allocation of alpha. Prospective identification of alpha is again critical here, and community protection predominates all other concerns. A sensitive, perceptive, ethical approach to alpha allocation for sidedness can complicate experimental design, but complexity in the name of ethics is no vice.

Keywords: Premature Ventricular Contraction; Lipid Research Clinic; Community Protection; Total Alpha; Heart Arrhythmia (search for similar items in EconPapers)
Date: 2006
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DOI: 10.1007/978-0-387-46212-7_9

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