Levels Of Clinical Significance
Write short note on levels of clinical significance.
Answer. There are four levels of clinical significance which are based on nature of benefit and size of treatment effect:
- Clinical significance level 1.
- Clinical significance level 2.
- Clinical significance level 3.
- Clinical significance level 4.
Clinical Significance Level 1
Treatment of clinical significance level 1 are the miracle cure in which the treatment provides tangential benefit and the treatment effect is large. e.g. vitamin C is given in cases of scurvy, bone marrow transplantation in cases of leukemia, etc. In above examples, treatment is beneficial and treatment effect is large.
Clinical Significance Level 2
It describes the treatment, which provides tangential benefit but its benefit from treatment is small. This is because
- Size of benefit of one therapy over another is small
- Due to the randomized control trials
- It is larger in size and rigorous in execution and analysis
For example, advantage of tissue plasminogen activator over streptokinase.
Clinical significance level 2 is an individual’s choice in which cost and side effects play major role.
Clinical Significance Level 3
Treatment at this level is the magical bullet. In this, the treatment effects are beneficial as well as intangible and are very convincing so that need for randomized control trials may appear remote.
For example, HAART therapy in AIDS patients, Chlorhexidine in prevention of caries.At this level, there is always uncertainty of whether intangible benefits convert into real, tangible patient benefits.
Clinical Significance Level 4
These are the treatments which have reliable evidence from large randomized control trials of small intangible benefits. Since the effect of treatment is less epidemiological studies or surveys are incapable of identifying treatment at this level. For example, tiny dropping of blood pressure, mild decrease in pocket depth. Treatment at this level may cause more harm.
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