The meaning of "p-value": Pursuing clinical and statistical significance. A narrative review.

The evolution of statistical thinking within the scientific community has developed over nearly three centuries. The concept of "probability," commonly represented by the p-value, has been applied in medical research for more than a century. Its integration into hypothesis testing has played an important role in advancing medical science. Nevertheless, the p-value has also become one of the most misunderstood and misapplied statistical measures. The common practice of rigidly categorizing the probability value as being above or below the 0.05 threshold has often taken on a dogmatic quality, at times resembling a doctrine rather than a purely scientific criterion. In reporting experimental results and conducting hypothesis testing, references to "statistical significance" are frequently equated with "truth", while findings deemed "not statistically significant" are mistakenly interpreted as "false". This is a conflation and it is incorrect. The objective of this article is to provide a concise review of the history of statistics in medicine, clarify the development of the "probability value" concept, discuss its role in hypothesis testing, and consider its interpretation alongside clinical significance.