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Abstract
Physicians depend on the medical literature to keep current with clinical information.
Little is known about residents' ability to understand statistical methods or how
to appropriately interpret research outcomes.
To evaluate residents' understanding of biostatistics and interpretation of research
results.
Multiprogram cross-sectional survey of internal medicine residents.
Percentage of questions correct on a biostatistics/study design multiple-choice knowledge
test.
The survey was completed by 277 of 367 residents (75.5%) in 11 residency programs.
The overall mean percentage correct on statistical knowledge and interpretation of
results was 41.4% (95% confidence interval [CI], 39.7%-43.3%) vs 71.5% (95% CI, 57.5%-85.5%)
for fellows and general medicine faculty with research training (P < .001). Higher
scores in residents were associated with additional advanced degrees (50.0% [95% CI,
44.5%-55.5%] vs 40.1% [95% CI, 38.3%-42.0%]; P < .001); prior biostatistics training
(45.2% [95% CI, 42.7%-47.8%] vs 37.9% [95% CI, 35.4%-40.3%]; P = .001); enrollment
in a university-based training program (43.0% [95% CI, 41.0%-45.1%] vs 36.3% [95%
CI, 32.6%-40.0%]; P = .002); and male sex (44.0% [95% CI, 41.4%-46.7%] vs 38.8% [95%
CI, 36.4%-41.1%]; P = .004). On individual knowledge questions, 81.6% correctly interpreted
a relative risk. Residents were less likely to know how to interpret an adjusted odds
ratio from a multivariate regression analysis (37.4%) or the results of a Kaplan-Meier
analysis (10.5%). Seventy-five percent indicated they did not understand all of the
statistics they encountered in journal articles, but 95% felt it was important to
understand these concepts to be an intelligent reader of the literature.
Most residents in this study lacked the knowledge in biostatistics needed to interpret
many of the results in published clinical research. Residency programs should include
more effective biostatistics training in their curricula to successfully prepare residents
for this important lifelong learning skill.