> A subsequent Bayesian reanalysis did show a statistically significant advantage to psilocybin, but this difference was not clinically significant.
What does it mean for something to be statistically significant, but not "clinically significant"?
What does it mean for something to be statistically significant, but not "clinically significant"?
In this trial, the difference between the psilocybin group and the escitalopram group was, on average, two points on the QIDS-SR-16 scale. Those two points might represent someone reporting that their sleep has slightly improved, or that they feel slightly more energetic and slightly more able to concentrate. We can detect that difference in the analysis of the data and we can be somewhat confident that it's a real difference, but it's not the sort of change that most people would be able to distinguish from normal day-to-day variation.
Of course those very subtle differences might aggregate to a meaningful benefit across a whole patient population, but we also have to consider the cost-benefit tradeoff. A tiny benefit might be highly significant if the treatments were very similar in cost, but they aren't - escitalopram is a very cheap generic drug that can be safely prescribed by family doctors and nurse prescribers with minimal follow-up, while psilocybin currently requires a full day in a specialised clinic with significant preparation and follow-up.
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