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JAMA Facial Plastic Surgery Guide to Statistics and Methods |

Thoughtful Methods to Increase Evidence Levels and Analyze Nonparametric Data

Lisa E. Ishii, MD, MHS1
[+] Author Affiliations
1Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland
JAMA Facial Plast Surg. 2015;17(4):307-308. doi:10.1001/jamafacial.2015.0465.
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This statistics guide describes how a well-designed observational study can provide valuable data and is a desirable option for studies where experimental designs like RCTs and non-RCTs are not feasible. It is important to select a statistical test appropriate for the specific data type.

In this issue of JAMA Facial Plastic Surgery, Sapthavee et al1 present a retrospective cohort study designed to compare the effectiveness of skin graft reconstruction and local flap reconstruction for nasal defects. This article is an excellent example of how level of evidence (LOE) can be increased from level 4 (case series) to level 3 (retrospective cohort study) by adding a comparison cohort group to the analysis (Table 1).2 It is also a good example of using a nonparametric statistical test, the Wilcoxon rank sum test, to evaluate nonparametric data.

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