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Comment & Response
April 17, 2019

The Fragility Index—P Values Reimagined, Flaws and All

Author Affiliations
  • 1Division of General Surgery, Department of Surgery, University of Toronto, Toronto, Ontario, Canada
JAMA Surg. 2019;154(7):674. doi:10.1001/jamasurg.2019.0567

To the EditorP values are often misused and misinterpreted in the medical literature. Common mistakes include assuming P values measure the probability of a hypothesis being true (ie, indicate uncertainty) and quantify the strength of an observed effect (ie, conflating small P values with true effects).1 As a solution, Tignanelli et al2 strongly recommend the use of the Fragility Index (FI) and Fragility Quotient (FQ) in the reporting and appraisal of surgical randomized clinical trials (RCTs).

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