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EDITOR
The dispute between Barber and Thompson,1 who are
advocating a t test, and Williams, Cohen, and Russell, who
are advocating a Mann-Whitney U test,2 has its roots in
the use of P values rather than confidence intervals. If Williams et al had reported their results as a confidence interval for the difference in mean cost, as recommended for the results of clinical trials published in the BMJ, the question would not have arisen.
The sample size is surely large enough for the large sample Normal comparison, which does not require data to follow a normal
approximation and to which the t method approximates, to be
valid, even with such highly skewed data. This gives a confidence
interval for the difference in cost of secondary treatment (routine
minus open access) equal to -£180 to +£238, the point estimate being
£29, and the same P value as the t