A Narrative Methodological Review of Discordance Between Statistical and Clinical Significance in Research on Digital Interventions for Adolescent Depression

Abstract Background and Objective : Across trials of digital intervention for adolescent depression, statistically significant findings often coexist with only marginal clinical improvement whereas underpowered studies may fail to detect clinically meaningful benefits. This study aimed to apply the Multidimensional Clinical Interpretation Framework (MCIF), a seven-domain sequential framework for evaluate the clinical relevance of evidence from adolescent's Digital depression interventions trials. Methods : A narrative methodological review with conceptual framework development was conducted. PubMed, PsycINFO, Scopus and Web of science were searched from January 2005 to March 2026, with targeted citation tracking of key methodological publications. Two independent reviewers screened titles and abstracts, with disagreements resolved by consensus. Of 3,847 identified records, 42 studies met eligibility criteria. Results: Review of the 42 included trials showed that clinically meaningful outcomes were inconsistently reported with statistical significance frequently prioritized over interpretable effect magnitudes. To address these shortcomings, the Multidimensional Clinical Interpretation Framework (MCIF) was developed. It integrates seven interpretive domains (statistical outcome, effect size, measurement reliability, clinical meaningfulness, functional improvement, implementation feasibility, and reporting transparency) into a single sequential evaluative structure. The MCIF provides a practical and step-by-step approach to evaluating the real-world relevance of digital depression interventions for adolescents. Conclusion: reliance of statistical significance alone is insufficient for interpreting effectiveness. The MCIF is a tool that provides a structured, multidimensional approach to improve interpretation, strengthen reporting, and facilitate translation of research evidence into clinical practice.