Establishing a National Cardiovascular Disease Surveillance System in the United States Using Electronic Health Record Data: Key Strengths and Limitations.

J Am Heart Assoc · 2022 · PMC9238467 · PMID 35411783

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an adverse trendno p-value reported

Ideally, when a surveillance system reveals an adverse trend in some metric over time, a true worsening attributable to some biologically plausible underlying cause(s) is operating.

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Quoted from the open-access full text in Europe PMC under the licence the publisher applied. The sentence is reproduced exactly as published; the emphasis is ours.