Show me the evidence: using number needed to treat.
This article reviews one of the basic tools of evidence-based medicine, the calculation and interpretation of Number Needed to Treat (NNT) and Number Needed to Harm (NNH). Especially appealing is the simplicity of extracting this information from journal articles that report binary outcomes, such as medication response or emergence of adverse events. On-line resources and calculators can help the clinician in determining confidence intervals for these metrics. After a discussion of absolute versus relative risk, P-values, and the mechanics of calculating NNT and NNH, the application of NNT and NNH to a large clinical trial, the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) for schizophrenia, is described.
Citrome
Leslie
L
Department of Psychiatry, New York University School of Medicine, USA. citrome@nki.rfmh.org
D014150:Antipsychotic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001569:Benzodiazepines / Q000627:therapeutic use; D003024:Clozapine / Q000627:therapeutic use; D016001:Confidence Intervals; D003627:Data Interpretation, Statistical; D003657:Decision Making; D019317:Evidence-Based Medicine; D006801:Humans; D016013:Likelihood Functions; D000077152:Olanzapine; D010879:Piperazines / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic / Q000706:statistics & numerical data; D012107:Research Design; D018570:Risk Assessment / Q000706:statistics & numerical data*; D018967:Risperidone / Q000627:therapeutic use; D012559:Schizophrenia / Q000188:drug therapy; D013844:Thiazoles / Q000627:therapeutic use; D016896:Treatment Outcome
D014150:Antipsychotic Agents; D010879:Piperazines; D013844:Thiazoles; D001569:Benzodiazepines; C092292:ziprasidone; D003024:Clozapine; D018967:Risperidone; D000077152:Olanzapine