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. 1996 Feb 17;312(7028):426–429. doi: 10.1136/bmj.312.7028.426

The number needed to treat: a clinically useful nomogram in its proper context.

G Chatellier 1, E Zapletal 1, D Lemaitre 1, J Menard 1, P Degoulet 1
PMCID: PMC2350093  PMID: 8601116

Abstract

The number needed to treat is a meaningful way of expressing the benefit of an active treatment over a control. It can be used either for summarising the results of a therapeutic trial or for medical decision making about an individual patient, but its use at the bedside has been impeded by the need for time consuming calculations. A nomogram has therefore been devised that will greatly simplify the calculations. Since calculations are now easy, the number needed to treat can be used to access the value of several interventions, although it does have its limitations. In particular it should not be used when it is not known whether the relative risk reduction associated with an intervention is constant for all levels of risk, or for periods of time longer than that studied in the original trials.

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Selected References

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  1. Anderson K. M., Odell P. M., Wilson P. W., Kannel W. B. Cardiovascular disease risk profiles. Am Heart J. 1991 Jan;121(1 Pt 2):293–298. doi: 10.1016/0002-8703(91)90861-b. [DOI] [PubMed] [Google Scholar]
  2. Bucher H. C., Weinbacher M., Gyr K. Influence of method of reporting study results on decision of physicians to prescribe drugs to lower cholesterol concentration. BMJ. 1994 Sep 24;309(6957):761–764. doi: 10.1136/bmj.309.6957.761. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Chatellier G., Blinowska A., Menard J., Degoulet P. Do physicians estimate reliably the cardiovascular risk of hypertensive patients?. Medinfo. 1995;8(Pt 2):876–879. [PubMed] [Google Scholar]
  4. Collins R., Peto R., MacMahon S., Hebert P., Fiebach N. H., Eberlein K. A., Godwin J., Qizilbash N., Taylor J. O., Hennekens C. H. Blood pressure, stroke, and coronary heart disease. Part 2, Short-term reductions in blood pressure: overview of randomised drug trials in their epidemiological context. Lancet. 1990 Apr 7;335(8693):827–838. doi: 10.1016/0140-6736(90)90944-z. [DOI] [PubMed] [Google Scholar]
  5. Cook R. J., Sackett D. L. The number needed to treat: a clinically useful measure of treatment effect. BMJ. 1995 Feb 18;310(6977):452–454. doi: 10.1136/bmj.310.6977.452. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Forrow L., Taylor W. C., Arnold R. M. Absolutely relative: how research results are summarized can affect treatment decisions. Am J Med. 1992 Feb;92(2):121–124. doi: 10.1016/0002-9343(92)90100-p. [DOI] [PubMed] [Google Scholar]
  7. Grover S. A., Lowensteyn I., Esrey K. L., Steinert Y., Joseph L., Abrahamowicz M. Do doctors accurately assess coronary risk in their patients? Preliminary results of the coronary health assessment study. BMJ. 1995 Apr 15;310(6985):975–978. doi: 10.1136/bmj.310.6985.975. [DOI] [PMC free article] [PubMed] [Google Scholar]
  8. Laupacis A., Sackett D. L., Roberts R. S. An assessment of clinically useful measures of the consequences of treatment. N Engl J Med. 1988 Jun 30;318(26):1728–1733. doi: 10.1056/NEJM198806303182605. [DOI] [PubMed] [Google Scholar]
  9. Lie R. T., Wilcox A. J., Skjaerven R. A population-based study of the risk of recurrence of birth defects. N Engl J Med. 1994 Jul 7;331(1):1–4. doi: 10.1056/NEJM199407073310101. [DOI] [PubMed] [Google Scholar]
  10. Naylor C. D., Chen E., Strauss B. Measured enthusiasm: does the method of reporting trial results alter perceptions of therapeutic effectiveness? Ann Intern Med. 1992 Dec 1;117(11):916–921. doi: 10.7326/0003-4819-117-11-916. [DOI] [PubMed] [Google Scholar]
  11. Viscoli C. M., Horwitz R. I., Singer B. H. Beta-blockers after myocardial infarction: influence of first-year clinical course on long-term effectiveness. Ann Intern Med. 1993 Jan 15;118(2):99–105. doi: 10.7326/0003-4819-118-2-199301150-00004. [DOI] [PubMed] [Google Scholar]
  12. Yusuf S., Zucker D., Peduzzi P., Fisher L. D., Takaro T., Kennedy J. W., Davis K., Killip T., Passamani E., Norris R. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomised trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet. 1994 Aug 27;344(8922):563–570. doi: 10.1016/s0140-6736(94)91963-1. [DOI] [PubMed] [Google Scholar]

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