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nnt [2025/02/07 14:58] – [Examples of High NNT] andrewtaustin | nnt [2025/02/07 15:09] (current) – [Numbers Needed to Treat (NNT)] andrewtaustin | ||
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- | ====== Numbers Needed to Treat (NNT) ====== | + | {{tag> |
+ | ====== Numbers Needed to Treat (NNT) ====== | ||
The Number Needed to Treat (NNT) is an important concept in evidence-based medicine (EBM). It represents the average number of patients who must be treated with a specific therapy or intervention for one additional patient to benefit compared to a control group (often a placebo or standard of care). The NNT is derived as the inverse of the Absolute Risk Reduction (ARR), providing a practical measure of clinical effectiveness. | The Number Needed to Treat (NNT) is an important concept in evidence-based medicine (EBM). It represents the average number of patients who must be treated with a specific therapy or intervention for one additional patient to benefit compared to a control group (often a placebo or standard of care). The NNT is derived as the inverse of the Absolute Risk Reduction (ARR), providing a practical measure of clinical effectiveness. | ||
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+ | In short, NNT represents the number of patients who must be treated to prevent one additional negative outcome or achieve one additional positive outcome. | ||
===== Definition and Calculation ===== | ===== Definition and Calculation ===== | ||
- | Absolute Risk (AR): The proportion of patients experiencing an event in a group (e.g., 10% of patients have a heart attack in a control group). | + | **Absolute Risk (AR)**: The proportion of patients experiencing an event in a group (e.g., 10% of patients have a heart attack in a control group). |
- | Absolute Risk Reduction (ARR): The difference in the absolute risk between the treatment group and the control group. | + | |
- | Formula: //ARR = AR_control - AR_treatment// | + | **Absolute Risk Reduction (ARR)**: The difference in the absolute risk between the treatment group and the control group. |
- | Number Needed to Treat (NNT): The inverse of the absolute risk reduction. | + | |
- | Formula: //NNT = 1 / ARR// | + | **Formula**: //ARR = AR_control - AR_treatment// |
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+ | **Number Needed to Treat (NNT)**: The inverse of the absolute risk reduction. | ||
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+ | **Formula**: //NNT = 1 / ARR// | ||
For example, if the incidence of a particular outcome (e.g., myocardial infarction) in a control group is 10% and the incidence in the treatment group is 5%, the ARR is 0.05 (or 5%). | For example, if the incidence of a particular outcome (e.g., myocardial infarction) in a control group is 10% and the incidence in the treatment group is 5%, the ARR is 0.05 (or 5%). | ||
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Below are illustrative examples (approximate values) of interventions with relatively low NNTs: | Below are illustrative examples (approximate values) of interventions with relatively low NNTs: | ||
- | **Antibiotics for Bacterial Pneumonia** | + | **Antibiotics for Bacterial Pneumonia**: |
NNT can be as low as around 5 for preventing serious complications in susceptible populations. The high impact of appropriate antibiotic therapy in an acute setting leads to a favourable NNT. | NNT can be as low as around 5 for preventing serious complications in susceptible populations. The high impact of appropriate antibiotic therapy in an acute setting leads to a favourable NNT. | ||
- | **Smoking Cessation Interventions in High-Risk Patients** | + | **Smoking Cessation Interventions in High-Risk Patients**: |
Intensive behavioural therapy combined with pharmacotherapy (e.g., nicotine replacement, | Intensive behavioural therapy combined with pharmacotherapy (e.g., nicotine replacement, | ||
- | **Vaccinations (e.g., Influenza in Elderly or High-Risk Populations)** | + | **Vaccinations (e.g., Influenza in Elderly or High-Risk Populations)**: |
Depending on the population, seasonal influenza vaccination can have an NNT ranging from around 12 to 40 to prevent one case of influenza, though these numbers vary widely by season, vaccine match, and patient comorbidities. During severe flu seasons or in particularly vulnerable groups, the NNT can be pretty low. | Depending on the population, seasonal influenza vaccination can have an NNT ranging from around 12 to 40 to prevent one case of influenza, though these numbers vary widely by season, vaccine match, and patient comorbidities. During severe flu seasons or in particularly vulnerable groups, the NNT can be pretty low. | ||