Communicating the benefits and harms of treatments.

Full Abstract

Although various measures can be used to describe the benefits and harms of treatments, not all of these clearly show the benefits or otherwise of treatments in a clinically useful way. Relative risk and relative risk reduction are commonly used to describe the results of studies, but they are of limited clinical usefulness as they do not take baseline risks into account and tend to exaggerate the results of studies. Absolute risk measures such as the number needed to treat (NNT) and the number needed to harm (NNH) allow risk to be expressed in a much more clinically relevant way. The absolute risk measures reflect baseline risk and more accurately indicate the magnitude of the treatment effect. However, because they vary according to the baseline risk of the population, they are of limited generalisability, and the published NNT of a treatment in one population cannot be directly applied to another population with a different baseline risk. There are, however, a number of simple methods which can allow us to estimate NNTs or NNHs for our own patients based on published data. The benefits of a treatment (expressed as the NNT) and the harms of the treatment (expressed as the NNH) can be combined into a single ratio called the likelihood of being helped or harmed (LHH). LHH can be adjusted for individual patients by taking account of their own values and unique circumstances.

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Author information

Author/s: Akobeng, A K (AK);

Affiliation: Department of Paediatric Gastroenterology, Central Manchester and Manchester Children's University Hospitals, Booth Hall Children's Hospital, Charlestown Road, Blackley, Manchester, UK. tony.akobeng@cmmc.nhs.uk

Journal and publication information

Publication Type: Journal Article; Review

Journal: Archives of disease in childhood (Arch Dis Child), published in England. (Language: eng)

Reference: 2008-Aug; vol 93 (issue 8) : pp 710-3

Dates: Created 2008/07/22; Completed 2008/08/12;

PMID: 18456681, status: MEDLINE (last retrieval date: 11/6/2008)

Sourced from the National Library of Medicine. Abstract text and other information may be subject to copyright.

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MeSH headings (categories)

This article was linked to the MESH Headings shown below.

Clinical Trials as Topic
Communication
Evidence-Based Medicine
Humans

Probability
Research Design
Risk Assessment
Therapeutics - adverse effects

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