What is your NNT (Numbers needed to treat) and NNH

joeprivate

What is the NNT and the NNH for the treatment or drugs you or your friends are taking? The results might come as a surprise to many people.
Many people including some medical professionals may not of heard of NNT and NNH so I will give a bit of background information.
There is a way of understanding how much modern medicine has to offer individual patients. It is a simple statistical concept called the “Number-Needed-to-Treat”, or for short the ‘NNT’. The NNT offers a measurement of the impact of a medicine or therapy by estimating the number of patients that need to be treated in order to have an impact on one person. The concept is statistical, but intuitive, for we know that not everyone is helped by a medicine or intervention — some benefit, some are harmed, and some are unaffected. The NNT tells us how many of each.
The number needed to treat (NNT) is an epidemiological measure used in communicating the effectiveness of a health-care intervention, typically a treatment with medication. The NNT is the average number of patients who need to be treated to prevent one additional bad outcome (e.g. the number of patients that need to be treated for one to benefit compared with a control in a clinical trial). It is defined as the inverse of the absolute risk reduction. The ideal NNT is 1, where everyone improves with treatment and no one improves with control. The higher the NNT, the less effective is the treatment.
The core value of the NNT is its straightforward communication of the science that can help us understand the likelihood that a patient will be helped, harmed, or unaffected by a treatment.
I would be interested to hear form Boards users if they have ever heard or discussed NNT or NNH number needed to harm with a medical professionals.I have found the website THENNT.COM a good resource.

Here are some examples of NNT's/NNH

Statins Given for 5 Years for Heart Disease Prevention (With Known Heart Disease)
1 in 83 were helped (life saved)
1 in 39 were helped (preventing non-fatal heart attack)
1 in 125 were helped (preventing stroke)
NNH
1 in 100 were harmed (develop diabetes*)
1 in 10 were harmed (muscle damage)
Aspirin to Prevent Cardiovascular Disease in Patients with Known Heart Disease or Strokes
1 in 50 were helped (cardiovascular problem prevented)
1 in 333 were helped (prevented death)
1 in 77 were helped (prevented non-fatal heart attack)
1 in 200 were helped (prevented non-fatal stroke)
NNH
1 in 400 were harmed (major bleeding event*)
Aspirin Given Immediately for a Major Heart Attack (STEMI)
1 in 42 were helped (life saved)
NNH
1 in 167 were harmed (non-dangerous bleeding)
Vitamin D For Preventing Fractures (Older Adults in the Community)
NNT None were helped (fracture prevented)
NNH 1 in 36 were harmed (kidney stones, kidney damage)
Unfortunately, in large randomized trials (some of very high quality) there is one group that appears to have benefited and this was only true when Vitamin D was combined with calcium supplementation: frail, elderly individuals in institutional settings. Among this group there was a small reduction in hip fractures, which is an important and dreaded injury for a variety of reasons. The NNT for avoiding a hip fracture in this group was approximately 42.
Sildenafil (Viagra) for male erectile dysfunction:
NNT
Dose optimisation led to at least 60% of attempts at sexual intercourse being successful in 49% of men, compared with 11% with placebo; the NNT was 2.7
For global improvement in erections the NNT was 1.7
NNH
Treatment-related adverse events occurred in 30% of men on dose optimised sildenafil compared with 11% on placebo; the NNH was 5.4

A TED talk on NNT ww.youtube.com/watch?v=UCk_vTkS6bU
I cant post the full link
Hope you find the topic of NNT useful and look up the NNT/NNH for the drugs you and your friends take and discuss is there a better drug or treatment.

Pretzill

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