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The number needed to treat: a clinically useful measure of treatment effect
Open accessAbstract
The relative benefit of an active treatment over a control is usually expressed as the relative risk, the relative risk reduction, or the odds ratio. These measures are used extensively in both clinical and epidemiological investigations. For clinical decision making, however, it is more meaningful to use the measure "number needed to treat." This measure is calculated on the inverse of the absolute risk reduction. It has the advantage that it conveys both statistical and clinical significance to the doctor. Furthermore, it can be used to extrapolate published findings to a patient at an arbitrary specified baseline risk when the relative risk reduction associated with treatment is constant for all levels of risk.
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“A low NNT, between 1 and 10, is desirable as it minimizes the costs associated with treating many individuals to benefit just one.23,24”
From Internet Filtering and Adolescent Exposure to Online Sexual Material (2018) · cites this paper as [24]
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Metadata
- Authors
- Cook, R. J., & Sackett, D. L.
- Affiliations
- University of Waterloo (CA)
- John Radcliffe Hospital (GB)
- ORCID
- Cook, Richard J
- Venue
- BMJ
- Publisher
- BMJ
- Published
- 1995-02-18
- Volume
- 310
- Issue
- 6977
- Pages
- 452-454
- ISSN
- 0007-1447 (ISSN-L)
- 0959-8138
- 1468-5833
- PMC
- PMC2548824
- OpenAlex
- W2111149452
- Cited by
- 1,885
- References
- 24
- Citations by year
- 2026: 27 · 2025: 35 · 2024: 33 · 2023: 44 · 2022: 36 · 2021: 51 · 2020: 32 · 2019: 48 · 2018: 44 · 2017: 59 · 2016: 62 · 2015: 59 · 2014: 60 · 2013: 82 · 2012: 76
- FWCI
- 52.22
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Licence
- www.bmj.com/company/legal-information/terms-conditions/legal-information/tdm-licencepolicy (tdm)
- Locations
- BMJ (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
- Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
- Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
- Keywords
- number needed to treat, absolute risk reduction, relative risk reduction, relative risk, odds ratio, treatment effect measurement, clinical decision-making, risk-benefit assessment
- MeSH terms
- Cerebrovascular Disorders, Humans, Hypertension, Statistics as Topic, Odds Ratio, Randomized Controlled Trials as Topic, Treatment Outcome, Risk Assessment
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