Cited by 179Meta-analysis and systematic reviewsStatistical Methods in Clinical TrialsStatistical Methods in Epidemiology

How to obtain nnt from cohen’s D: comparison of two methods

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Furukawa, Toshi A., Leucht, Stefan·2011·PLoS ONE

Abstract

BACKGROUND: In the literature we find many indices of size of treatment effect (effect size: ES). The preferred index of treatment effect in evidence-based medicine is the number needed to treat (NNT), while the most common one in the medical literature is Cohen's d when the outcome is continuous. There is confusion about how to convert Cohen's d into NNT. METHODS: We conducted meta-analyses of individual patient data from 10 randomized controlled trials of second generation antipsychotics for schizophrenia (n = 4278) to produce Cohen's d and NNTs for various definitions of response, using cutoffs of 10% through 90% reduction on the symptom severity scale. These actual NNTs were compared with NNTs calculated from Cohen's d according to two proposed methods in the literature (Kraemer, et al., Biological Psychiatry, 2006; Furukawa, Lancet, 1999). RESULTS: NNTs from Kraemer's method overlapped with the actual NNTs in 56%, while those based on Furukawa's method fell within the observed ranges of NNTs in 97% of the examined instances. For various definitions of response corresponding with 10% through 70% symptom reduction where we observed a non-small number of responders, the degree of agreement for the former method was at a chance level (ANOVA ICC of 0.12, p = 0.22) but that for the latter method was ANOVA ICC of 0.86 (95%CI: 0.55 to 0.95, p<0.01). CONCLUSIONS: Furukawa's method allows more accurate prediction of NNTs from Cohen's d. Kraemer's method gives a wrong impression that NNT is constant for a given d even when the event rate differs.

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  • Based on an NNT of 2 for the main analyses, for every two people treated with exercise, at least one is expected to have a large magnitude reduction in depressive symptoms.

    “Based on a NNT of 2 for the main analyses this means that for every two people treated with exercise, it is expected at least one to have a large magnitude reduction in depressive symptoms.43”

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  1. [21]2008 Review Manager (RevMan). 5.0 ed Copenhagen The Nordic Cochrane Centre, The Cochrane Collaboration

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Authors
Furukawa, T. A., & Leucht, S.
Affiliations
  • Kyoto University (JP)
  • TUM Klinikum (DE)
Corresponding author
Furukawa, Toshi A.
Venue
PLoS ONE
Published
2011-04-27
Volume
6
Issue
4
Pages
e19070
ISSN
1932-6203 (ISSN-L)
OpenAlex
W2057672284
Cited by
179
References
29
Citations by year
2026: 9 · 2025: 18 · 2024: 23 · 2023: 14 · 2022: 8 · 2021: 12 · 2020: 20 · 2019: 14 · 2018: 25 · 2017: 6 · 2016: 8 · 2015: 6 · 2014: 5 · 2013: 6 · 2012: 3
FWCI
5.47
Type
journal article
Language
en
Open access
Locations
  • PLoS ONE (publishedVersion, cc-by)
  • Europe PMC (PubMed Central) (publishedVersion, cc-by)
  • PubMed Central (publishedVersion, cc-by)
  • PubMed (publishedVersion)
  • Institutional Repositories DataBase (IRDB) (submittedVersion, other-oa)
  • RePEc: Research Papers in Economics (submittedVersion)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion, cc-by-sa)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion)
  • mediaTUM – the media and publications repository of the Technical University Munich (Technical University Munich) (submittedVersion, other-oa)
  • Kyoto University Research Information Repository (Kyoto University) (submittedVersion, cc-by)
Funders
  • American Psychiatric Publishing
  • Bristol-Myers Squibb
  • Eli Lilly and Company
  • Pfizer
  • AstraZeneca
  • GlaxoSmithKline
  • Sanofi
  • Astellas Pharma
  • Shionogi
  • H. Lundbeck A/S
Topics
  • Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
  • Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Keywords
number needed to treat, Cohen's d, effect size, atypical antipsychotics, schizophrenia, symptom severity reduction, treatment response definition, interobserver agreement
MeSH terms
Humans, Schizophrenia, Antipsychotic Agents, Sample Size, Evidence-Based Medicine

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