Just an uneducated question, re: a listmember's query:
(snip) - "I am getting some negative RRR [with CAT snipper]. What would be
their interpretation?. I know that RRR = 0 is null effect and RRR= 1 is
cure."
Here's my question: If - as must be presumed by the range for RRR of 0-1 -
the term RRR assesses only efficacy of intervention and not risks of
intervention - is there a number that incorporates risk of treatment? (In
other words a more global assessment of intervention that would allow a
negative outcome)?
Without such a global value, how do we measure the many thrombolytic trials
in stroke, for example, that show more deaths with treatment intervention
than without? I am increasingly concerned by the ways sponsored
researchers do "spin control" and it seems to me that RRR is one such term
that can be so abused if the reader is not alert. For example, an
intervention that reduces a primary endpoint (fatal MI in the pt with
diabetes) but increases total death rate (from pancreatitis/hepatitis
whatever - [shades of Rezulin]) the outcome may be spun as positive through
a set of maneuvers from a.) referring to a positive RRR (correctly) and
then b.) combining endpoints (death and disability) to a more neutral - or
even positive effect (as has been done in the thrombolytic trials).
Have I misunderstood something here?
jeanne
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