A question I have , is what is a good number for NNT? Bandolier 12
indicated that a NNT of 2-4 is suggestive of good NNT ( i.e., ARR of
0.25-0.50). However most the the RCT reported in journal s NEJM, Annals
etc have statistical significance however their NNT are usually over 20,
ie, finasteride for BPH( NNT= 30). I reckon one of the disadvantages of
NNT maybe that despite the NNT being over 20 , these patients may have
significant improvement in quality of life and other subjective issues.
Or is the fact that NNT of 2-4 an over enthusiastic expectation when it
comes to a clinical response.I guess in the case of chronic diseases
with outcomes occurring over decades a NNT of 50 would be acceptable,
however in other more acute conditions one would consider a smaller
number for NNT as desirable. Could the members throw some additional
light in the defining what is a good number for NNT.
Amit Ghosh, MD
General Internal Medicine
University of Minnesota
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