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-thanks, Kev -my point in this case was only to contrast relative versus absolute risk -but in general, the objective of the HPVvaccine is to avoid cervical cancer, not to avoid CIN-2 -in adolescents and young women, regression of CIN-2 is common with almost 70% regressing to normal within 3 years https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3057366/ -if you have interest in the HPVvaccine impact in cervical cancer the relative risk is lower by 29% https://www.ncbi.nlm.nih.gov/pubmed/29859731 (the absolute risk is 0.00024, so you need to vaccinated 417,000 females to avoid ONE case onf cancer of cervix, not a death, at a cost of around 185 millions of dolars) -about the calculation: -how? with GRADE -where? from data in the Supplementary appendix This appendix formed part of the original submission and has been peer reviewed. We post it as supplied by the authors. Supplement to: Drolet M, Bénard E, Pérez N, Brisson M, on behalf of the HPV Vaccination Impact Study Group. Population-level impact and herd effects following the introduction of human papillomavirus vaccination programmes: updated systematic review and meta-analysis. Lancet 2019; published online June 26. http://dx.doi.org/10.1016/S0140-6736(19)30298-3. https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30298-3/fulltext -you have access to the GRADE table at the end of my comment http://www.nogracias.org/2019/07/12/presentacion-en-falso-del-exito-triunfal-de-la-vacuna-del-virus-del-papiloma-manipulacion-emocional-y-estadistica-por-juan-gervas/ *Síntesis* En conclusión, el análisis del impacto de la vacuna del virus del papiloma humano, y el de toda intervención sanitaria, debería basarse en la disminución del riesgo absoluto. Dicho impacto es nulo respecto a la vacuna del virus del papiloma (7). Precisamos de una mejor vacuna, y declarar una moratoria en la aplicación de las que tenemos. NOTA: La tabla adjunta ( vacuna VPH Fact Box por 10.000 mujeres y varones, Vac VPH, seguim 5-8 años. Drolet <http://www.nogracias.org/wp-content/uploads/2019/07/vacuna-VPH-Fact-Box-por-10.000-mujeres-y-varones-Vac-VPH-seguim-5-8-años.-Drolet.odt> ) está hecha con el método GRADE, a petición del autor, por Galo Agustín y Cristina Andreu. Es de libre distribución como este texto. El sáb., 13 jul. 2019 a las 13:01, K Hopayian (< [log in to unmask]>) escribió: > Dear Juan, > Thanks it is good to see some absolute risks. > Now let us consider preferences and values. It is difficult to know if > talking about a whole population, unlike say an individual decision > regarding whether to take a bisphosphonate for osteoporosis. > So we might have to speculate how much most women would value avoiding CIN > cervix, with attendant anxiety, intervention and occasional complications. > I do not know what most women would say. If it were me as an individual, I > would consider a lifetime NNT of 159 is pretty good. I would compare it > against most NNTs that inform preventive strategies and which are for > shorter periods e.g. 5-10 years for CVS diseases. > > Kev > > Prof. Kev (Kevork) Hopayian, > MD FRCGP > Clinical Professor, University of Nicosia, Cyprus > RCGP [INT] Educational Consultant > Sessional GP, Suffolk > > > > On 13 Jul 2019, at 11:06, Juan Gérvas <[log in to unmask]> wrote: > > RELATIVE RISK VERSUS ABSOLUTE RISK > According with the direct intepretation of the Lancet paper, > "*Triumphant* *success of HPV vaccine"* > https://www.nature.com/articles/d41586-019-02026-4 > *"Hopes raised of cervical cancer eradication"* > https://www.bbc.com/news/health-48758730 > > 1/ > An example of the impact of the relative risk: #HPVvaccine. > See you, decrease relative risk and decrease absolute risk from > https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)30298-3/fulltext > You have the analysis (and the table) in Spanish in: > > http://www.nogracias.org/2019/07/12/presentacion-en-falso-del-exito-triunfal-de-la-vacuna-del-virus-del-papiloma-manipulacion-emocional-y-estadistica-por-juan-gervas/ > 2/ > *Anogenital wart *diagnoses decreased > *GIRLS* aged > 15–19 years: > relative risk by 67% > absolute risk by 0.21% > 20-24 year: > relative risk by 54%; > absolute risk by 0.28% > 25-29 years: > relative risk by 31%; > absolute risk by 0,07%. > *BOYS* aged > 15-19 years: > relative risk by 48%; > absolute risk by 0.04%. > 20-24 years: > relative risk by 32%; > absolute risk by 0.14%. > 3/ > *After 5–9 years of vaccination, CIN2+ *decreased among screened girls > aged > 15-19 years: > relative risk by 51% > absolute risk by 0.63% > 20-24 years: > relative risk by 31% > absolute risk by 0.28% > -un saludo juan gérvas @JuanGrvas > > ------------------------------ > > To unsubscribe from the EVIDENCE-BASED-HEALTH list, click the following > link: > > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=EVIDENCE-BASED-HEALTH&A=1 > > > > ------------------------------ > > To unsubscribe from the EVIDENCE-BASED-HEALTH list, click the following > link: > > https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=EVIDENCE-BASED-HEALTH&A=1 > ######################################################################## To unsubscribe from the EVIDENCE-BASED-HEALTH list, click the following link: https://www.jiscmail.ac.uk/cgi-bin/webadmin?SUBED1=EVIDENCE-BASED-HEALTH&A=1