Worksheet Therapy-Cebm
Worksheet Therapy-Cebm
Worksheet Therapy-Cebm
THERAPY STUDY: Are the results of the trial valid? (Internal Validity)
Absolute Risk Reduction (ARR) = risk of The absolute risk reduction tells us the absolute difference in the
the outcome in the control group - risk of rates of events between the two groups and gives an indication of the
the outcome in the treatment group. This baseline risk and treatment effect. An ARR of 0 means that there is
is also known as the absolute risk no difference between the two groups thus, the treatment had no
difference. effect.
In our example, the ARR = 0.15 - 0.10 = The absolute benefit of treatment is a 5% reduction in the death rate.
0.05 or 5%
Relative Risk Reduction (RRR) = The relative risk reduction is the complement of the RR and is
absolute risk reduction / risk of the probably the most commonly reported measure of treatment effects.
outcome in the control group. An It tells us the reduction in the rate of the outcome in the treatment
alternative way to calculate the RRR is to group relative to that in the control group.
subtract the RR from 1 (eg. RRR = 1 -
RR)
In our example, the RRR = 0.05/0.15 = The treatment reduced the risk of death by 33% relative to that
0.33 or 33% occurring in the control group.
Or RRR = 1 - 0.67 = 0.33 or
33%
Number Needed to Treat (NNT) = The number needed to treat represents the number of patients we
inverse of the ARR and is calculated as 1 need to treat with the experimental therapy in order to prevent 1 bad
/ ARR. outcome and incorporates the duration of treatment. Clinical
significance can be determined to some extent by looking at the
NNTs, but also by weighing the NNTs against any harms or adverse
effects (NNHs) of therapy.
In our example, the NNT = 1/ 0.05 = 20 We would need to treat 20 people for 2 years in order to prevent 1
death.