Tong Feng, Chen Kun, He Han-qing
Department of Epidemiology and Health Statistics, School of Medicine, Zhejiang University, Hangzhou 310031, China.
Zhonghua Liu Xing Bing Xue Za Zhi. 2005 Jul;26(7):540-3.
To introduce the concept, methods for calculation and application of "number needs to be exposed (NNE)" in Epidemiological studies.
Data was analyzed from a study on the association between diaspirin cross-linked hemoglobin (DCLHb) with 28-day mortality in patients with severe traumatic hemorrhagic shock.
The crude "number needed to be exposed for one additional person to be harmed" (NNEH) was 3.7 (95% CI: 2.2-11.5) for the exposure to DCLHb. After controlling the confounding bias of the baseline mortality risk, the adjusted NNEH became 2.6 (95% CI: 1.6-8.0) id., on average, among 2.6 patients exposed to DCLHb, one additional case of death would have developed within 28 days after initial hospitalization if the distribution of baseline mortality risk in exposed group had been equal to that in the unexposed group.
NNE could be expressed as the estimated average number of persons needed to be exposed for contributing (either developing or preventing for) one additional case of disease or death in a prospective study when compared with the unexposed persons. As a new index for measuring the absolute effect of an exposure, NNE presented the results on epidemiological studies in a more intuitive and understandable manner. Consequently, this method could be favorably accepted by clinicians, health policy makers and the public.
介绍流行病学研究中“需要暴露人数(NNE)”的概念、计算方法及应用。
分析了一项关于双阿司匹林交联血红蛋白(DCLHb)与严重创伤性失血性休克患者28天死亡率之间关联的研究数据。
暴露于DCLHb的粗“导致一人额外受伤害所需暴露人数(NNEH)”为3.7(95%可信区间:2.2 - 11.5)。在控制了基线死亡风险的混杂偏倚后,调整后的NNEH变为2.6(95%可信区间:1.6 - 8.0),即平均而言,如果暴露组的基线死亡风险分布与未暴露组相同,那么在初次住院后28天内,每2.6名暴露于DCLHb的患者中会额外出现一例死亡。
与未暴露者相比,在一项前瞻性研究中,NNE可表示为导致一例额外疾病或死亡(发病或预防)所需暴露的估计平均人数。作为衡量暴露绝对效应的一个新指标,NNE以更直观和易懂的方式呈现了流行病学研究结果。因此,这种方法可能会被临床医生、卫生政策制定者和公众欣然接受。