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[使用“需治疗人数”来解释治疗效果]

[Using "number needed to treat" to interpret treatment effect].

作者信息

Ke Der-Shin

机构信息

Section of Neurology, Department of Medicine, Chi Mei Medical Center, Tainan, Taiwan.

出版信息

Acta Neurol Taiwan. 2006 Jun;15(2):120-6.

Abstract

Evidence-based medicine (EBM) has rapidly emerged as a new paradigm in medicine worldwide. The clinical medicine in twenty-first century could be the era of EBM. Randomized controlled trial has been regarded as the gold standard for evaluating the treatment effect of a new drug or a new therapy. The effect of a treatment versus controls may be expressed in relative or absolute measures. Relative measures include relative risk, relative risk reduction, and odds ratio. Absolute risk reduction and number needed to treat are absolute measures. For rational decision-making, absolute measures are more meaningful because they have taken baseline risk and the amount of clinical benefit into account. The number needed to treat (NNT), the reciprocal of the absolute risk reduction, is a useful estimate of treatment effect. Interpreting a NNT should be very cautious accompanied by information about the experimental treatment (including drugs and surgical procedures), the control treatment for comparison, the baseline risk of the study population, the length of the follow-up period, and an exact definition of the endpoint.

摘要

循证医学(EBM)已迅速成为全球医学领域的一种新范式。21世纪的临床医学可能会是循证医学的时代。随机对照试验一直被视为评估新药或新疗法治疗效果的金标准。治疗组与对照组的效果可以用相对或绝对指标来表示。相对指标包括相对危险度、相对危险度降低率和比值比。绝对危险度降低率和需治疗人数是绝对指标。为了做出合理决策,绝对指标更有意义,因为它们考虑了基线风险和临床获益量。需治疗人数(NNT)是绝对危险度降低率的倒数,是对治疗效果的一种有用估计。解读NNT时应非常谨慎,同时要伴有关于实验性治疗(包括药物和手术程序)、用于比较的对照治疗、研究人群的基线风险、随访期长度以及终点的确切定义等信息。

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