Martinez-Gutierrez Juan Carlos, Leslie-Mazwi Thabele, Chandra Ronil V, Ong Kevin L, Nogueira Raul G, Goyal Mayank, Albuquerque Felipe C, Hirsch Joshua A
Department of Neurology, Massachusetts General Hospital, Brigham and Women's Hospital, Boston, USA.
Neuroendovascular Program, Massachusetts General Hospital, Harvard Medical School, Boston, USA.
Interv Neuroradiol. 2019 Dec;25(6):613-618. doi: 10.1177/1591019919858733. Epub 2019 Jun 27.
The number needed to treat is a commonly used statistical term in modern neurointerventional practice. It represents the number of patients that need to be treated for one patient to benefit from an intervention. Given its growing popularity in reflecting study results, understanding the basics behind this statistic is of practical value to the neurointerventionalist.
Here, we review the basic theory and calculation of the number needed to treat, its application to stroke interventions, and its limitations. In addition, we demonstrate several simple methods of calculating the number needed to treat utilizing recent thrombectomy trial results. By presenting the number needed to treat as a universal metric, we provide a comprehensive comparative of the number needed to treat for key stroke therapies, including mechanical thrombectomy, tissue plasminogen activator, carotid endarterectomy, and prevention with antiplatelet and statin drugs.
In comparison with available stroke therapies, mechanical thrombectomy stands out as the most effective acute intervention in patients with emergent large-vessel occlusions. Understanding how the number needed to treat is derived and its implications helps provide perspective to clinical trial data, identify health-care resource priorities, and improve communication with patients, health-care providers, and additional key stakeholders.
需治疗人数是现代神经介入实践中常用的统计术语。它表示为使一名患者从干预措施中获益所需治疗的患者数量。鉴于其在反映研究结果方面日益普及，了解这一统计数据背后的基础知识对神经介入医生具有实际价值。
在此，我们回顾需治疗人数的基本理论和计算方法、其在中风干预中的应用及其局限性。此外，我们利用近期血栓切除术试验结果演示几种计算需治疗人数的简单方法。通过将需治疗人数作为通用指标呈现，我们对关键中风治疗方法的需治疗人数进行了全面比较，包括机械血栓切除术、组织纤溶酶原激活剂、颈动脉内膜切除术以及使用抗血小板和他汀类药物进行预防。
与现有的中风治疗方法相比，机械血栓切除术是对急性大血管闭塞患者最有效的急性干预措施。了解需治疗人数是如何得出的及其影响有助于为临床试验数据提供视角、确定医疗资源优先级，并改善与患者、医疗服务提供者及其他关键利益相关者的沟通。
