statines, NNTStatinen en Numbers Needed to Treat

2000 ◽  
Vol 38 (10) ◽  
pp. 214-214
Author(s):  
   
Keyword(s):  
En Numbers ◽  
Numbers Needed To Treat

Statins: numbers needed to treat and personal decision making

BMJ ◽  
2014 ◽  
Vol 349 (aug05 12) ◽  
pp. g4980-g4980
Author(s):  
R. S. Bhopal
Keyword(s):  
Decision Making ◽  
Numbers Needed To Treat ◽  
Personal Decision

A Systematic Review of Treatments for Infant Colic

PEDIATRICS ◽  
2000 ◽  
Vol 106 (Supplement_1) ◽  
pp. 184-190
Author(s):  
Michelle M. Garrison ◽  
Dimitri A. Christakis
Keyword(s):  
Systematic Review ◽  
Selection Criteria ◽  
Reference Lists ◽  
Bibliographic Databases ◽  
Herbal Tea ◽  
Randomized Controlled ◽  
Numbers Needed To Treat ◽  
Adequate Quality ◽  
Infant Colic ◽  
Meta Analyses

Objective: To conduct a systematic review of rigorously evaluated treatments for infant colic. Methods. Online bibliographic databases were searched for the term “colic” in articles classified as clinical trials or randomized controlled trials and conducted in infants. Reference lists from review articles, meta-analyses, and the selected articles were also reviewed for potential studies. The abstracts or full-text articles of 57 relevant studies were examined, of which 22 met the selection criteria. The methodology and findings of all retrieved articles were critically evaluated. Data were extracted from each article regarding study methods, intervention studied, outcomes measured, and results. Results. Four of the interventions studied had data of adequate quality and statistically significant numbers needed to treat (NNT): hypoallergenic diet (NNT = 6), soy formula (NNT = 2), reduced stimulation (NNT = 2), and herbal tea (NNT = 3). Conclusions. There are some effective therapies for infant colic, but additional rigorous studies of existing and alternative therapies are needed.

Efficacy and Adverse Events of Subcutaneous, Oral, and Intranasal Sumatriptan Used for Migraine Treatment: A Systematic Review Based on Number Needed To Treat

Cephalalgia ◽  
1998 ◽  
Vol 18 (8) ◽  
pp. 532-538 ◽  
Author(s):  
P Tfelt-Hansen
Keyword(s):  
Systematic Review ◽  
Adverse Events ◽  
Randomized Clinical Trials ◽  
Migraine Treatment ◽  
Number Needed To Treat ◽  
Onset Of Action ◽  
Therapeutic Gain ◽  
Numbers Needed To Treat ◽  
Subcutaneous Sumatriptan ◽  
Speed Of Onset

Objectives: To evaluate the efficacy, speed of onset, and adverse events of 6 mg subcutaneous, 100 mg oral, and 20 mg intranasal sumatriptan in the treatment of migraine attacks. Design: Systematic review of placebo-controlled randomized clinical trials. Data sources: Thirty trials up to April 1997 retrieved from a systematic literature search (Medline, review papers, handsearching of journals, congress proceedings, manufacturer's database); no restriction on language. Outcome parameters: Numbers needed to treat (NNT) were calculated for relief of headache and for adverse events (when data were available). Therapeutic gain was used to evaluate speed of onset of action. Results: Subcutaneous sumatriptan was more efficacious, combined number needed to treat 2.0 at 1 h, than oral (3.0 at 2 h) and intranasal sumatriptan (3.1 at 2 h). For adverse events, the NNT was 3.0 for subcutaneous and 8.3 for oral sumatriptan. Only limited data on adverse events for intranasal sumatriptan were available. Therapeutic gain analysis during the first 2 h showed that subcutaneous sumatriptan was the fastest-acting form of administration. Conclusions: Subcutaneous sumatriptan in a dose of 6 mg is significantly more efficacious than 100 mg of oral sumatriptan, but causes more adverse events than oral sumatriptan. Subcutaneous sumatriptan is the form with the quickest onset of action. Intranasal sumatriptan has the same efficacy as oral sumatriptan and a quicker onset of action than the oral form, but with a limited therapeutic effect for the first 30 min after administration.

scholarly journals The Numbers Needed to Treat for Neurological Disorders

2005 ◽  
Vol 32 (4) ◽  
pp. 440-449 ◽  
Author(s):  
Miguel Bussière ◽  
Samuel Wiebe
Keyword(s):  
Absolute Risk ◽  
Time Frame ◽  
Therapeutic Interventions ◽  
Cochrane Library ◽  
Number Needed To Treat ◽  
Therapeutic Effects ◽  
Surgical Interventions ◽  
Blood Patch ◽  
Numbers Needed To Treat ◽  
Meta Analyses

ABSTRACT:Background:Numerous therapeutic interventions have been developed in the neurosciences. Clinicians need summary measures about efficacy of therapies that derive from the best available evidence, and that can be readily extrapolated to clinical practice. The number needed to treat (NNT) is intuitive and clinically applicable. We provide clinicians with a single source that summarizes important therapies in the main neurological and neurosurgical areas.Methods:Critically appraised evidence about therapies in the neurosciences was obtained from meta-analyses in all neurosciences groups in the Cochrane library, and from critically appraised topics at the University of Western Ontario. Therapies were included if they were deemed relevant and if outcomes were dichotomous. For each therapy, we obtained absolute risk differences and their 95% confidence intervals (CI), the corresponding NNTs, control and experimental event rates, and the time-frame of the outcome assessment.Results:We assembled a table of NNTs for 87 interventions in ten disease categories, deriving from meta-analyses (70%) or randomized controlled trials (30%), and assessing surgical interventions (7%), procedures (9%) or pharmacological treatments (84%). The NNTs varied widely, ranging from 1 in the use of epidural blood patch for post-dural puncture headache to 4608 for meningococcal vaccination. Preventative interventions had substantially larger NNTs. Time-frames were inappropriately short for many chronic conditions.Conclusions:Large collections of NNTs provide useful, updateable summaries of therapeutic effects in the neurosciences, an increasingly interventional clinical field.

scholarly journals Diclofenac Potassium in Acute Postoperative Pain and Dysmenorrhoea: Results from Comprehensive Clinical Trial Reports

2018 ◽  
Vol 2018 ◽  
pp. 1-12 ◽  
Author(s):  
R. Andrew Moore ◽  
Sheena Derry
Keyword(s):  
Cochrane Review ◽  
Third Molar ◽  
Gynaecological Surgery ◽  
Acute Postoperative Pain ◽  
Double Blind ◽  
Third Molar Extraction ◽  
Maximum Pain ◽  
Numbers Needed To Treat ◽  
Study Designs ◽  
Clinical Study Reports

We compared the efficacy of diclofenac potassium in unpublished clinical study reports (CSRs) and published reports to examine publication bias, industry bias, and comprehensiveness. Novartis provided CSRs of randomised double-blind trials of diclofenac potassium involving postoperative patients following third molar extraction (3 trials, n=519), gynaecological surgery (3 trials, n=679), and dysmenorrhoea (2 trials, n=711) conducted in 1988–1990. Searches identified published reports of 6 trials. Information from 599/1909 patients was not published; trials with 846/1909 patients were published in a defunct journal. Greater methodological information in CSRs contributed to lesser risk of bias than published trials. Numbers needed to treat (NNT) from CSRs for all six postoperative trials for at least 50% of maximum pain relief over 6 h were 2.2 (95% confidence interval, 1.9–2.6) and 2.1 (1.8–2.4) for 50 and 100 mg diclofenac potassium, respectively. A Cochrane review of published trial data reported NNTs of 2.1 and 1.9, and one comprehensive analysis reported NNTs of 2.2 and 2.1, respectively. All analyses had similar results for patients remedicating within 8 h. No data from dysmenorrhoea CSRs appeared in a Cochrane review. CSRs provide useful information and increase confidence. Stable efficacy estimates with standard study designs reduce the need for updating reviews.

Effect of discontinuation v. maintenance of antipsychotic medication on relapse rates in patients with remitted/stable first-episode psychosis: a meta-analysis

2018 ◽  
Vol 49 (5) ◽  
pp. 772-779 ◽  
Author(s):  
Taro Kishi ◽  
Toshikazu Ikuta ◽  
Yuki Matsui ◽  
Ken Inada ◽  
Yuki Matsuda ◽  
...  
Keyword(s):  
Meta Analysis ◽  
First Episode Psychosis ◽  
First Episode ◽  
Antipsychotic Treatment ◽  
Episode Psychosis ◽  
Numbers Needed To Treat ◽  
Reported Data ◽  
Relapse Rates ◽  
Risk Of Relapse ◽  
Maintenance Group

AbstractBackgroundDiscontinuation of antipsychotics predisposes patients with remitted/stable first-episode psychosis (FEP) to a higher risk of relapse, but it remains unclear how long discontinuation increases the relapse rate in these patients compared with maintenance.MethodsThis meta-analysis of randomized controlled trials (RCTs) compared relapse rates in FEP patients between antipsychotic treatment discontinuation and maintenance groups at 1, 2, 3, 6, 9, 12 (primary), and 18–24 months. The risk ratio (RR) and numbers needed to treat/harm (NNT/NNH) were calculated using a random-effects model.ResultsTen RCTs were identified (n = 776; mean study duration, 18.6 ± 6.0 months). The antipsychotics were discontinued abruptly in four RCTs (which reported data only at 12 months) and after tapering off gradually over several months (mean length, 3 months) in six RCTs. Compared with the discontinuation group, the maintenance group experienced significantly fewer relapses at all time points except 1 month [RR (NNT): 2 months, 0.49 (13); 3 months, 0.46 (9); 6 months, 0.55 (6); 9 months, 0.48 (3); 12 months, 0.47 (3); and 18–24 months, 0.57 (4)]. The maintenance group was associated with higher discontinuation due to adverse events (RR, 2.61; NNH, not significant).ConclusionsMaintaining antipsychotic treatment prevented relapse for up to 24 months in FEP patients. Discontinuation of antipsychotics for ⩾2 months significantly increased the risk of relapse. However, 45.7% of patients who discontinued antipsychotics for 12 months (39.4% after 18–24 months) did not experience a relapse.

Epidemiology and stroke risk factors

2017 ◽  
Author(s):  
Hugh Markus ◽  
Anthony Pereira ◽  
Geoffrey Cloud
Keyword(s):  
Public Health ◽  
Risk Factors ◽  
Stroke Risk ◽  
Relative Risk Reduction ◽  
Stroke Care ◽  
Modifiable Risk Factors ◽  
Comprehensive Review ◽  
Stroke Risk Factors ◽  
The United Kingdom ◽  
Numbers Needed To Treat

In this opening chapter on the epidemiology and risk factors for stroke, the ‘size of the problem’ in public health terms both in the United Kingdom and worldwide is set out. Incidence, prevalence, and mortality of stroke are discussed. Epidemiological terms and definitions as applied to stroke care are reviewed and illustrated, including absolute and relative risk reduction and numbers needed to treat. This chapter also discusses aetiological subtyping of stroke which represents a syndrome caused by multiple different underlying pathologies. It ends with a comprehensive review of the major and minor modifiable and non-modifiable risk factors for stroke disease.

Magnetic structure of ionizing shock waves Part 3. Normal shocks

1972 ◽  
Vol 7 (1) ◽  
pp. 177-185 ◽  
Author(s):  
B. P. Leonard
Keyword(s):  
Magnetic Field ◽  
Shock Waves ◽  
Electric Field ◽  
Field Component ◽  
Magnetic Energy ◽  
Transverse Field ◽  
Transverse Magnetic ◽  
En Numbers ◽  
Magnetic Field Magnitude ◽  
Oblique Shocks

Normal ionizing shock waves are considered as a subclass of oblique shocks in which the upstream transverse magnetic field component is zero; i.e. the upstream field is normal to the plane of the shock. Non-trivial (switch-on) normal shocks involve a non-zero downstream transverse field component; magnetically trivial normal shocks are simply gas shocks with an imbedded constant normal magnetic field. As with oblique shocks, switch-on normal ionizing shock waves are plane- polarized, provided the conductivity is a scalar. Ohmic structures are discussed for several values of shock Alfv én number, treating the electric field as a free parameter, as usual. For Alfv én numbers extending from zero to two (for the infinite-Mach-number case), there is always a finite range of E field values. Above two, only the gas shock exists, and this requires a unique electric field value. Because the magnetic field magnitude increases through switch-on shocks, there is no mechanism available for converting magnetic energy into thermal energy, as is the case for oblique or skew shocks. Thus, there is no significant downstream heating above the viscous temperature; and, in some cases, slight downstream cooling may even occur. Expansion shocks are not possible in this geometry. Previous studies are reviewed in the light of structural requirements, and some erroneous results are clarified; in particular, it should be noted that MHD switchon solutions for the pre-ionized case are not imbedded in the family of ionizing switch-on solutions.

scholarly journals Numbers needed to treat derived from meta-analyses---sometimes informative, usually misleading

BMJ ◽  
1999 ◽  
Vol 318 (7197) ◽  
pp. 1548-1551 ◽  
Author(s):  
L. Smeeth ◽  
A. Haines ◽  
S. Ebrahim
Keyword(s):  
Numbers Needed To Treat ◽  
Meta Analyses
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