Number Needed To Treat
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Number Needed To Treat
The number needed to treat (NNT) or number needed to treat for an additional beneficial outcome (NNTB) is an epidemiological measure used in communicating the effectiveness of a health-care intervention, typically a treatment with medication. The NNT is the average number of patients who need to be treated to prevent one additional bad outcome (e.g. the number of patients that need to be treated for one of them to benefit compared with a control in a clinical trial). It is defined as the inverse of the absolute risk reduction, and computed as 1/(I_u - I_e), where I_e is the incidence in the treated (exposed) group, and I_u is the incidence in the control (unexposed) group. This calculation implicitly assumes monotonicity, that is, no individual can be harmed by treatment. The modern approach, based on counterfactual conditionals, relaxes this assumption and yields bounds on NNT. A type of effect size, the NNT was described in 1988 by McMaster University's Laupacis, Sackett and ...
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Illustration Of Risk Reduction
An illustration is a decoration, interpretation or visual explanation of a text, concept or process, designed for integration in print and digital published media, such as posters, flyers, magazines, books, teaching materials, animations, video games and films. An illustration is typically created by an illustrator. Digital illustrations are often used to make websites and apps more user-friendly, such as the use of emojis to accompany digital type. llustration also means providing an example; either in writing or in picture form. The origin of the word "illustration" is late Middle English (in the sense ‘illumination; spiritual or intellectual enlightenment’): via Old French from Latin ''illustratio''(n-), from the verb ''illustrare''. Illustration styles Contemporary illustration uses a wide range of styles and techniques, including drawing, painting, printmaking, collage, montage, digital design, multimedia, 3D modelling. Depending on the purpose, illustration ma ...
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Atorvastatin
Atorvastatin is a statin medication used to prevent cardiovascular disease in those at high risk and to treat abnormal lipid levels. For the prevention of cardiovascular disease, statins are a first-line treatment. It is taken by mouth. Common side effects include joint pain, diarrhea, heartburn, nausea, and muscle pains. Serious side effects may include rhabdomyolysis, liver problems, and diabetes. Use during pregnancy may harm the fetus. Like all statins, atorvastatin works by inhibiting HMG-CoA reductase, an enzyme found in the liver that plays a role in producing cholesterol. Atorvastatin was patented in 1986, and approved for medical use in the United States in 1996. It is on the World Health Organization's List of Essential Medicines. It is available as a generic medication. In 2020, it was the most commonly prescribed medication in the United States, with more than 114million prescriptions. Medical uses The primary uses of atorvastatin is for the treatment of dyslipide ...
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Drug Discovery
In the fields of medicine, biotechnology and pharmacology, drug discovery is the process by which new candidate medications are discovered. Historically, drugs were discovered by identifying the active ingredient from traditional remedies or by serendipitous discovery, as with penicillin. More recently, chemical libraries of synthetic small molecules, natural products or extracts were screened in intact cells or whole organisms to identify substances that had a desirable therapeutic effect in a process known as classical pharmacology. After sequencing of the human genome allowed rapid cloning and synthesis of large quantities of purified proteins, it has become common practice to use high throughput screening of large compounds libraries against isolated biological targets which are hypothesized to be disease-modifying in a process known as reverse pharmacology. Hits from these screens are then tested in cells and then in animals for efficacy. Modern drug discovery involves the ...
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Number Needed To Harm
In medicine, the number needed to harm (NNH) is an epidemiological measure that indicates how many persons on average need to be exposed to a risk factor over a specific period to cause harm in an average of one person who would not otherwise have been harmed. It is defined as the inverse of the absolute risk increase, and computed as 1/(I_e - I_u), where I_e is the incidence in the treated (exposed) group, and I_u is the incidence in the control (unexposed) group. Intuitively, the lower the number needed to harm, the worse the risk factor, with 1 meaning that every exposed person is harmed. NNH is similar to number needed to treat (NNT), where NNT usually refers to a positive therapeutic result and NNH to a detrimental effect or risk factor. A combined measure, the number needed to treat for an additional beneficial or harmful outcome (NNTB/H), is also used. Relevance The NNH is an important measure in evidence-based medicine and helps physicians decide whether it is prudent ...
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Number Needed To Vaccinate
Number needed to vaccinate (NNV) is a metric used in the evaluation of vaccines, and in the determination of vaccination policy. It is defined as the average number of patients that must be vaccinated to prevent one case of disease. It is a specific application of the number needed to treat metric (NNT). Derivation NNV is the inverse of the absolute risk reduction of the vaccine. If the incidence in the vaccinated population is I_e, and the incidence in the unvaccinated population is I_u, then the NNV is 1/(I_u - I_e). For example, one study reported a number needed to vaccinate of 5206 for invasive pneumococcal disease. Significance In order to determine a NNV, it is necessary to identify a specific population and a defined endpoint, because these can vary: * Tuberculosis vaccination rates are much higher in Europe than in the United States. * When evaluating a vaccine against chickenpox, it is necessary to define whether or not the endpoint would include shingles due to reactiv ...
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Population Impact Measures
Population impact measures (PIMs) are biostatistical measures of risk and benefit used in epidemiological and public health research. They are used to describe the impact of health risks and benefits in a population, to inform health policy. Frequently used measures of risk and benefit identified by Jerkel, Katz and Elmore, describe measures of risk difference (attributable risk), rate difference (often expressed as the odds ratio or relative risk), population attributable risk (PAR), and the relative risk reduction, which can be recalculated into a measure of ''absolute benefit'', called the number needed to treat. Population impact measures are an extension of these statistics, as they are measures of absolute risk at the population level, which are calculations of number of people in the population who are at risk to be harmed, or who will benefit from public health interventions. They are measures of absolute risk and benefit, producing numbers of people who will benefit fr ...
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Business Week
''Bloomberg Businessweek'', previously known as ''BusinessWeek'', is an American weekly business magazine published fifty times a year. Since 2009, the magazine is owned by New York City-based Bloomberg L.P. The magazine debuted in New York City in September 1929. Bloomberg Businessweek business magazines are located in the Bloomberg Tower, 731 Lexington Avenue, Manhattan in New York City and market magazines are located in the Citigroup Center, 153 East 53rd Street between Lexington and Third Avenue, Manhattan in New York City. History ''Businessweek'' was first published based in New York City in September 1929, weeks before the stock market crash of 1929. The magazine provided information and opinions on what was happening in the business world at the time. Early sections of the magazine included marketing, labor, finance, management and Washington Outlook, which made ''Businessweek'' one of the first publications to cover national political issues that directly impacted the ...
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Relative Risk
The relative risk (RR) or risk ratio is the ratio of the probability of an outcome in an exposed group to the probability of an outcome in an unexposed group. Together with risk difference and odds ratio, relative risk measures the association between the exposure and the outcome. Statistical use and meaning Relative risk is used in the statistical analysis of the data of ecological, cohort, medical and intervention studies, to estimate the strength of the association between exposures (treatments or risk factors) and outcomes. Mathematically, it is the incidence rate of the outcome in the exposed group, I_e, divided by the rate of the unexposed group, I_u. As such, it is used to compare the risk of an adverse outcome when receiving a medical treatment versus no treatment (or placebo), or for environmental risk factors. For example, in a study examining the effect of the drug apixaban on the occurrence of thromboembolism, 8.8% of placebo-treated patients experienced the disease, b ...
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Primary Prevention
Preventive healthcare, or prophylaxis, consists of measures taken for the purposes of disease prevention.Hugh R. Leavell and E. Gurney Clark as "the science and art of preventing disease, prolonging life, and promoting physical and mental health and efficiency. Leavell, H. R., & Clark, E. G. (1979). Preventive Medicine for the Doctor in his Community (3rd ed.). Huntington, NY: Robert E. Krieger Publishing Company. Disease and disability are affected by environmental factors, genetic predisposition, disease agents, and lifestyle choices, and are dynamic processes which begin before individuals realize they are affected. Disease prevention relies on anticipatory actions that can be categorized as primal, primary, secondary, and tertiary prevention. Each year, millions of people die of preventable deaths. A 2004 study showed that about half of all deaths in the United States in 2000 were due to preventable behaviors and exposures. Leading causes included cardiovascular disease, ...
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Hypertension
Hypertension (HTN or HT), also known as high blood pressure (HBP), is a long-term medical condition in which the blood pressure in the arteries is persistently elevated. High blood pressure usually does not cause symptoms. Long-term high blood pressure, however, is a major risk factor for stroke, coronary artery disease, heart failure, atrial fibrillation, peripheral arterial disease, vision loss, chronic kidney disease, and dementia. Hypertension is a major cause of premature death worldwide. High blood pressure is classified as primary (essential) hypertension or secondary hypertension. About 90–95% of cases are primary, defined as high blood pressure due to nonspecific lifestyle and genetic factors. Lifestyle factors that increase the risk include excess salt in the diet, excess body weight, smoking, and alcohol use. The remaining 5–10% of cases are categorized as secondary high blood pressure, defined as high blood pressure due to an identifiable cause, such ...
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Cholesterol
Cholesterol is any of a class of certain organic molecules called lipids. It is a sterol (or modified steroid), a type of lipid. Cholesterol is biosynthesized by all animal cells and is an essential structural component of animal cell membranes. When chemically isolated, it is a yellowish crystalline solid. Cholesterol also serves as a precursor for the biosynthesis of steroid hormones, bile acid and vitamin D. Cholesterol is the principal sterol synthesized by all animals. In vertebrates, hepatic cells typically produce the greatest amounts. It is absent among prokaryotes (bacteria and archaea), although there are some exceptions, such as '' Mycoplasma'', which require cholesterol for growth. François Poulletier de la Salle first identified cholesterol in solid form in gallstones in 1769. However, it was not until 1815 that chemist Michel Eugène Chevreul named the compound "cholesterine". Etymology The word "cholesterol" comes from the Ancient Greek ''chole-'' ...
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Placebo
A placebo ( ) is a substance or treatment which is designed to have no therapeutic value. Common placebos include inert tablets (like sugar pills), inert injections (like Saline (medicine), saline), sham surgery, and other procedures. In general, placebos can affect how patients perceive their condition and encourage the body's chemical processes for relieving pain and a few other symptoms, but have no impact on the disease itself. Improvements that patients experience after being treated with a placebo can also be due to unrelated factors, such as regression to the mean (a statistical effect where an unusually high or low measurement is likely to be followed by a less extreme one). The use of placebos in clinical medicine raises ethical concerns, especially if they are disguised as an active treatment, as this introduces dishonesty into the doctor–patient relationship and bypasses informed consent. While it was once assumed that this deception was necessary for placebos to have ...
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