NNT & NNH Short clinical trial phase.pptx

number of treatment ,number of harm clinical trial. ARR ARI

1. NNT & NNH S M Raysul Haque

2. Study: As an Example,

3. Study: As an Example Here Clotostrapzin also sowed a severe side effect of Hemorrhagic Stroke

4. Study: As an Example Should we recommend this new drug ? What are the calculation we need to consider before this recommendation? NNT and NNH Beside this what are the general things we need to consider before recommending or practicing this new drug ? Cost , Benefit and Risk

5. Terms need to Know: When we test a new treatment (or intervention), we want to know how many people in each group have the “event” we’re studying (for example: a heart attack, recovery, side effect) CER (Control Event Rate) → The proportion of people in the control group (placebo or standard treatment) who had the event. EER (Experimental Event Rate) → The proportion of people in the treatment group who had the event.

6. Terms need to Know: When we test a new treatment (or intervention), we want to know how many people in each group have the “event” we’re studying (for example: a heart attack, recovery, side effect) EER = “What happened in the new treatment group?” CER = “What happened in the old/no treatment group?”

7. Terms need to Know: Absolute Risk Increase (ARI) When the treatment raises the event rate compared to control (e.g., more side effects). Formula: ARI = EER − CER (positive number means harm) Absolute Risk Reduction (ARR) When the treatment lowers the event rate compared to control. Formula: ARR = CER − EER (positive number means benefit)

8. NNT

9. NNH

10. NNH= 1 / ARI

11. NNT VS NNH So for this particular study we need to treat 7 patient with Blood Clotting Disorder to reduce 1 case of Rare Blood Clotting Disorder On the other hand if we treat 100 patient with Blood Clotting Disorder there will be 1 case of Hemorrhagic Stroke

12. Another Way

13. Remember But Not Always True

14. NNT 5 or 50 or 50000 – Which one is Good

15. Scenario - 1 For the treatment of Flatus reduction DRUG A has NNT of 5 and also a high Side effect of Myocardial Infraction.

16. Scenario - 2 For the treatment of a bad disease at home DRUG A has NNT of 50 in case of hospitalization and the drug is way expensive .

17. Scenario - 3 For the treatment of a very bad disease DRUG A has NNT of 50000 in case of mortality and the drug is free of cost and provided by government.

18. THANKS