Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor
Copyright 2000 American Medical Association. All Rights Reserved.
Applicable FARS/DFARS Restrictions Apply to Government Use.2000
To the Editor: We agree with Dr Kumana and
colleagues1 that NNT is useful to assess
the effectiveness of medical therapies. Although the authors briefly mentioned
the importance of evaluating treatments relative to other "indicated drug
interventions," they did not provide comparisons of the NNTs from statin trials
to the NNTs of other commonly accepted preventive therapies. It is important,
however, to discuss the NNT compared with the overall cardiovascular risk
of the study population, because the NNT in a primary prevention trial usually
is much higher than in a secondary prevention trial due to the lower absolute
cardiovascular event rates. The NNTs from primary prevention of cardiovascular
disease trials in middle-aged patients are listed in Table 1.
Fontanarosa PB, McBride PE, Stein JH. Assessing Prevention Interventions by "Number Needed to Treat". JAMA. 2000;284(3):303-305. doi:10.1001/jama.284.3.303