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July 19, 2000

Assessing Prevention Interventions by "Number Needed to Treat"

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

JAMA. 2000;284(3):303-305. doi:10.1001/jama.284.3.303

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.

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