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July 19, 2000

Assessing Prevention Interventions by "Number Needed to Treat"—Reply

Author Affiliations

Stephen J.LurieMD, PhD, Contributing EditorIndividualAuthor

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

In Reply: The different NNTs in the 4 trials we described were largely related to baseline risks in the respective control groups. We therefore stressed the strategic importance of comparing trials carried out under different circumstances and not just with different drugs. However, the influence of possible differences due to the intrinsic efficacy of each statin or the dosages used cannot be ruled out.

We agree with Dr Lam that NNTs refer to additional benefits beyond those associated with "control treatment" and thank him for making this comparison more explicit. Regarding derivation of the average NNT per year, we stated that it was extrapolated by assuming that the effects of statins were evenly distributed over the period of treatment for which the NNT itself was calculated. The product of the corresponding period and the NNT therefore gave a value for the average NNT per year.

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