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Guidelines to understand and compute the number needed to treat
BMJ Mental Health ( IF 5.2 ) Pub Date : 2021-11-01 , DOI: 10.1136/ebmental-2020-300232
Valentin Vancak 1 , Yair Goldberg 2 , Stephen Z Levine 3
Affiliation  

Objective We aim to explain the unadjusted, adjusted and marginal number needed to treat (NNT) and provide software for clinicians to compute them. Methods The NNT is an efficacy index that is commonly used in randomised clinical trials. The NNT is the average number of patients needed to treat to obtain one successful outcome (ie, response) due to treatment. We developed the nntcalc R package for desktop use and extended it to a user-friendly web application. We provided users with a user-friendly step-by-step guide. The application calculates the NNT for various models with and without explanatory variables. The implemented models for the adjusted NNT are linear regression and analysis of variance (ANOVA), logistic regression, Kaplan-Meier and Cox regression. If no explanatory variables are available, one can compute the unadjusted Laupacis et al ’s NNT, Kraemer and Kupfer’s NNT and the Furukawa and Leucht’s NNT. All NNT estimators are computed with their associated appropriate 95% confidence intervals. All calculations are in R and are replicable. Results The application provides the user with an easy-to-use web application to compute the NNT in different settings and models. We illustrate the use of the application from examples in schizophrenia research based on the Positive and Negative Syndrome Scale. The application is available from . The output is given in a journal compatible text format, which users can copy and paste or download in a comma-separated values format. Conclusion This application will help researchers and clinicians assess the efficacy of treatment and consequently improve the quality and accuracy of decisions.

中文翻译:

了解和计算需要治疗的人数的指南

目的 我们旨在解释未调整的、调整的和边缘需要治疗的数量 (NNT),并为临床医生提供计算它们的软件。方法 NNT是随机临床试验中常用的疗效指标。NNT 是因治疗而获得成功结果(即反应)所需治疗的平均患者数量。我们开发了供桌面使用的 nntcalc R 包,并将其扩展为用户友好的 Web 应用程序。我们为用户提供了用户友好的分步指南。该应用程序计算带有和不带有解释变量的各种模型的 NNT。调整后的 NNT 的实施模型是线性回归和方差分析 (ANOVA)、逻辑回归、Kaplan-Meier 和 Cox 回归。如果没有可用的解释变量,可以计算未调整的 Laupacis 等人的 NNT、Kraemer 和 Kupfer 的 NNT 以及 Furukawa 和 Leucht 的 NNT。所有 NNT 估计量均使用其相关的适当 95% 置信区间进行计算。所有计算均在 R 中进行并且可复制。结果 该应用程序为用户提供了一个易于使用的 Web 应用程序来计算不同设置和模型下的 NNT。我们通过基于阳性和阴性综合症量表的精神分裂症研究示例来说明该应用程序的使用。该应用程序可从。输出以期刊兼容的文本格式给出,用户可以以逗号分隔值格式复制和粘贴或下载。结论 该应用程序将帮助研究人员和临床医生评估治疗效果,从而提高决策的质量和准确性。
更新日期:2021-10-21
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