Talking about Treatment
Authors: Benjamin Djulbegovic
Journal: Annals of Internal Medicine (2000)

Letters4 January 2000Talking about TreatmentBenjamin Djulbegovic, MD, PhD, Gary H. Lyman, MD, MPH, and Iztok Hozo, PhDBenjamin Djulbegovic, MD, PhDH. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Djulbegovic)H. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Lyman)Indiana University North West; Gary, IN 46408 (Hozo)Search for more papers by this author, Gary H. Lyman, MD, MPHH. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Djulbegovic)H. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Lyman)Indiana University North West; Gary, IN 46408 (Hozo)Search for more papers by this author, and Iztok Hozo, PhDH. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Djulbegovic)H. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Lyman)Indiana University North West; Gary, IN 46408 (Hozo)Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-132-1-200001040-00021 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail TO THE EDITOR:In his article about the application of population-based therapeutic measures in the care of individual patients, Steiner (1) concluded that because we cannot be sure who will benefit from treatment for any NNT (number of patients needed to be treated to prevent one bad outcome) that is greater than 1, “all you can say is that on the basis of best available evidence, everything possible is being done to prevent an adverse effect.” In fact, the question Steiner asks for NNT greater than 1 is, What is the minimal therapeutic benefit at which treatment is worth administering?... References1. Steiner JF. Talking about treatment: the language of populations and the language of individuals. Ann Intern Med. 1999;130:618-22. LinkGoogle Scholar2. Djulbegovic B, Hozo I. Using Internet to calculate clinical action thresholds. Comp Biomed Res. 1998;32:168-85. Google Scholar3. Djulbegovic B, Hozo I, Fields K, Sullivan D. High-dose chemotherapy in the adjuvant treatment of breast cancer: benefit risk analysis. Cancer Control. 1998;5:394-405. CrossrefMedlineGoogle Scholar4. Pauker S, Kassirer J. Therapeutic decision making: a cost benefit analysis. N Engl J Med. 1975;293:229-34. CrossrefMedlineGoogle Scholar5. Curb JD, Pressel SL, Cutler JA, Savage PJ, Applegate WB, Black H, et al . Effect of diuretic-based antihypertensive treatment on cardiovascular disease risk in older diabetic patients with isolated systolic hypertension. Systolic Hypertension in the Elderly Program Cooperative Research Group. JAMA. 1996;276:1886-92. CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: H. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Djulbegovic)H. Lee Moffitt Cancer Center and Research Institute; Tampa, FL 33612 (Lyman)Indiana University North West; Gary, IN 46408 (Hozo) PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoTalking about Treatment: The Language of Populations and the Language of Individuals John F. Steiner Talking about Treatment Richard Saitz Talking about Treatment Kenneth M. Kessler Talking about Treatment John C. Peirce Talking about Treatment Bimal P. Jain Metrics Cited ByWhipple's disease: often a late diagnosis and a rare cause of nephropathy 4 January 2000Volume 132, Issue 1Page: 94KeywordsAntihypertensive drug therapyCardiovascular therapyDiureticsNumber needed to harmNumber needed to treatPatientsRisk management Issue Published: 4 January 2000 CopyrightCopyright © 2000 by American College of Physicians. All Rights Reserved.PDF DownloadLoading ...