What is the NNT? It stands for “the number needed to treat” and it’s a pretty common measurement talked about in health care. Simply put, it quantifies how many people need to be treated for one person to be helped.
The best therapies have a low NNT:
If your kid is throwing up and you take her to the hospital, she might get a drug called Zofran. The NNT for that is 5, meaning that only five kids need to take Zofran for one of them to stop throwing up.
Useless or harmful therapies have a high NNT:
Now, say you’re pushing 50. You’re healthy, but your doctor suggests you start taking a baby aspirin. Just in case, you know? That NNT is 2,000. That’s how many people have to take a daily aspirin for one (nonfatal) heart attack to be prevented. Statistically speaking: Not especially helpful.
Knowing the number needed to treat sounds like a great way to help you and your physician make evidence-based decisions about your health care, doesn’t it? But as I said, although the NNT is tossed about a lot, it’s not used nearly enough by doctors and patients.
Related post: Save money by Choosing Wisely
So I was excited to learn that a patient-friendly website has been developed to make finding a treatment’s NNT easy.
Take an active role in your care
I’ve said it many times on this blog: patients need to take charge of their own health care. Ask questions, demand evidence! Don’t be the victim of an industry that is designed to profit on your health.
As theNNT’s founding physician explains in the article:
“People tend to think that if it’s a medical intervention, there’s science behind it,” he says. Unfortunately, that’s often not the case. “It is a lie to tell patients to do something without telling them, ‘You should know we’ve done lots of research on this and we can’t find any benefit to it.’”
[His] goal for the site is nothing short of a revolution in medical practice. He wants doctors to base their treatments on good scientific evidence, not tradition, hunch, and the fear that patients will see them as doing nothing. That’s the big picture, anyway. And he wants patients to start demanding such care. (my emphasis)
The website is still pretty small. In fact, after the article appeared in Wired, the site crashed from too much traffic! I hope the group of docs finds time to expand on what they’ve started. They seem pretty passionate about what they are doing, luckily for us.
If you go to the website and search under “Therapy Reviews” you can select from a number of common treatments, listed by specialty. The answers are color coded for a quick and easy understanding of the available research. Green means a low NNT; red a high NNT. Black is the worst—it means the treatment causes more harm than it helps. Yellow is indeterminate.
I chose one of my pet peeves—statins. I’ve had to fight to keep my husband off statins; his cholesterol is borderline, but he has absolutely no other risk factors for heart disease. What does the NNT say?
RED: The NNT is 1 in 60.
How about another of my pet peeves, antibiotics for a sinus infection?
BLACK: 1 in 18 were helped (NNT=18), but 1 in 8 were harmed by medication side effects.
Related post: The Z-Pak deception
theNNT.com is in its early stages, yes, but I think it could be an invaluable tool for patients, like me, who want to control their health care and health costs by sticking to evidence-based care. I’m very thankful that there are some like-minded physicians who are willing to review the available research and make this information accessible to everyone.