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Absolute risk reduction
In epidemiology, the absolute risk reduction or risk difference is the loss of chance of a given action or therapy in regards to a management action or therapy.
It is the inverse of the variety required to cure.
In general, absolute risk reduction is the change between the management group’s occurrence amount (CER) and the trial group’s occurrence amount (EER). The change is usually measured with respect to two therapies A and B, with A typically a medication and B a sugar pill. For example, A could be a 5-year therapy with a theoretical medication, and B is therapy with sugar pill, i.e. no therapy. A described endpoint has to be specified, such as a success or a reaction amount. For example: the appearance of United States in a 5 season interval. If the prospects pA and pB of this endpoint under therapies A and B, respectively, are known, then the overall danger reduce is calculated as (pB – pA).
The inverse of the overall danger reduce, NNT, is an important measure in pharmacoeconomics. If a scientific endpoint is harmful enough (e.g. death, heart attack), medication with a low overall danger reduce may still be indicated in particular situations. If the endpoint is slight, health providers may reduce to compensate medication with a low overall danger reduce.
Consider a theoretical medication which decreases the comparative chance of melanoma malignancy of the digestive tract by 50% over five decades. Even without the medication, melanoma malignancy of the digestive tract is fairly unusual, maybe 1 in 3,000 in every five-year interval. The amount of melanoma malignancy of the digestive tract for a five-year therapy with the medication is therefore 1/6,000, as by healing 6,000 individuals with the medication, one can expect to reduce the variety of melanoma malignancy of the digestive tract situations from 2 to 1.
The raw computation of overall danger reduce is a probability (0.003 less situations per person, using the melanoma malignancy of the digestive tract example above). Writers such as Ben Goldacre believe that this information is best presented as a organic variety in the perspective of the guideline danger (“reduces 2 situations of melanoma malignancy of the digestive tract to 1 case if you cure 6,000 individuals for five years”).Natural numbers, which are used in the variety required to cure approach, are easily recognized by non-experts.
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