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Citation:
Are the results of this single preventive or therapeutic trial valid?
Was the assignment of patients to
treatments randomised?
-and was the randomisation list concealed?
Were all patients who entered the trial
accounted for at its conclusion? -and were
they analysed in the groups to which they
were randomised?
Were patients and clinicians kept blind
to which treatment was being received?
2.8%
9.6% - 2.8%
9.6%
= 71%
Absolute Risk
Reduction
ARR
CER - EER
Number Needed
to Treat
NNT
1/ARR
1/6.8% = 15 pts,
(11 to 23)
YOUR CALCULATIONS:
CER
EER
Relative Risk
Reduction
RRR
CER - EER
CER
Absolute Risk
Reduction
ARR
CER - EER
Number Needed
to Treat
NNT
1/ARR
Can you apply this valid, important evidence about a treatment in caring for
your patient?
Do these results apply to your patient?
Is your patient so different from
those in the trial that its results
cant help you?
How great would the potential
benefit of therapy actually be for
your individual patient?
Method I: f
Additional Notes:
Control
Event
Rate
(CER)
.05
.10
.20
.30
.40
.50
.70
.90
0.9
*
209
110
61
46
40
38
44
101
0.85
139
73
40
30
26
25
28
64
0.8
104
54
30
22
19
18
20
46
0.6
52
27
14
10
9
8
9
18
0.55
46
24
13
9
8
7
7
15
0.5
41
21
11
8
7
6
6
**
12
(1 - PEER) x PEER x (1 -
Are your patients values and preferences satisfied by the regimen and its
consequences?
Do your patient and you have a
clear assessment of their values
and preferences?
Are they met by this regimen and
its consequences?
Should you believe apparent qualitative differences in the efficacy of therapy in some
subgroups of patients? Only if you can say yes to all of the following:
1. Do they really make biologic and clinical sense?
2. Is the qualitative difference both clinically (beneficial for some but useless or harmful for
others) and statistically significant?
3. Was this difference hypothesised before the study began (rather than the product of
dredging the data), and has it been confirmed in other, independent studies?
4. Was this one of just a few subgroup analyses carried out in this study?
Additional Notes:
Diagnostic
Test Result
(serum ferritin)
Positive
(<65 mmol/L)
Negative
(>65 mmol/L)
Totals
Target Disorder
(iron deficiency anaemia)
Present
Absent
731 b
270
a
78
d
1500
Totals
a+b
1001
c+d
1578
c
809
b+d 1770
a+c
a+b+c+d
2579
YOUR CALCULATIONS:
Target Disorder
Present
Diagnostic
Test Result
Totals
Absent
Positive
a+b
Negative
c+d
Totals
a+c
b+d 1770
a+b+c+d
Sensitivity = a/(a+c) =
Specificity = d/(b+d) =
Likelihood Ratio for a positive test result = LR+=sens/(1-spec)=
Likelihood Ratio for a negative test result=LR-=(1-sens)/spec=
Positive Predictive Value = a/(a+b) =
Negative Predictive Value = d/(c+d) =
Pre-test Probability (prevalence) = (a+c)/(a+b+c+d) =
Pre-test-odds = prevalence/(1-prevalence) =
Post-test odds = Pre-test odds x Likelihood Ratio =
Post-test Probability = Post-test odds/(Post-test odds + 1) =
Additional Notes:
PROGNOSIS WORKSHEET:
Page 1 of 2
Citation:
Typical calculation of CI
If p = 24/60 = 0.4 (or 40%) &
n=60
Your calculation:
SE: ____________
95% CI:
Can you apply this valid, important evidence about prognosis in caring for
your patient?
1. Were the study patients similar to your
own?
2. Will this evidence make a clinically
important impact on your conclusions
about what to offer or tell your
patient?
Additional Notes:
Totals
Yes
(Cohort)
a b
a+b
Treatment
No
c d
c+d
(Cohort)
Totals
a+c b+d
a+b+c+d
In a randomised trial or cohort study: Relative Risk = RR = [a/(a+b)]/[c/(c+d)]
In a case-control study: Odds Ratio (or Relative Odds) = OR = ad/bc
In this study:
PEER (OR - 1) + 1
.
PEER (OR - 1) x (1 - PEER)
Additional Notes:
3. Is it worth it?
If a cost-minimisation analysis, is the
difference in costs big enough to
warrant switching over to the cheaper
one?
If a cost-effectiveness analysis, is the
difference in effectiveness great
enough for you to want to spend the
difference?
If a cost-utility analysis, where does it
lie in your local, current league table?
Additional Comments:
Cost/QALY
( Aug. 1990)
220
240
270
490
940
1100
1180
1140
2090
4710
5780
7840
14,150
17,260
18,830
19,870
21,970
54,380
107,780
126,290
Additional Notes:
Additional Comments: