Doctors Launch ‘TheNNT.com’ to Give Treatment Info - Health Blog - WSJ

By Katherine Hobson

Conveying how well a therapy works — and doing so in understandable terms — isn’t easy, but a group of physicians is trying to change that.

Their new website, TheNNT.com, looks at a stat called the “number needed to treat,” which it defines as “a measurement of the impact of a medicine or therapy [that estimates] the number of patients that need to be treated in order to have an impact on one person.” (Here’s the new site’s explanation of the NNT. We’ve mentioned the metric before in a post about gauging heart risk.)

The site summarizes the evidence (taken mostly from systematic reviews like those from the Cochrane Collaboration) behind a range of treatments and therapies, including the Mediterranean Diet for post-heart attack care and antibiotics for ear infections. It also includes, when appropriate, the “number needed to harm,” which indicates how many people you’d have to treat before one is harmed by the intervention. Both stats are presented as a proportion — i.e. one in 42 people will have his or her life saved by taking aspirin after a major heart attack (an NNT of 42), and one in 167 will have non-dangerous bleeding (a NNH of 167).

A perfect NNT would be one — treat one person, and one person benefits.  The higher the NNH, the better.

One of the site’s creators, Graham Walker, chief emergency resident at St. Luke’s-Roosevelt Hospital Center in New York City, tells the Health Blog he was surprised that data on the effectiveness of treatments “was out there, but not easily accessible.” After talking about a year ago with two of his attending physicians, Ashley Shreves and David Newman (now at Mt. Sinai School of Medicine), Walker learned they had also “been thinking about whether there’s a way to disseminate this information more easily.”

(Longtime Health Blog readers may remember Walker from earlier posts; we got his student’s-eye view of Match Day and the early days of his emergency medicine residency. We didn’t know he was involved in this project until we’d already decided to write about it.)

Walker says the site has no outside funding — it’s “a labor of love” — and that while it will most likely be used primarily by physicians, he and his co-authors try to write in a way that’s accessible to the rest of us.

Not everything is amenable to a NNT, Walker says. It’s generally only for yes/no questions, such as “does aspirin prevent death?” It’s not helpful with things that involve a scale — such as by how much an antidepressant improves a quality-of-life index.

The site officially went live last week. Walker says they’re getting a few emails a day, some thanking them and a handful of criticisms — such as the concern that the NNT stat oversimplifies study data. (The reviews all have links to the original research, Walker says.)

Walker says the point of the site is to help physicians “do the best things for our patients.” And he says, quoting his collaborator Newman, “that means when we have the data, we should use it.”

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