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Absolute risk of HRTFrom: Arthur Freeland, MD (arthurfree@aol.com)Wed Jul 10 22:59:24 2002
When looking at the risk of any intervention, it is helpful to look at the NNT (number needed to treat - i.e. the total number of people treated in order to save one life, or prevent one case) and the NNH (the number needed to harm)i.e. from table below: one would have to treat 250 women with combination HRT for five years to see ONE stroke due to treatment. These are an effective measure of absolute risk/benefit. Since the Wyeth letter had some absolute numbers it is possible to calculate the NNT and NNH. The only problem I saw with their numbers is that the relative risk was given with a denominator of five woman years (the duration of the study) and the absolute risk was given per single woman year. For direct comparison, I've calculated the NNT and NNH for FIVE years. (In parentheses are the absolute increased risk per woman year given in the Wyeth letter) Outcome Relative Risk NNH NNT Heart attack 1.29 286 (7/10,000/yr) Stroke 1.41 250 (8/10,000/yr) Breast Cancer 1.26 250 (8/10,000/yr) Thromboembolism 2.11 111 (18/10,000/yr) Colon Cancer 0.63 333 (6/10,000/yr) Hip Fracture 0.66 400 (5/10,000/yr) As you can see, the absolute numbers, even over five years, are very small but not negligible.
-- Arthur Freeland, MD Kirksville, Missouri
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