Sneaky Research? Absolute Versus Relative Risk Reduction: The Way It Can Be Used To Trick You

Talking With Docs
26 Aug 202210:59
EducationalLearning
32 Likes 10 Comments

TLDRIn this episode of 'Talking with Docs,' Dr. Brad Wein and Dr. Paul Zalazel discuss the importance of understanding medical statistics and the difference between absolute and relative risk reduction. They emphasize the value of consulting medical journals over mainstream media for accurate health information. The doctors explain how the number needed to treat (NNT) can guide preventative healthcare decisions and highlight the significance of confidence intervals, meta-analyses, and systematic reviews in validating medical findings.

Takeaways
  • 📚 Importance of understanding medical and scientific jargon in accessing accurate health information.
  • 🧠 The internet provides vast amounts of medical information, but it's crucial to discern reliable sources from social media and mainstream media.
  • 📈 Key statistical terms in medical research include risk reduction, absolute risk reduction, and relative risk reduction.
  • 🔢 Absolute risk reduction (ARR) is the percentage decrease in the risk of an event occurring, while relative risk reduction (RRR) is the proportionate decrease in risk.
  • 🐔 A humorous example used in the script is the hypothetical study of eating chicken wings to prevent chickenpox, illustrating the difference between ARR and RRR.
  • 🤔 The way information is presented, such as focusing on RRR over ARR, can be misleading and should be critically evaluated.
  • 💡 The number needed to treat (NNT) is a statistic that indicates how many patients need to be treated to prevent one adverse outcome, which is useful for preventative medicine.
  • 🔎 Scientific research should present both absolute and relative risk to avoid misinterpretation and guide decision-making.
  • 📊 Confidence intervals are a statistical method to determine if results are due to chance or the effect of the intervention, commonly set at 95%.
  • 🔍 Meta-analyses and systematic reviews are methods to aggregate data from multiple studies to increase the power of findings and draw broader conclusions.
  • 🌟 The script concludes with an encouragement for viewers to take charge of their health and to critically engage with their healthcare providers about treatment options.
Q & A

  • What is the main topic of discussion in the episode of 'Talking with Docs'?

    -The main topic of discussion is statistics in medical treatment, specifically focusing on understanding commonly used terms like risk reduction, absolute risk reduction, relative risk reduction, and the number needed to treat (NNT).

  • Why do the doctors recommend reading medical journals over mainstream media for scientific information?

    -They recommend reading medical journals because mainstream media can sometimes be misleading or present information in a way that is not accurate or complete. Medical journals provide more in-depth, accurate, and evidence-based information on scientific studies and findings.

  • What is the difference between absolute risk reduction and relative risk reduction?

    -Absolute risk reduction refers to the actual decrease in the number of people experiencing an outcome (like a disease) in a treated group compared to an untreated group. Relative risk reduction is the percentage decrease in risk of the outcome in the treated group compared to the untreated group. Absolute risk reduction provides a more accurate understanding of the treatment's effectiveness at an individual level.

  • What is the 'number needed to treat' (NNT) and how is it calculated?

    -The 'number needed to treat' (NNT) is a measure used to determine how many patients need to be treated with a medication or intervention to prevent one additional bad outcome. It is calculated by dividing the number of people in the control group who experienced the outcome by the difference in the number of people in the treatment group who experienced the outcome.

  • Why is it important to consider both absolute risk reduction and relative risk reduction when evaluating medical treatments?

    -Both measures provide different perspectives on the effectiveness of a treatment. Relative risk reduction can sometimes be misleading if the baseline risk is very low, as it can appear much larger than the actual benefit. Absolute risk reduction, on the other hand, gives a clearer picture of the actual benefit at an individual level, which is crucial for making informed decisions about treatment.

  • What is a 'confidence interval' in statistics and why is it important?

    -A confidence interval is a range of values, often set at 95%, within which the true value of a parameter (like the effect of a treatment) is likely to fall. It is important because it gives an indication of the precision of the estimate and helps determine whether the results are due to chance or reflect a true effect.

  • What is the difference between a meta-analysis and a systematic review?

    -A meta-analysis combines the results of multiple studies to increase the sample size and the power of the analysis, allowing for more reliable conclusions. A systematic review, on the other hand, is a comprehensive examination of all relevant literature to identify whether the studies are methodologically sound and then synthesizes the findings, potentially including a meta-analysis if appropriate.

  • How does the 'number needed to treat' (NNT) relate to the effectiveness of a medical intervention?

    -The lower the NNT, the more effective the intervention is considered to be because it means fewer people need to be treated to prevent one instance of the negative outcome. This makes the intervention more clinically significant and cost-effective.

  • What is an example of a hypothetical study discussed in the episode?

    -The hypothetical study discussed is one where eating chicken wings once a week is suggested to reduce the incidence of chickenpox. The study involves 2,000 people, with 1,000 in the control group and 1,000 in the treatment group, and the outcome measured is the incidence of chickenpox.

  • Why is it important for patients to understand statistical terms like absolute risk reduction and NNT?

    -Understanding these statistical terms allows patients to make more informed decisions about their healthcare. It helps them assess the actual benefit of a treatment or intervention, rather than relying solely on percentages that might seem impressive but do not reflect the true clinical significance.

  • What advice do the doctors give regarding the interpretation of medical studies and statistics?

    -The doctors advise patients to be wary of high relative risk reduction numbers and to dig deeper to understand the absolute risk reduction. They also suggest discussing potential treatments with healthcare providers to understand the associated risks and benefits, making decisions together.

Outlines
00:00
📚 Introduction to Medical Statistics

The video begins with an introduction to the importance of understanding medical statistics, emphasizing the need to discern reliable information from the vast amount available on the internet. The hosts, Dr. Brad Wein and Dr. Paul Zalazel, discuss the significance of jargon in medical literature and the importance of sourcing information from reputable studies rather than social media or mainstream media. They introduce the concept of risk reduction, explaining the difference between absolute and relative risk reduction, and use a humorous hypothetical study on chicken wings and chickenpox to illustrate these concepts.

05:02
📉 Understanding Risk Reduction and Number Needed to Treat (NNT)

This paragraph delves deeper into the nuances of risk reduction in medical statistics. The hosts clarify the potential for misleading information when only relative risk reduction is highlighted without the context of absolute risk reduction. They introduce the concept of the number needed to treat (NNT), which provides insight into how many patients need to be treated to prevent one adverse outcome. The discussion includes a detailed explanation of how NNT is calculated and its implications for preventative medicine and government guidelines. The paragraph also touches on the importance of confidence intervals, meta-analysis, and systematic reviews in scientific research.

10:02
🎓 Final Thoughts and Call to Action

In the concluding paragraph, the hosts wrap up the discussion on medical statistics with a call to action for viewers to take charge of their health by understanding the statistics behind medical treatments. They encourage viewers to engage with their healthcare providers to make informed decisions about their medical care. The hosts also tease the next video, which will review a meta-analysis on the absolute and relative risk reduction of cholesterol by statins, hinting at the controversy surrounding this topic.

Mindmap
Keywords
💡Statistics
Statistics is a branch of mathematics that deals with the collection, analysis, interpretation, presentation, and organization of data. In the context of the video, statistics are used to analyze medical treatments and their outcomes, helping to determine the effectiveness of various health interventions. The hosts discuss the importance of understanding statistical terms when interpreting medical studies and the impact of treatments on patient outcomes.
💡Risk Reduction
Risk reduction refers to the decrease in the likelihood of a particular event or outcome occurring. In medical terms, it often indicates how much a treatment or intervention lowers the risk of a negative health event. The video emphasizes the difference between absolute risk reduction and relative risk reduction, which are crucial for understanding the true impact of a medical treatment.
💡Absolute Risk Reduction (ARR)
Absolute risk reduction, or ARR, is a measure that quantifies the proportionate decrease in the risk of a specific outcome in a treated group compared to a control group. It is expressed as a percentage and provides a clear understanding of the actual benefit of a treatment at an individual level. ARR is important because it gives a more realistic view of the treatment effect than relative risk reduction.
💡Relative Risk Reduction (RRR)
Relative risk reduction is the proportion by which the risk of an event is reduced with an intervention compared to a control. It is calculated by comparing the risk of the event in the untreated group to the risk in the treated group. While RRR can seem more impressive because it does not depend on the actual event rate, it can sometimes be misleading because it does not reflect the actual decrease in risk that an individual can expect.
💡Number Needed to Treat (NNT)
The number needed to treat, or NNT, is a measure used in evidence-based medicine to determine how many patients need to be treated with a particular intervention for one additional patient to benefit. It is calculated by taking the reciprocal of the absolute risk reduction. A lower NNT indicates a more effective treatment, as fewer patients need to be treated for one to experience the benefit.
💡Medical Journals
Medical journals are scholarly publications that contain articles and research studies related to the field of medicine. They are a primary source of information for healthcare professionals and researchers, providing the latest findings in medical science. The hosts of the video encourage viewers to consult medical journals for accurate and reliable information on medical treatments and outcomes, rather than relying on mainstream media or social media platforms.
💡Confidence Intervals
Confidence intervals are a statistical measure that provides a range of values, within which the true value of a parameter (such as the effect of a treatment) is likely to fall. They are used to assess the precision of an estimate and to determine whether results are statistically significant. A common confidence interval is 95%, which means that if a study is repeated many times, the true effect would fall within the calculated interval 95% of the time.
💡Meta-Analysis
A meta-analysis is a statistical technique that combines the results of multiple independent studies to provide a more comprehensive understanding of a particular issue or question. By pooling data from various sources, a meta-analysis can increase the sample size and statistical power, which in turn can lead to more reliable and generalizable conclusions.
💡Systematic Review
A systematic review is a rigorous and structured approach to reviewing scientific literature on a specific topic. It involves a thorough search for all relevant studies, critical appraisal of their quality, and synthesis of the findings. Systematic reviews aim to reduce bias and provide a reliable summary of the current state of research on a given subject.
💡Health Information
Health information refers to the data and knowledge related to health and healthcare. It encompasses a wide range of topics, from medical research findings to personal health records and public health statistics. The video emphasizes the importance of obtaining health information from credible sources, such as medical journals, rather than from potentially misleading sources like mainstream media or social media.
💡Medical Treatment
Medical treatment refers to the interventions or procedures used by healthcare professionals to prevent, diagnose, or treat diseases and health conditions. The video discusses how statistical analysis can help evaluate the effectiveness of different medical treatments and their impact on patient outcomes.
Highlights

The importance of understanding medical and scientific information from reliable sources is emphasized, especially in the era of the internet where access to such information is abundant.

The podcast aims to clarify commonly used terms in medical treatment discussions, focusing on how they impact outcomes.

The difference between absolute risk reduction and relative risk reduction is explained, highlighting the potential for misinterpretation when only relative risk reduction is presented.

A hypothetical study about eating chicken wings to prevent chickenpox is used to illustrate the concepts of absolute and relative risk reduction.

The concept of the number needed to treat (NNT) is introduced as a way to understand the practical implications of a treatment's effectiveness.

The importance of considering both absolute risk reduction and NNT when evaluating the effectiveness of preventative medical treatments is discussed.

The podcast warns against the potential for misleading information when scientific data is presented without the context of absolute risk reduction.

Confidence intervals are explained as a statistical method to determine if results are due to chance or the effect of the treatment.

The value of having studies repeated by different institutions to confirm results and ensure they are not due to chance is emphasized.

Meta-analysis is introduced as a method to combine results from multiple studies to increase the power and reliability of findings.

Systematic review is defined as the process of evaluating all relevant studies to determine their quality and relevance.

The podcast concludes with a teaser for the next episode, which will review a meta-analysis on the absolute and relative risk reduction of cholesterol by statins.

The hosts encourage viewers to take charge of their own health by understanding medical information and making informed decisions with their healthcare providers.

The podcast's goal is to provide statistical basics to help viewers better understand medical studies and the implications of their findings.

Transcripts

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