BMJ 2000;321:950-953 ( 14 October )

Education and debate

    Disease impact number and population impact number: population perspectives to measures of risk and benefit
    Commentary: DINS, PINS, and thingsclinical and population perspectives on treatment effects

Disease impact number and population impact number: population perspectives to measures of risk and benefit

Richard F Heller, professor of community medicine and biostatistics ^a, Annette J Dobson, professor of biostatistics ^b. 

^a Centre for Clinical Epidemiology and Biostatistics, University of Newcastle, New South Wales 2308, Australia, ^b Department of Social and Preventive Medicine, University of Queensland, Queensland 4006, Australia

Correspondence to: R F Heller, Centre for Clinical Epidemiology and Biostatistics, David Maddison Clinical Sciences Building, Royal Newcastle Hospital, Newcastle, New South Wales 2308, Australia rfhcceb@attglobal.net

The first 150 words of the full text of this article appear below.

The number needed to treat statistic is a clinically useful measure of treatment effect, conveying both statistical and clinical importance to the treating doctor. ^{1 2} This information, however, is limited to clinical decision making and lacks a public health perspective. We propose two new statistics, which should allow the impact of an intervention to be seen in the context of the broader population.

The number needed to treat is defined as the number of patients who must be treated to prevent one patient from experiencing the adverse effects of the disease being studied.³ For example, treating five diabetic patients with intensive therapy may result in one fewer patient who dies or has a macrovascular event.⁴ This gives an immediate and simple understanding of the impact of the intervention. The number needed to treat statistic, however, relates only to those people actually treated and does not give an appreciation of how many . . . [Full text of this article]

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Rapid Responses:

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Smeeth and Ebrahim are too negative

Dick Heller
bmj.com, 17 Oct 2000 [Full text]

Disease impact number and population impact number: What is new?

Javier Llorca
bmj.com, 21 Oct 2000 [Full text]

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