In the editorial by Drs Marx and Bucher in the March/April 2003 issue of Evidence-Based Medicine, an example illustrating the application of estimates of RRRs to individual risk is misleading. In their example, Marx and Bucher state that the NNTwould increase in patients with a baseline risk 11 times that of the low risk group, which is counterintuitive. If a high risk patient is judged to have...

CONTEXT Droperidol is widely used for the prevention of postoperative nausea and vomiting (PONV) in European countries. It is unclear how efficacious low-dose droperidol is in the prevention of PONV. OBJECTIVES To test the efficacy of low-dose droperidol in the prevention of PONV in adults and to test for dose-responsiveness. DESIGN Systematic review of randomised controlled trials with met...

OBJECTIVE Managed care and other decision makers need sound comparative information to support the formulary selection process and reimbursement decisions for the treatment of migraine. The objective of this study was to compare currently marketed triptan therapies using number-needed-to-treat (NNT) and doses-needed-to-treat (DNT) measures. DNT was further used to derive triptan treatment cost ...

BACKGROUND General anesthesia does not block central nervous processing of auditive information. Therefore, positive suggestions even given during surgery might have the potential to encourage well-being and recovery of patients. Aim of this review was to summarize the evidence on the efficacy of therapeutic suggestions under general anesthesia in adults undergoing surgery compared to an attent...

Background Recent randomized controlled trials (RCTs) support using physiotherapeutic scoliosis-specific exercises (PSSE) for adolescents with idiopathic scoliosis (AIS). All RCTs reported statistically significant results favouring PSSE but none reported on clinical significance. The number needed to treat (NNT) helps determine if RCT results are clinically meaningful. The NNT is the number of...

Evidence The largest multicentre, double-blind, placebo-controlled RCT of 4757 patients with AMD1 examined the effects of antioxidants (500 mg of vitamin C, 400 IU of vitamin E, and 15 mg of beta-carotene); zinc (80 mg of zinc oxide); and antioxidants in combination with zinc on AMD progression. • Mean age 69 years; 56% females; 6.3 years follow-up. • Baseline retinal photography classified pat...

BACKGROUND Evaluation of company clinical trial reports could provide information for meta-analysis at the commercial introduction of a new technology. METHODS Clinical trial reports of sildenafil for erectile dysfunction from September 1997 were used for meta-analysis of randomised trials (at least four weeks duration) and using fixed or dose optimisation regimens. The main outcome sought wa...

OBJECTIVE To define the evidence for doses of inhaled corticosteroids in asthma and describe this in clinically meaningful, evidence-based terms. DATA SOURCE Cochrane Database of Systematic Reviews. STUDY SELECTION AND DATA EXTRACTION We identified systematic reviews of randomised controlled trials of dosing of inhaled corticosteroids in asthma. Data on efficacy and safety of different dose...

BACKGROUND The format or frame in which the results of randomized trials are presented has been shown to influence health professional's self-reported practice. We sought to investigate the effect of framing cardiovascular risk as two different formats in a randomized trial. METHODS We recruited 457 patients aged between 60 and 79 years with high blood pressure from 20 family practices in Avo...

INTRODUCTION Scientific evidence supports the synergy between biomedical and behavioral interventions aimed at preventing the transmission of HIV as a strategy to eradicate AIDS. OBJECTIVE To characterize comparatively the benefits from biomedical and behavioral interventions to prevent HIV transmission. METHODS Narrative review. We performed a comparative analysis of the benefits of studie...