Definition of NNT/NNH - The Efficacy Scorecard
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Number Needed to Treat (NNT): The average number of patients who need to be treated to prevent one additional bad outcome.
- A measure of a therapy's effectiveness.
- Formula: $NNT = 1 / ARR$ (Absolute Risk Reduction).
- A low NNT indicates a more effective intervention.
- Conventionally rounded up to the next whole number.
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Number Needed to Harm (NNH): The average number of patients who need to be treated for one additional person to be harmed.
- A measure of a therapy's potential for harm.
- Formula: $NNH = 1 / ARI$ (Absolute Risk Increase).
- A low NNH indicates a higher risk of harm.
- Conventionally rounded down to the nearest whole number.

- Interpretation:
- The ideal intervention has a ↓ low NNT and a ↑ high NNH.
- Provides a direct measure of the real-world impact of a clinical choice.
⭐ NNT is a more clinically intuitive metric than relative risk. It helps in communicating the likelihood of a treatment's benefit to a patient in tangible terms (e.g., "We need to treat 10 people like you for one person to benefit").
High-Yield Points - ⚡ Biggest Takeaways
- NNT (Number Needed to Treat) is the average number of patients who must be treated to prevent one additional adverse outcome.
- NNH (Number Needed to Harm) is the number of individuals who must be exposed to a risk factor to cause one additional adverse outcome.
- NNT is the reciprocal of the Absolute Risk Reduction (ARR); NNT = 1/ARR.
- NNH is the reciprocal of the Attributable Risk (AR); NNH = 1/AR.
- A low NNT indicates a more effective treatment.
- A high NNH indicates a safer intervention.
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