PubMed · 2587296
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L R Tulman, B S Jacobsen. Goldilocks and variability.. https://pubmed.ncbi.nlm.nih.gov/2587296/
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CONTEXT: Ongoing efforts to improve the quality of reporting for randomized controlled trials (RCTs) include the Consolidated Standards of Reporting Trials (CONSORT) statement. We examined the frequency of explicit reporting of the number needed to treat (NNT) and the absolute risk reduction (ARR) in RCTs. METHODS: Five frequently cited journals were investigated: Annals of Internal Medicine, BMJ, JAMA, The Lancet, and the New England Journal of Medicine. For each journal, 4 years were evaluated: 1989, 1992, 1995, and 1998. All issues of each journal for each year were reviewed manually. Eligible articles were those in which an RCT was conducted on the use of a medication showing a significant treatment effect. Elements abstracted from each eligible article were the condition investigated, event being treated or prevented, intervention, study results, and reporting methods (relative risk reduction, NNT, and ARR). RESULTS: Of 359 eligible articles, NNT was reported in 8 articles. Six of the 8 studies were from 1998. Absolute risk reduction was reported in 18 articles, 10 of which were from 1998. CONCLUSIONS: Despite CONSORT recommendations, few authors expressed their findings in terms of NNT or ARR. Consideration should be given to including these values in reports of RCTs.
CONTEXT: An estimated correlation between 2 variables is valid only within the range of observed data. Extrapolation is risky and should be performed with caution. METHODS: To assess the prevalence of problems with data extrapolation in the medical literature, all articles published from January through June 2000 in BMJ, JAMA, The Lancet, and The New England Journal of Medicine (NEJM) were reviewed manually. Articles containing at least 1 scatterplot with raw data and a corresponding fitted regression line were included in the analysis. Articles were considered to involve extrapolation if they contained at least 1 fitted line beyond the observed data in any scatter plot. RESULTS: A total of 178 articles presenting at least 1 scatterplot were identified. Among them, 37 articles (21%) (5 from BMJ, 7 from JAMA, 23 from The Lancet, and 2 from NEJM) were included. Twenty-two articles (59% [95% confidence interval, 42%-75%]) from all 4 journals involved extrapolation. None changed the line type to indicate extrapolation. Four articles (11%) contained a plot in which the fitted line reached unreasonable or meaningless values. Three articles (8%) stated explicit conclusions about values outside the range of the observed data. CONCLUSIONS: A high proportion of the articles analyzed from all 4 weekly general medical journals involved extrapolation without indication. Researchers, reviewers, and editors should be aware of this problem and work to eliminate it.
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