Clinical relevance of an intervention assessed by a meta-analysis of randomized clinical trials

Abstract

Objectives: Many meta-analyses usually omit the number needed to treat, or perform the calculation incorrectly, despite its importance in clinical decision-making. Accordingly, we will explain in an easily understandable way how to perform this procedure to assess the clinical relevance of the intervention.

Study design and setting: The expressions of the Cochrane Library and the concepts of clinical relevance and evidence-based medicine were applied. Simple cutoff points were also established to facilitate the task of interpreting results. The method was applied to two published meta-analyses to illustrate its application to real cases (treatment nonadherence).

Results: In the first example, with a risk in the control group ranging from 0.22 to 0.70, sending mobile phone messages to remind chronic patients to take their medication is clinically relevant with a high degree of evidence. For the second example (single-pill regimen in patients suffering from hypertension and/or dyslipidemia after 6 months), the range of the assumed control risk was between 0.28 and 0.57.

Conclusion: The constructed algorithm could be applied to published meta-analyses or incorporated systematically in all meta-analyses with these characteristics.

Keywords: Clinical trials as topic; Data interpretation; Evidence-based medicine; Meta-analysis as topic; Methods; Number needed to treat; Statistical.