{"id":47,"date":"2009-02-13T17:19:19","date_gmt":"2009-02-13T16:19:19","guid":{"rendered":"http:\/\/stg-blogs.bmj.com\/adc-archimedes\/?p=47"},"modified":"2009-02-16T14:29:05","modified_gmt":"2009-02-16T13:29:05","slug":"relativist-or-absolute-certainty","status":"publish","type":"post","link":"https:\/\/stg-blogs.bmj.com\/adc\/2009\/02\/13\/relativist-or-absolute-certainty\/","title":{"rendered":"Relativist or absolute certainty?"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" class=\"alignleft\" style=\"float: left\" src=\"http:\/\/farm3.static.flickr.com\/2410\/1758818178_0cafd90ee8_t.jpg\" alt=\"Pill Bottle\" width=\"67\" height=\"100\" \/>If you were offered a choice of medication to treat an ailment you were suffering from, and you&#8217;d asked about how effective they were (and there&#8217;s a huge chunk of the population that wouldn&#8217;t, and would be happy to just do as they are told), then what information would you like? <!--more-->How much information do you want to know? &#8220;It works better than the previous treatments&#8221;, or a more mathematical estimate? Would you prefer to be told &#8220;For every ten folk I give this drug to, one will benefit?&#8221;, or &#8220;Taking the drug improves success rates by 10%.&#8221; or perhaps &#8220;Taking the drug will double your chances of success&#8221;?<br \/>\nAs you have no doubt figured out, the statements all refer to the same underlying difference of treatment success in 20%, vs 10% in the comparison group. The statements refer to the &#8216;number needed to treat&#8217;, the &#8216;absolute risk reduction&#8217; and the relative risk. Their &#8216;truth&#8217; may be actually the same, but the perception of them is strikingly different: the majority of folk choose the drug that doubles the success. Relative risks are almost always chosen over descriptions of absolute improvement, and this is not limited to the &#8216;general population&#8217; but applies to healthcare professionals too. So how can we use this? We can remember it when we&#8217;re being &#8216;sold at&#8217; by drug reps. We can use it when we&#8217;re selling ideas to patients and families (&#8220;But the medicine is going to double the chance of success!&#8221;) And we can also use it, with care, when we&#8217;re discussing issues with managers and budget holders to describe the benefits of interventions we honestly believe will make healthcare better.<\/p>\n<p>Acknowledgement. Photo from <a title=\"Photographer\" href=\"http:\/\/flickr.com\/photos\/wainwright\/\">cdw9<\/a>, on <a href=\"http:\/\/flickr.com\/photos\/wainwright\/1758818178\/sizes\/o\/\">flickr<\/a><!--TrendMD v2.4.8--><\/p>\n","protected":false},"excerpt":{"rendered":"<p>If you were offered a choice of medication to treat an ailment you were suffering from, and you&#8217;d asked about how effective they were (and there&#8217;s a huge chunk of the population that wouldn&#8217;t, and would be happy to just do as they are told), then what information would you like? [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/stg-blogs.bmj.com\/adc\/2009\/02\/13\/relativist-or-absolute-certainty\/\">Read More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_jetpack_memberships_contains_paid_content":false,"footnotes":""},"categories":[79,80,82],"tags":[],"class_list":["post-47","post","type-post","status-publish","format-standard","hentry","category-archimedes","category-critical-appraisal-note","category-therapy"],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"_links":{"self":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/47","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/comments?post=47"}],"version-history":[{"count":0,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/posts\/47\/revisions"}],"wp:attachment":[{"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/media?parent=47"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/categories?post=47"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/stg-blogs.bmj.com\/adc\/wp-json\/wp\/v2\/tags?post=47"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}