tailieunhanh - Báo cáo y học: "Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headach"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache. | Haas et al. Chiropractic Osteopathy 2010 18 9 http content 18 1 9 CHIROPRACTIC OSTEOPATHY RESEARCH Open Access Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache Mitchell Haas 1 Michael Schneider2 and Darcy Vavrek1 Abstract Background The number needed to treat NNT for one participant to benefit is considered a useful clinically meaningful way of reporting binary outcomes from randomized trials. Analysis of continuous data from our randomized controlled trial has previously demonstrated a significant and clinically important difference favoring spinal manipulation over a light massage control. Methods Eighty participants were randomized to receive spinal manipulation or a light massage control n 40 group . Improvements in cervicogenic headache pain primary outcome disability and number in prior four weeks were dichotomized into binary outcomes at two thresholds 30 representing minimal clinically important change and 50 representing clinical success. Groups were compared at 12 and 24-week follow-up using binomial regression generalized linear models to compute the adjusted risk difference RD between groups and number needed to treat NNT after adjusting for baseline differences between groups. Results were compared to logistic regression results. Results For headache pain clinically important improvement 30 or 50 was more likely for spinal manipulation adjusted RD 17 to 27 and NNT to p .005 to .028 . Some statistically significant results favoring manipulation were found for headache disability and number. Conclusion Spinal manipulation demonstrated a benefit in terms of a clinically important improvement of cervicogenic headache pain. The use of adjusted NNT is recommended however adjusted RD may be easier to interpret than NNT. The study demonstrated how results may depend on the threshold for dichotomizing variables into binary outcomes. Trial .

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