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Are We Neglecting the Neediest?

John A. Spertus, MD, MPH; Mark I. Furman, MD

Arch Intern Med. 2007;167(10):987-988.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

The rational and efficient application of effective treatment to those who derive the most benefit is an inherent attribute of high-quality health care.¹ Yet how are physicians to accomplish this efficient and effective use of treatment within the frenetic pace of patient care? Accomplishing these aims requires adherence to a basic tenet of clinical epidemiology, that for an intervention with a given relative risk reduction, the absolute benefits are greatest in those with the greatest underlying risk.² For example, if the use of statin therapy in patients with coronary artery disease results in a 30% relative risk reduction in death and the underlying risk of mortality is 20%, then the absolute risk reduction is 6 deaths for each 100 patients treated and the number of patients who need to be treated to save 1 life is 17. Conversely, if the underlying . . . [Full Text of this Article]

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