Relative risk reduction

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In epidemiology, the relative risk reduction is a measure calculated by dividing the absolute risk reduction by the control event rate.[1][2][3][4]

The relative risk reduction can be more useful than the absolute risk reduction in determining an appropriate treatment plan, because it accounts not only for the effectiveness of a proposed treatment, but also for the relative likelihood of an incident (positive or negative) occurring in the absence of treatment.

Like many other epidemiological measures, the same equations can be used to measure a benefit or a harm (although the signs may need to be adjusted, depending upon how the data was collected.)

Worked example

  Example 1: risk reduction Example 2: risk increase
Experimental group (E) Control group (C) Total (E) (C) Total
Events (E) EE = 15 CE = 100 115 EE = 75 CE = 100 175
Non-events (N) EN = 135 CN = 150 285 EN = 75 CN = 150 225
Total subjects (S) ES = EE + EN = 150 CS = CE + CN = 250 400 ES = 150 CS = 250 400
Event rate (ER) EER = EE / ES = 0.1, or 10% CER = CE / CS = 0.4, or 40% EER = 0.5 (50%) CER = 0.4 (40%)
Equation Variable Abbr. Example 1 Example 2
CER − EER < 0: absolute risk reduction ARR (−)0.3, or (−)30% N/A
> 0: absolute risk increase ARI N/A 0.1, or 10%
(CER − EER) / CER < 0: relative risk reduction RRR (−)0.75, or (−)75% N/A
> 0: relative risk increase RRI N/A 0.25, or 25%
1 / (CER − EER) < 0: number needed to treat NNT (−)3.33 N/A
> 0: number needed to harm NNH N/A 10
EER / CER relative risk RR 0.25 1.25
(EE / EN) / (CE / CN) odds ratio OR 0.167 1.5
EER − CER attributable risk AR (−)0.30, or (−)30% 0.1, or 10%
(RR − 1) / RR attributable risk percent ARP N/A 20%
1 − RR (or 1 − OR) preventive fraction PF 0.75, or 75% N/A

References

  1. ↑ Barratt A, Wyer P, Hatala R, McGinn T, Dans A, Keitz S, Moyer V, For G (2004). "Tips for learners of evidence-based medicine: 1. Relative risk reduction, absolute risk reduction and number needed to treat". CMAJ 171 (4): 353–8. doi:10.1503/cmaj.1021197. PMC 509050. PMID 15313996. 
  2. ↑ Relative Risk Reduction
  3. ↑ Relative risk
  4. ↑ Measuring the size of an intervention
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