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Treatment effect

Efficacious versus detrimental effects in treatment

The nature of the treatment or exposure and its risks and benefits are assessed using RCTs to remove as much bias as possible from the study and have differences amongst participants occur purely by chance. As a result of the randomization and blinding associated with rigorous RCT designs, sometimes researchers do not know if the treatment or exposure will cause harm or benefit. Most treatments or exposures tested in RCTs are precluded by observational studies that generate evidence of certain types of treatment effects.

If one can hypothesize a decrease in the number of outcomes as a result of a treatment or exposure in an a priori fashion (based on the literature, the opinions of peers and colleagues, and clinical expertise), then the epidemiological measure of interest is absolute risk reduction (ARR).

Inversely, if a hypothesis stipulated an increase in the risk of an outcome occurring, researchers will want to use absolute risk increase (ARI).

What type of treatment effect is expected as a result of treatment?

Decrease in the number of outcomes
Absolute Risk Reduction
Increase in the number of outcomes
Absolute Risk Increase

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There are two treatment effects that play a role in epidemiology: Efficacious treatment effects and detrimental treatment effects. The treatment effect dictates if number needed to treat (NNT) or number needed to harm (NNH) is calculated.

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