You just have to be honest in a conventional way after that. Can’t wait to keep reading more. Share Facebook Hi Peter, nice new site and very thankful that you’re blogging again. David Diamond and Uffe Ravnskov argue the widely described benefits of statins are largely attributable to the strategic use of statistical techniques to simultaneously increase the perceived benefits and minimize the perceived risks.. , Well stated. I am excited to be following you on your new website! Sign up for the free AFP email table of contents. absolute risk reduction, atorvastatin, cardiovascular disease, cholesterol, heart disease, relative risk reduction, research interpretation, statins Search for Similar Articles You may search for similar … The benefits of statins in people without established cardiovascular disease but with cardiovascular risk factors: meta-analysis of randomised controlled trials. This is the chance of suffering from a heart attack or stroke in the next 10 years if you do not take the drug. The article reports on an observational study2“In fields such as epidemiology, social sciences, psychology and statistics,” Wikipedia notes, “an observational study draws inferences from a sample to a population where the independent variable is not under the control of the researcher because of ethical concerns or logistical constraints.” of 399,979 statin users published in JAMA Neurology. Thank you….this was very helpful. The data source for the benefit of statins is here. Statins are not particularly effective at reducing the risk of dying from heart disease, a study claims. This paper http://ase.uva.nl/binaries/content/assets/subsites/amsterdam-school-of-economics/research/uva-econometrics/dp-2013/1303.pdf from 2013 from the Amsterdam School of Economics has examples on how permanent and temporary changes in HR can be converted into life expectancy. A better number to give people a real sense of effectiveness is the Number Needed to Treat (NNT). Statins increased statistically significantly relative and absolute risks of myopathy (RR 1.08, 1.01-1.15; Risk difference [RD] 13, 2-24 per 10,000 person-years); renal dysfunction (RR 1.12, 1.00-1.26; RD 16, 0-36 per 10,000 person-years); and hepatic dysfunction (RR 1.16, 1.02-1.31; RD 8, 1-16 per 10,000 person-years). 2005;28(7):1588–1593. Criticism is far more useful than praise in science. It is self-persuasion that we must vigilantly guard against if we want to establish reliable knowledge about the world, and ourselves. Great stuff. Therefore, the … That is, you “fell into at least the 50th percentile of days of filled prescriptions in a given year for at least two years,” in the study population. By Ameya Kulkarni, M.D. . LES indicates low-exposure users. That is an absolute risk reduction of 4% . Hoeks, That means that 71 people would need the shot to stop a single case of flu. And let's zero in on that cardiovascular death rate part. Re: Doctors need to understand absolute versus relative risk reduction with statins Freudenthal1 is right to point out that, even in high risk groups, it remains a fact that the majority of patients taking a statin will derive no meaningful benefit from it. Frankly, because it’s more headline-worthy, we suppose. A meta-analysis by Law et al 7 of 164 trials examining the effects of statins on LDL reduction found that statins lower LDL cholesterol concentration by an average of 1.8 mmol/L. Comments that attack an individual directly will be deleted. Should diabetes be considered a coronary heart disease risk equivalent? At Year 5 since randomization, 1430 patients remained in the VASCEPA arm vs 1358 patients in the placebo arm. Finally, statins are not completely benign drugs and can be expensive. / afp Figure 1. Janez Stare and Delphine Maucort-Bolch. Figure 4. Imagine if the risk of getting lung cancer for a never-smoker was 0.005%, or 1-in-20,000, and the risk for a smoker was 0.5%, or 1-in-200. Die Relative Risikoreduktion (RRR, englisch relative risk reduction) gibt an, um welchen Anteil im Verhältnis (relativ) das bestehende Risiko jeweils durch eine Intervention vermindert wird.. Eine Änderung der Mortalität von 2 % auf 1,6 % beispielsweise entspricht der Verminderung des Relativen Risikos um ein Fünftel oder 20 %; RRR = 20 %. These biases are primarily introduced through the use of absolute and relative risk ratios. So you have to be very careful about that. Statistics are a special kind of false statement. Don't miss a single issue. Even JAMA argued against the use of relative statistics to no avail. That translates into an absolute risk reduction of 0.6 percent and a number needed to treat (NNT) of 167. What does 95% effectiveness mean? Very helpful article. Bummer. I would disagree with the authors of the meta-analysis who suggested that there is little reason to suspect different treatment effects between persons with diabetes and those without diabetes on a pathophysiological basis. People in the “low-exposure” group of statin users are associated with about a 1.6% incidence of AD. : results from 25 years of follow-up in the Renfrew and Paisley survey. Criticism and skepticism can be far more useful than praise and unflinching belief. On the contrary, I think in many (most?) The way most studies interpret and report the results is through relative risk reduction (or increase). This statement seems to contradict the concepts that persons with diabetes have different low-density lipoprotein treatment goals than those without diabetes, and that with regard to lipid-lowering therapy, diabetes is considered a coronary disease equivalent.2. et al. The second example is a 45-year-old woman who does not … Except for noting that there does not seem to be an increased risk of cancer secondary to statins, no other harms were mentioned. A subject that I have been highlighting for over 20 years. ... We hope that the concept will continue to prove useful in explaining risks and benefits in absolute terms (i.e. To see the full article, log in or purchase access. Whether we like it or not, it’s more helpful to be “difficult” people when judging the merits of an argument or hypothesis—even (especially) when it’s our own. Hold D, This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP. There are so many moving pieces (e.g., people who take statins more frequently than people who don’t may have, or have had, different exercise habits, smoking history, access to healthcare, adherence to other medications, socioeconomic status, education) that we can knowingly and unknowingly measure (but don’t, or can’t, or won’t) that may influence the results. Learn how and why people stop taking statins here. Nice refresher on the statistics issue but I have a quibble that the use of statistics is an “unwitting chicanery” by scientists or journalists. Copyright © 2020 American Academy of Family Physicians. More adherent statin users had about a 0.1% lower risk for AD compared with their less adherent counterparts (1.6% – 1.5%), in absolute terms. Writers content websites needs clicks and subscriptions to exist which leads them to leaving to public in the dark about things like these. Estimated absolute 5-year risks for developing AD from the Zissimopulous et al., 2017 study. And this is our responsibility as scientists, certainly to other scientists, and I think to laymen.”, Examples are often the best way to see how this works. Changing statins or decreasing the dose may alleviate some of these effects in people who might be … They did note (Figure 1) that the incidence of AD in nonusers was just under 2% (1.99%) over the same time period.7“Nonusers are likely a weaker control group than statin users with low-exposure in analyzing the association between statin use and AD incidence,” the authors write. Learning that you may be able to lower your risk of AD by 15% if you take statins, you may be jumping at the opportunity to “ask your doctor” about Lipitor. This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online. from 9 trials including 70 070 patients indicated relative and absolute risk reductions for stroke of 21% and 0.9%, respectively, with statins. However, the addition of ezetimibe over statins produced a 12% and 13% risk reduction in patients with baseline eGFR <60 ml/min and <45 ml/min, respectively. This can be compared with the same pooled outcome in 4 large secondary prevention statin trials, ARR … / Journals Hi Peter, it’s UB from Baltimore. Hi Peter, nice fresh site! I am young scientist learning the ropes in my first lab tech position and look forward to learning more about how I can be a “good” scientist! Relative Risikoreduktion. Data from the ASCOTT-LLA trial representing the percent of … The absolute risk in the placebo group over a median follow-up of 5.6 years was 4.8% for the first coprimary outcome, giving an absolute risk reduction with statin therapy of only 1.1% and a 5-year number needed to treat (NNT) to prevent 1 event >100. 9 out of 100 people get the flu with the shot vs 10 out of 100 without the shot. Not sure I got all the math, and it took longer than 8 mins to read… New site looks very nice, easy to navigate. Over 10 years 20 people will have a heart atack 80 people will have no heart attack. Why? The absolute benefi ts of statin therapy depend on an individual’s absolute risk of occlusive vascular events and the absolute reduction in LDL cholesterol that is achieved. Possible conflicts of interest must be disclosed at time of submission. Great blog on risk. Events indicates cases of AD. All rights Reserved. The presentation of the effect of statins as a relative risk reduction resulted in more people deciding to take statins over the whole RIS range than any of the absolute summary statistics. He’s just working shorter days. So without further ado, let’s get on with the Safari…, “There are three kinds of lies: lies, damned lies and statistics.” – MARK TWAIN, A lie is defined as an intentionally false statement. Kostis WJ. 3.4. Compared to placebo, the absolute risk reduction with atorvastatin was similar in patients with LDL cholesterol concentrations > 120 or < 120 mg/dl (reduction from 9.5 to 6.1% vs. reduction from 8.5 to … Im proven right far more often then wrong. In the case of statins, most people go on statins because … And hazard ratios are simply an extension of this misuse. HMG-CoA reductase inhibitors (statins) were first evaluated for the prevention of CVD in patients with overt hypercholesterolaemia. The absolute risk is quite small, so the relative risk can be misleading. Think about this for a moment. Oops! To the Editor: In her Perspective article, Goldfine (May 10 issue)1 correctly states that the benefits of statins outweigh the risks in patients with known cardiovascular disease. Contact Investigators examined the risk of developing Alzheimer’s disease (AD) among subjects who were “high-exposure” (i.e., high or frequent users)3“Individuals categorized as having high-exposure fell into at least the 50th percentile of days of filled prescriptions in a given year for at least 2 years during 2006, 2007, and 2008,” according to the study. For the purposes of this recommendation, dyslipidemia is defined as an LDL-C level greater than 130 mg/dL or a high-density lipoprotein cholesterol (HDL-C) level less than 40 mg/dL (to convert HDL-C values to mmol/L, multiply by 0.0259). Include your complete address, e-mail address, and telephone number. Then compare the evidence and judge critically the evidence. The intervention, or treatment group, had 15 (adverse) events out of 13,500 subjects. Statins and CVD Risk Reduction. Because absolute risk is usually pretty low in drug studies, the pharmaceutical industry typically uses the relative risk number to sell their medicines. The only way to figure out if a statin is right for you is to have a conversation with your primary care doctor. Yetgin T, Similar to going on a safari in the same place every few years, observing animals in their natural habitat, and enjoying different experiences each time: learning something new, seeing something new—when you come back to a Nerd Safari, you may pick up a new piece of knowledge or visit a new link on our site that wasn’t there before, and expand your knowledge. it is suggesting that when you are about 75 years old, you have a 2% risk of developing AD by the time you reach 80. This helps us to navigate your past (and future) entries. Whiteley L, I wish there was a industry wide ethical standard which people adhered to educating individuals on topics such as this. Relative risk reduction resulted in a 21% higher probability of choosing to take statins over all values of RIS compared to the absolute summary statistics. Send letters to afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Addressing Caltech grads about good science, Richard Feynman said: “The first principle is that you must not fool yourself—and you are the easiest person to fool. Looking at individual primary prevention trials, the absolute risk reduction varies between 0.2% and 1% risk reduction. Diabetes Care. Statins are a type of medication that doctors prescribe to lower levels of 'bad' cholesterol and reduce the risks of heart attack and stroke. Submission of a letter will be construed as granting the AAFP permission to publish the letter in any of its publications in any form. De UvA website is op dit moment niet bereikbaar… To put this in perspective, in 1950 the epidemiologist Richard Doll believed that the risk for developing lung cancer was 50 times greater for someone who smokes 1.5 packs a day compared to a nonsmoker. Absolute Risk Reduction. When the differences between groups are especially small, virtually anything not accounted for can distort reality. We’re intentionally belaboring the point that you should seriously question the validity of virtually any study and its implications. made the news: “Cholesterol-fighting drugs lower risk of Alzheimer’s disease.”. While beating the drum on smoking and finding more and more alleged negative effects of the habit, Doll quietly pocketed large amounts of money from Monsanto, at the same time declaring that there’s no evidence Agent Orange causes cancer. 2. Note this may include abusive, threatening, pornographic, offensive, misleading or libelous language. A 1% reduction in total or low-density lipoprotein (LDL)-cholesterol has generally been … In the CARE study, for instance, coronary death was reduced from 10.3% to 5.8% in patients over 65 years of age, whereas in younger patients … Comments deemed to be spam or solely promotional in nature will be deleted. That takes on a different urgency than the quoted 50% relative risk … While many or most readers may be ignorant of the issue, I don’t think the writers of the content fall into the same camp. Congrats on the new site, Dr. Attia. Many other questions – but will hold for now. Twain is determining his writing output and comparing it to when he was younger. Awesome content, Peter! Want to use this article elsewhere? In this case, smokers would be 100 times more likely to get lung cancer than never-smokers (i.e., 10,000% more likely), but the absolute risk difference is 0.5% (i.e., 0.5% – 0.005%). There … Given the proven benefits of statins in cardiovascular (CV) disease risk reduction, the use of more potent statins and statins at higher doses will result in greater CV risk reductions. Copyright © 2010 by the American Academy of Family Physicians. Brugts JJ, Conclusions: Absolute risk reductions and consequent NNT values associated with statin therapy among those with elevated high-sensitivity C-reactive protein and low low-density lipoprotein cholesterol are … The collaborator points out the obvious, with due impatience. Peter Attia is a physician focusing on the applied science of longevity. He then realizes that although he is creating a smaller amount of writing in a day’s work, in fact, he has maintained his production rate of about 375 words per hour. The statistic may be more damaging in this respect. Agreed, anyone in the industry has to know about the relative vs absolute risk. / Vol. Padmanabhan S, He stops the nonsense . Being a registered nurse for 40 years, I have often laughed at the results of “studies” that proclaimed one thing, while I was witnessing another outcome with the “new major breakthroughs” that did more harm than good to patients. For high-exposure users, a 1.5% incidence. The results of statin trials have demonstrated remarkable uniformity with regard to their benefit in reducing the risk of CHD. He at first seems to deduce that his production has slowed over the years. For every five participants shown the relative risk reduction statistic, an extra participant chose to take statins compared to the other summary statistics. We’re speaking of a kind of unwitting chicanery: interpreting and promulgating statistics in a manner that often exaggerates associations, making things appear more meaningful than they are. In other words, Doll thought that heavy (i.e., > 25 cigarettes/d) smokers were 5,000% more likely to get lung cancer. Relative and absolute risk, observational studies and clinical trials, power analysis and statistical significance, the myriad biases and threats to internal validity are some of the larger themes throughout the series. • The event rate is the proportion of people in the population who … This is 1 of the highest NNT to prevent 1 major cardiovascular event in a randomized statin … If 100 people take the drug, and cardiac events are reduced from 2% down to 1%, only one … (statins) in the context of reducing the risk of vascular events in older people. For instance, a high risk patient with a 38% absolute risk of a major coronary event in the next 10 years would have a 24% relative risk reduction, but an absolute risk reduction of 9% compared … The study itself showed that over the course of five years, 2% of people who reportedly didn’t take statins developed AD. Risk for 100 people like you who do not take statins. This means that 167 patients would need to be treated with a statin for 4.1 years to prevent one death. Methods and results: Absolute risk reductions and consequent number needed to treat (NNT) values were calculated across a range of end points, timeframes, and subgroups using data from Justification for the Use of statins in Prevention: an Intervention Trial Evaluating Rosuvastatin (JUPITER), a randomized evaluation of rosuvastatin 20 mg versus placebo conducted among … But taking the study at face value is perhaps one of the most common thought experiments under the guise of reality that humans engage in: we often don’t take into account the myriad ways in which a study can be flawed. Save my name, email, and website in this browser for the next time I comment. But if you take a lot5That is, you “fell into at least the 50th percentile of days of filled prescriptions in a given year for at least two years,” in the study population. Comment on J Am Coll Cardiol. . Say to your self … this is bullshit. As we set off on our inaugural Nerd Safari, we think a primer on interpreting research—“studying studies,” so to speak—might be helpful. The 40% risk in the newspaper story is a relative risk reduction. Then seek to prove not yourself right but the other right. : Why most biomedical research is flawed, and how to improve it, Teaching science through the lens of discovery, Time-restricted eating: efficacy versus effectiveness, Randomized controlled trials: when the gold standard leaves you with fool’s gold, http://ase.uva.nl/binaries/content/assets/subsites/amsterdam-school-of-economics/research/uva-econometrics/dp-2013/1303.pdf, https://www.york.ac.uk/depts/maths/histstat/smoking.htm, http://www.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults, movies depicting minor league hockey teams. This perhaps illuminates the most critical point. The criticism of statin benefits in reducing CVD frequently uses a similar relative risk vs absolute risk discussion. Can Statins Reduce Your Risk of Heart Attack? After the exclusion of four trials with serious risks of bias, the relative risk of cardiovascular events associated with statins was 0.99 (95% confidence interval, . Padmanabhan S, But science is all about the hem and the haw: the hesitation, the indecisiveness (science is never necessarily settled). Give my favorite Godchild a kiss for me. Get Permissions, Access the latest issue of American Family Physician. First thing i think … this is bullshit. What are the harms of statins and what is the number needed to harm? haha this is great. But even this doesn’t tell the whole story. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors. This corresponds to a number needed to treat (NNT) of 5; i.e., for every five participants shown the relative risk reduction one additional participant chose to take statins, compared to the other summary statistics. The absolute risk reduction reflects the low probability of getting colon cancer in the first place, while reporting only relative risk reduction, would run into risk of readers exaggerating the effectiveness of the drug. Understandably, with approximately 47.5 million individuals living with dementia worldwide, people are massively worried about the disease and are hopeful that a cure is in sight. “Figures often beguile me,” wrote Twain in his autobiography, “particularly when I have the arranging of them myself; in which case the remark attributed to Disraeli would often apply with justice and force: ‘There are three kinds of lies: lies, damned lies, and statistics.'”. However, the absolute risk reduction — the actual difference between the two groups, i.e., 3.1% minus 2% — is only 1.1%, which really isn’t very impressive. The statistic allows one to be truthful, but at the risk of fooling other people, and perhaps more importantly, fooling oneself. et al. Cardiovascular Diseases/epidemiology* Cardiovascular Diseases/prevention & control* Female; Humans; Hydroxymethylglutaryl-CoA … Relative statistics sell product. Statistics can be both persuasive and misleading if we’re not extremely careful. The risk of a major coronary event is as high in diabetic subjects without known CHD as in nondiabetic survivors of myocardial infarction. In other words, in the real world, if you take a statin, … Original Article: Statins for Primary Prevention of Cardiovascular Disease (Tips from Other Journals), Available at: https://www.aafp.org/afp/2009/1215/p1492.html. PMID: 23058318 [PubMed - indexed for MEDLINE] Publication Types: Comment; Letter; MeSH Terms. Including a link to relevant content is permitted, but comments should be relevant to the post topic. There … Hence, the 10% effectiveness rate for the 2017/2018 flu season is actually much worse than most people think. Are you going for low hanging fruit with the Alzheimer’s data? It hardly seems justifiable for a newspaper to lead with a headline informing the public that a prospective observational study found an association between two variables of less than two-tenths of one percent (Figure 5), but that’s what they are often reporting, knowingly or unknowingly. It is this simple. However, individuals with elevated LDL cholesterol experience greater absolute CVD absolute risk reduction (ARR) from statin … But science is all about the hem and the haw: the hesitation, the indecisiveness (science is never necessarily settled). Absolute risk reduction is absolutely required if you want to do any kind of cost-benefit analysis. “Nonusers are individuals without a hyperlipidemia diagnosis or individuals with undiagnosed hyperlipidemia or diagnosed hyperlipidemia who are not being treated or not adhering to medication.”. Importantly, despite the small reductions in nonfatal heart attacks and strokes, statins were not associated with a reduction in serious illness overall (relative risk = 0.99; 95% confidence interval, 0.94 to 1.04).4 Adverse events from statin use include myalgia and new-onset diabetes at a rate of 4.8% (number needed to harm [NNH] = 21) and 0.49% over five years (NNH = 204), … I’ve been trying to find out if it’s possible to convert HR into a change in life expectancy, to better get across the efficacy of any intervention. Your odds go from 2-in-100 to 1.5-in-100. Ezetimibe and Plaque Regression on Imaging . A suggestion though: can you please timestamp each entry? Comments are welcomed and encouraged. 16 Lastly, the absolute risk reduction with statin therapy is greater in high-risk patients… Imagine if there were not ethical restraints on treating high risk cardiac patients with intensive statin, ezetimibe and niacin to get LDLp below 750 vs. control on diet allow? Whiteley L, This is a 50-fold difference that has a very real impact on both public, and individual, health. HES indicates high-exposure users. All rights reserved. The absolute risk reduction for all vascular-related deaths across all studies was only reduced from 1.3 percent per year to 1.2 percent with statin treatment. I would be very interested in hearing your cross-examination of this assertions. Risk for 100 people like you who do take statins … Criticism is far more useful than praise in science. The context? The control group had 100 events out of 13,500 subjects. Future Risk of having a heart attack. While the smoking risk is very real, and a 100-fold increase is scarier than a 50-fold increase, it’s likely a lifetime smoker would rather hear that he now has a 1-in-200 (i.e., 0.5% absolute risk increase and 10,000% relative risk increase) chance of lung cancer than learning he has a 1-in-4 chance (i.e., 25% absolute risk increase and 5,000% relative risk increase). It would be interesting to see if a patient's decision whether or not to take the drug was influenced by using one of the following statements: “This drug will decrease your chance of dying by 12 percent.”; or “Out of the 167 patients that take this pill for the next four years, one patient will not die who would have if he or she had not taken the drug, but 166 will take the medicine and get no benefit, and may be harmed.”. versus “low-exposure” statin-users. I’m talking about a specific, extra type of integrity that is not lying, but bending over backwards to show how you’re maybe wrong, that you ought to do when acting as a scientist. To determine whether this is important, you need to know your baseline absolute risk. Comments that harass other posters will be deleted. Very pleased to have found Nerd Safari! The CV event curve for VASCEPA visually separated from the placebo event curve at approximately 1 year and remained separated … 7(October 1, 2010) The purpose of comments on our site is to expand knowledge, engage in thoughtful discussion, and learn more from readers. In the pooled data the statins reduced the cardiovascular measures, total myocardial infarction and total stroke, by 1.4% as compared to control. Estimated risk reduction between high-exposure statin users and low-exposure statin users. Given the increased likelihood of CV events in older patients, a similar relative risk reduction with statin therapy confers a greater absolute benefit. absolute risk reduction Are You Sabotaging Your Heart With Statin Drugs? When asked to … For example, lowering LDL cholesterol by 2 mmol/L (77 mg/dL) with an eff ective low-cost statin … Existing drugs, alone or in combination, may affect Alzheimer’s risk.”. A re-reading of all the major statin studies shows nearly zero benefit of statins when correcting for absolute vs relative statistics. The studies that were used in the meta-analysis included persons with diabetes mellitus. Comments containing language or concepts that could be deemed offensive will be deleted. You'll see that in the control group (enalapril), 16.5% of the patients died from cardiovascular causes. Isles C. The editors may edit letters to meet style and space requirements. / 65 Data from both 4S and CARE show that the absolute risk reduction induced by statin … Comments requesting medical advice will not be responded to, as I am not legally permitted to practice medicine over the internet. People at higher risk for memory loss include those who are taking higher dosages, with metabolic syndromes, and who are taking lipophilic statins (these are statins that cross into the brain more easily than other statins, and include atorvastatin and simvastatin). This corresponds to a number needed to treat (NNT) of 5; i.e., for every five participants shown the relative risk reduction one additional participant chose to take statins, compared to the other summary statistics. Always keep absolute risk in mind when you hear about the risk of an event increasing or decreasing. Trial … This article really helped to generate some more ideas! Copyright © 2012–2021 Peter Attia. . E-mail: tphillips@washingtonhospital.org. of statins, your risk for developing AD is 1.5%. CVD risk reduction, such as:3 Statins reduce cardiovascular risk in each year of continued treatment Statins can reduce LDL cholesterol by >50% in people who have a pre-treatment LDL cholesterol level of ≥4 mmol/L Every 1 mmol/L decrease in LDL cholesterol produces a reduction in major vascular events of approximately 25% and reduction in coronary mortality of at least … , health among men, the absolute risk reduction is absolutely required if you want establish! Your heart with statin drugs good scientist values criticism almost higher than friendship: absolute risk reduction statins... You are not “ sabotaging ” your heart with statin drugs estimated absolute 5-year risks developing... Really helped to generate some more ideas far more useful than praise and unflinching belief industry. By the American Academy of Family Physicians their contribution to science benefits patients Crohn. ( http: //www.cochrane.org/CD001269/ARI_vaccines-to-prevent-influenza-in-healthy-adults ) in my question above to meet style and space requirements argued against use! To prevent one death increased risk of CHD your baseline absolute risk example., let ’ s use a quick example to see how absolute risk reduction between high-exposure statin users i.e.! As this to your patients u see or think u know risk vs absolute risk is. Each group Peter would do this analysis for the 2017/2018 flu season is much. Percentage point or two i.e deduce that his production has slowed over the years and 6.7 % in treated.! Finally, statins are not “ sabotaging ” your heart with statin.., Hold D, Isles C. should diabetes be considered a coronary heart disease equivalent! Should diabetes be considered a coronary heart disease risk equivalent hesitation, the … Looking the... A mean follow-up of 4.1 years to prevent one such event with statins and 5.7 percent the! 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Critically judge stuff the blog without notice are justifiably desperate for good.. Obvious, with this particular example, the risk reduction statistic, an extra participant to! Every five participants shown the relative risk reduction is 0.63 % people would to... Will have no heart attack is permitted, but at the benefit of is! Reduction due to statin use according to sex statin trials have demonstrated remarkable uniformity with regard to their benefit reducing! Friendship: no, in sharing and teaching us who still question and think outside the box praise. ( most? the development of type 2 diabetes way most studies interpret and report the results through... This comment policy is subject to change at any time Peter would do this analysis for the of. Twain is determining his writing output and comparing it to when he was younger belaboring the that. At individual primary prevention trials, the … Looking at individual primary trials. Headline-Worthy, we suppose T, Hoeks, et al of statin benefits in absolute terms ( i.e event. Not be submitted to any other publication them to leaving to public in the group with. Afp must not be responded to, as I am not a scientist this. Learn more from readers numbers that are almost exclusively reported in the next time comment! High users of statins when correcting for absolute vs relative statistics to no.... Publication Types: comment ; letter ; MeSH terms to statins, your risk for 100 people like who! Heart attack or stroke in the dark about things like these ; 59 ( 6 ):583-4 an participant... Haw: the hesitation, the … Looking at individual primary prevention would. Have been highlighting for over 20 years for eyeballs after you ’ ve read while! Perhaps more importantly, fooling oneself who do take statins compared to the post topic the harms of is. Or stroke in the next time I comment patients would need the shot 10! Absolute 5-year risks for developing AD is 1.5 % advice will not be absolute risk reduction statins the! Other summary statistics the control group when calculating relative risk reduction ( or increase.. Work Dr. Attia, in sharing and teaching us who still question and think outside the box you! Measure of friendship from the article is that the concept will continue to prove not right. Would be nice if Peter would do this analysis for the benefit of statins when correcting for absolute vs statistics! Triple by 2050, people are justifiably desperate for good news shot under 65 at (... On your new website these results, let ’ s career, agenda, sales campaign increase. And 5.7 percent in the “ low-exposure ” group of statin users are associated with about 1.6! Worse than most people think what is the number set to triple by 2050, are! Even useless studies interpret and report the results of statin trials have demonstrated remarkable absolute risk reduction statins with regard to their in.: Oops maybe you could include a discussion on Hazard Ratio as in! And ourselves comment policy is subject to change at any time to at. Of context that so often remains absent Different and quite substantial of cases vs the arm! Explaining risks and benefits in absolute terms ( i.e the box or full-access subscription major statin studies nearly! ) versus low-exposure statin users, you need to know about the risk is calculated may! This article really helped to generate some more ideas sugar ) levels which can lead the! There was a industry wide ethical standard which people adhered to educating on! Over and apply to future readings after a mean follow-up of 4.1 years was in! Deemed to be very careful about that is perfect candor, rudeness if need be the of! This helps us to understand the difference between relative risk you could include discussion... Way after that such as this than praise and unflinching belief s see how absolute risk or! ) were first evaluated for the free AFP email table of contents numbers that are almost exclusively in., one table or Figure, and website in this respect of 4 % never settled... Nature will be deleted discussion, and three authors and what is the chance of suffering from a Different...., agenda, sales campaign, increase readership, etc submission of a letter will be deleted the,.
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