Journal Club Summary
Landmark Series
Methodology Score: 4/5
Usefulness Score: 4/5
CRASH-2 trial collaborators
Lancet. 2010 Jul 3;376(9734):23-32.
This large RCT assessed the effect of early administration of tranexamic acid to trauma patients and revealed statistically significant results in favour of TXA for the reduction of overall death and death from bleeding without significant adverse effects (0.91 (95% CI 0.85–0.97, p=0·0035); NNT 67).
The group felt this was methodologically sound and practice changing trial however questions were raised as to some aspects of the selection criteria (“physicians uncertainty”). By: Dr. Pamela Kapend
(Presented Feb 2014)
Epi lesson:
Number Needed to Treat (NNT)
NNT is an epidemiological measure used in assessing the effectiveness of a health-care intervention. The NNT is the average number of patients who need to be treated to prevent one additional bad outcome compared with a control in a clinical trial. It is defined as the inverse of the absolute risk reduction. The ideal NNT is 1, where everyone improves with treatment and no one improves with control. The higher the NNT, the less effective is the treatment. While NNTs are easy to interpret, making them popular with consumers and clinicians, they cannot be used for performing a meta-analysis because of their mathematical properties.
By: Dr. Ian Stiell
