A randomized trial of laypersons' perception of the benefit of osteoporosis therapy: Number needed to treat versus postponement of hip fracture

• Published in: Clinical therapeutics Vol. 25; no. 10; pp. 2575 - 2585
• Main Authors: Christensen, Palle Mark, Brosen, Kim, Brixen, Kim, Andersen, Morten, Kristiansen, Ivar Sønbø
• Format: Journal Article
• Language: English
• Published: Belle Mead, NJ EM Inc USA 01.10.2003; Excerpta Medica; Elsevier Limited
• Subjects: Adult; Aged; Attitude to Health; Biological and medical sciences; Bones, joints and connective tissue. Antiinflammatory agents; Cross-Sectional Studies; Female; Hip Fractures - etiology; Hip Fractures - prevention & control; Humans; Interviews as Topic; Logistic Models; Male; Medical sciences; Middle Aged; Osteoporosis - complications; Osteoporosis - therapy; Pharmacology. Drug treatments; Risk Factors; Denmark; Europe; Human; Evaluation; Treatment efficiency; randomized trial; Diseases of the osteoarticular system; Controlled therapeutic trial; Bone disease; Fracture; Trauma; Hip; Osteoporosis; Survey; Analysis method; Treatment; perception of benefit; postponement of fracture; Perception; Profit; number needed to treat; Comparative study
• ISSN: 0149-2918; 1879-114X
• DOI: 10.1016/S0149-2918(03)80318-1

Background: Information on the benefits of therapeutic interventions can ve expressed in various ways, including relative risk reduction, absolute risk reduction, and number needed to treat (NNT). An alternative to such risk-based measures is postponement of an adverse outcome (eg, hip fracture in the case of osteoporosis). Objective: The goal of this study was to examine whether laypersons' perception of the benefit of an osteoporosis therapy differs when it is presented in terms of the NNT to avoid 1 hip fracture compared with the duration of postponement of hip fracture. Methods: This was a cross-sectional, randomized, controlled trial. Face-to-face interviews of a representative sample of the Danish population were conducted in respondents' homes. Respondents were randomized to receive information about the benefits of a hypothetical osteoporosis intervention either in terms of different magnitudes of NNT (10, 50, 100, or 400) or different durations of postponement of hip fracture (1 month, 6 months, 1 year, or 4 years). Participants were subsequently asked if they would consent to the intervention. Results: A total of 1728 individuals were contacted at home and asked if they would take part in a face-to-face interview; 967 (56%) were successfully interviewed. The age (mean age, 44.5 years; range, 20–74 years) and sex distrivution (51% male, 50% female) of the sample was similar to that of the general Danish population. Based on NNTs of 10, 50, 100, and 400, the proportions of responsiveness