Number Needed to Harm: Treatments Can Hurt You

Last week, we discussed the NNT, or number needed to treat. I'm sure it made a lot of you upset to realize that many therapies you've been sold as "awesome" were, in fact, somewhat incremental with respect to benefits. But another problem is that a lot of those therapies are anything but benign. They come not only with costs, but also with side effects or problems.

We can quantify harms, too. Watch and learn about NNH!

John Green -- Executive Producer
Stan Muller -- Director, Producer
Aaron Carroll -- Writer
Mark Olsen -- Graphics

[EnigmaHood]

I'm coming up with a new acronym. NNE, number needed to educate. The NNE for watching Healthcare Triage's videos is 1. That means if just 1 person watches Healthcare Triage's videos, that 1 person is instantly educated, and I think the likes/dislikes bar proves that. 

Lol great video as always, keep up the fantastic work.

[amanatee]

personal notes: NNH aspirin 3333 major bleeding event. NNT statin MI 60, stroke 268; NNH diabetes 50, muscle 10.

[christopherwunsch]

I was a critical care RN, who was prescribed a statin, at 29 years old, due to a cholesterol level in the 270-280's, and every pharma funded conference I attended, and what I learned in nursing school as well as my 12 years as an RN. And I conceded and agreed to take lipitor 10mg, as I desperately wanted to drastically reduce my risk of a heart attack, stroke or death, and from what I was taught, by taking my statin, my chances of benefit, greatly surpassed any potential adverse effect. (Wish I would have learned about statistical manipulation). Fast forward 2002, I was hospitalized for 28 days, with Alzheimer's like dementia, I wet and soiled myself, I could not walk, nor speak coherently, I did not know my wife, nor my 3 year old son, my parents nor siblings. Brain MRI revealed dozens of scattered lesions throughout the grey and white matter, biopsy revealed the lesions to be Apoptosis (Programmed cell death), Electron microscopy revealed Mitochondrial DNA mutations most similar to Mitochondrial Encephalomyopathy with Lactic Acidosis and Stroke Like Episodes (MELAS). Doctors prepared my wife for my grave diagnosis, and were waiting to transfer me to a nursing home at 34 years of age. When a visiting professor from Johns Hopkins was asked to evaluate me, and started me on a Mitochondrial cocktail (essentially a handful of vitamins, amino acids, and one KEY componend, a robust dose of CoQ10..and within 24 hours of starting this cocktail, I began to be able to communicate the need to use the restroom, I recognized my wife and my parents, I could speak coherently, walk with assistance, and ultimately was sent home with aggressive rehab. Shortly after discharge, I saw Good Morning America's Diane Sawyer, interviewing Dr Beatrice Golomb MD PhD, principal investigator in the UCSD Statin Effects Study, discussing statins and the unpublished risks they have, etc I enrolled in the study, sent my records from UW Madison, and when the study concluded I was called by dr Golomb, who informed me that I was one of a handful of patients in her study, with strikingly similar courses of Illness, and biopsy findings, she referred our cases to Mitochondrial Disease Expert, Dr Doug Wallace PhD or UC Irvine, who opined that "my use of Lipitor was the causal contributor to the holes in my brain (apoptosis) as well as the mitochondrial DNA mutations. Ive been disabled since Oct 10, 2002 due to the lasting effects of the brain damage from Lipitor. I have poured my heart and soul into researching, and do everything in my power to spread these truths like wildfire, to anyone who will listen to me, Thanks Doc Carroll

[mysticknight]

As a parent, I'm really glad you've made this and the previous video. I feel like it will give me a better way to communicate with doctor's and allow me to make an informed decision. Thanks.

[kimcoffey-philbrick]

Ty for your simple explanation! I am a PhD student in nursing and your channel is a great asset to my studies!

[anonharingenamn]

This stuff is complicated for most people, including me, to understand. VERY good information is being put on this channel and I appreciate it greatly.

[Tetracarbon]

I still love these fundamental videos. They are so important.

[ojbo]

Thanks for doing this. This should be taught in schools.

[MatthewNelson]

Really liked this and the last video, puts things into prospective. Thank you!

[shadedsun]

I'll be showing this video to my parents. I'm sure I'll have much more success convincing them about understanding the risks of meds with this! Thanks! :)

[srabbelier]

I love how you explain complicated medical situations in easy-to-understand wordings. Thanks!

[sam]

I wish this kind of information was more easily available. Doctors should inform their patients about these things thoroughly.

[HercadosP]

I love you for making this. I hope millions of people worldwide see this so the world can be better

[WaveFunctionRider]

Are the NNT and NNH easy to find? If so, where? Do doctors have better access to this information? Anyway, just curious. Great video and interesting topic.

[ltc]

The two videos about NNH and NNT are awesome considering all the pandemic related debates going on. And more importantly we know the content is not biased due to covid-19. It may be biased for other reasons. But knowing people who prepared this video doesn't have bias for or against covid-19 vaccines is a stress and anxiety relieving. Thank you to all involved.

[vlogerhood]

What about the NNH of NOT giving antibiotics for ear infection? Isn't the reason to treat with antibiotics to prevent tympanic membrane rupture, or mastoiditis?

[Snakeyes]

What a hero! Fight that antibacterial resistance AND promote efficient well-being! This guy's literally my hero!

[yourfullofsheite]

Everybody should know this.Sadly I did not till now.

[bradygriffith]

You guys should do another Questions video.

[terralynn]

Super interesting again! Thanks. I love this channel.