Albert and I developed an acute interest in risk reduction at about 3500 feet.
- Consider the benefit of using Coumadin for Stroke prevention in Atrial Fibrillation. Moderate risk patients on placebo have 8% risk of stroke in ONE year
- Coumadin decreases that to 3% risk of stroke in ONE year
- Quick !! Instinctively, what is the risk reduction? ….. 5% , right? That’s absolute risk reduction, NOT relative to anything else.
- Suppose Coumadin decreased the risk to 88%
- Quick !! The absolute reduction is? …. You’re right! 5% (the same as the first example) The relative risk though is different. 5 / 93 = 5.3% relative risk reduction
Relative Risk Reduction is RELATIVE to the baseline 8% so… 0.05/0.08 or 5% reduction /8% baseline = .62 or 62% relative risk reduction
OK, now consider if there was a very high baseline risk of 93%
So which is the most important? Absolute reduction or Relative reduction. Well, they each give you different kinds of information. I prefer the absolute risk reduction, but both are important. See also the Number Needed To Treat