Misrepresented risk in medical papers

2 years ago
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Professor Norman Fenton, Mathematician, Professor of Risk Information Management

Professor Fenton, YouTube channel

http://youtube.com/@normanfenton81

And Sub stack

https://wherearethenumbers.substack.com/
normanfenton.com

What is risk information management?

Thinking about risk, what do we mean by absolute risk and relative risk

Sounds a bit like the level of risk can be presented in a way that gives a particular impression of a greater or a lessor risk or benefit?

Are there occasions when a vested interest might want to give an impression of an increased benefit, or reduced risk from an intervention?

How could choosing RRR versus ARR influence the impression given for adverse reactions is medical journals?

Conversely

Are there occasions when a vested interest might want to give an impression of a decreased risk from an intervention?

So will RRR always be higher than ARR?

Why can the RRR vary between populations and vary over time?

So using one of the two measures to estimate the risk/benefit ratio would lead to different conclusions?

How could risk / benefit reporting be optimised in the medical literature?

Do you think the editors of prestigious international journals are aware of the differences between RRR and ARR?

In the case of this paper from the Journal of Expert Reviews of Vaccines

Efficacy and effectiveness of covid-19 vaccine - absolute vs. relative risk reduction

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9115787/

The original phase three data gave an efficacy for Pfizer vaccine, at preventing infection with SARS-CoV-2 of 95%, but it turns out the ARR was 0.84%

Why are these figures so different?

So is it fair to say that the ‘real world translation’ of the ARR of the Pfizer vaccine over 5 to 6 months of use increased to 3.7%?

What do we mean by number needed to treat?

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