We were hashing this out in our journal club, but could not get the stats to add up.
If you can PLEASE COMMENT HERE!
The NNT’s of 54 and 181 seem impossibly small, with huge clinical implications.
Please try it yourself; look at Table 3. Frequency and Rates of Outcomes during the Baseline and Intervention Periods, According to Study Group
With bloodstream infection from any pathogen, the Group 1 (standard care) number of events per 1000 patient days is 4.1. With Group 3, the number of events is 3.6 per 1000 patients days. Even taking change from baseline into account and assuming these NNTs have been calcuated AFTER randomization, between Group 1 and Group 3, we get nowhere close to their NNT’s.
PLEASE have a go and see if you can match their NNT’s.
IF you can’t there is a serious problem, with practice changing implications.
It’s too late to write letters to the NEJM, so a robust discussion in a peer reviewed forum seems a good way to go.
Thank you to Gordon Doig for stimulating this important discussion.