Clinical relevance of an intervention assessed by a meta-analysis of randomized clinical trials

Abstract

ObjectivesMany meta-analyses usually omit the number needed to treat, or perform the calculation incorrectly, despite its importance in clinical decision-making. Accordingly, we will explain in an easily understandable way how to perform this procedure to assess the clinical relevance of the intervention. Study Design and SettingThe expressions of the Cochrane Library and the concepts of clinical relevance and evidence-based medicine were applied. Simple cutoff points were also established to facilitate the task of interpreting results. The method was applied to two published meta-analyses to illustrate its application to real cases (treatment nonadherence). ResultsIn the first example, with a risk in the control group ranging from 0.22 to 0.70, sending mobile phone messages to remind chronic patients to take their medication is clinically relevant with a high degree of evidence. For the second example (single-pill regimen in patients suffering from hypertension and/or dyslipidemia after 6 months), the range of the assumed control risk was between 0.28 and 0.57. ConclusionThe constructed algorithm could be applied to published meta-analyses or incorporated systematically in all meta-analyses with these characteristics.