Methods used in reporting results of new treatments may be misleading

June 04, 2002

(SACRAMENTO, Calif.) -- Articles appearing in five top medical journals often present results in a way that may be misleading, according to two UC Davis School of Medicine researchers.

"The public expects advertisers to use the most flattering statistics to bolster claims of effectiveness in promoting products," said UC Davis research and family physician Jim Nuovo. "However, most of us expect that medical journals will provide complete reporting of all important aspects of research on a new treatment. Without more comparative data, readers may be basing their decisions to use a new treatment on incomplete information."

Nuovo and family physician Joy Melnikow, who are both faculty in UC Davis School of Medicine's Department of Family and Community Medicine, reviewed 359 articles involving new treatments published between 1989 and 1998 in the frequently cited journals: the Annals of Internal Medicine, British Journal of Medicine, Journal of American Medical Association, The Lancet and the New England Journal of Medicine. Results of the UC Davis review are published as a brief report in the June 5 edition of JAMA.

"Our review of the literature showed that, in the majority of cases, only the most favorable statistic -- the relative-risk reduction -- was used when reporting the results of these studies," Nuovo said.

Of the 359 articles discussing the results of randomized trials -- considered the gold standard for assessing new treatments -- only eight reported a more explicit statistic, the "number needed to treat," and only 18 used "absolute-risk reduction."

Number needed to treat is the statistical number of patients who may be subjected to a bad outcome, such as death, stroke or heart attack, before the new treatment prevents a bad outcome. For example, if a drug has a number needed to treat of five, it means physicians would statistically have to treat five people with the drug before preventing a bad outcome.

"Absolute-risk reduction" measures the actual difference between the treatment results compared to the placebo group. "Relative-risk reduction" is the percentage difference between the treatment results and the placebo group, and typically is the most favorable statistic.

"These additional measurements are important because we know that the way that information is presented affects the acceptance of treatment for both patients and physicians," Nuovo said.

Nuovo also suggested that medical journals should require their authors to follow the established guidelines that include these additional measurements. Number-needed-to-treat and absolute-risk reduction are part of the Consolidated Standards of Reporting Trials statement, which medical journals are to follow in publishing research.

"No single number can entirely explain the results of a trial," Nuovo said, "so it would be in the best interest of physicians and their patients to require complete reporting of the potential benefits and the potential risks of any new treatment. Doing so should increase the chance of the appropriate implementation of research on new treatments."
Copies of UC Davis Health System news releases are available on the Web at

University of California - Davis Health System

Related Physicians Articles from Brightsurf:

Needlestick, sharps injuries among resident physicians
Rates and characteristics of needle stick and other sharps injuries among resident physicians and other staff at a large health care center were examined in this study.

Prevalence of suicide-related behaviors among physicians
An analysis of published studies has found a relatively high prevalence of suicidal behaviors among physicians.

To support lactating emergency physicians, consider these strategies
A new paper highlights strategies that emergency departments can implement to support lactating emergency physicians.

Physicians call for an end to conversion therapy
Historically, conversion therapies have used electroshock therapy, chemical drugs, hormone administrations and even surgery.

Racial bias associated with burnout among resident physicians
Symptoms of physician burnout appear to be associated with greater bias toward black people in this study of nearly 3,400 second-year resident physicians in the United States who identified as nonblack.

Survey finds physicians struggle with their own self-care
Despite believing that self-care is a vitally important part of health and overall well-being, many physicians overlook their own self-care, according to a new survey released today, conducted by The Harris Poll on behalf of Samueli Integrative Health Programs.

Less burnout seen among US physicians, Stanford researcher says
The epidemic levels of physicians reporting burnout dropped modestly in 2017, according to a study by researchers at the Stanford University School of Medicine, the Mayo Clinic and the American Medical Association.

Payments to physicians may increase opioid prescribing
US doctors who receive direct payments from opioid manufacturers tend to prescribe more opioids than doctors who receive no such payments, according to new research published by Addiction.

Is marketing of opioids to physicians associated with overdose deaths?
This study examined the association between pharmaceutical company marketing of opioids to physicians and subsequent death from prescription opioid overdoses across US counties.

Nearly half of resident physicians report burnout
Resident physician burnout in the US is widespread, with the highest rates concentrated in certain specialties, according to research from Mayo Clinic, OHSU and collaborators.

Read More: Physicians News and Physicians Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to