digestVidSign in
summary

College of Naturopathic Medicine - Relative Risk Reduction vs. Absolute Risk Reduction - Dr Malhotra - A CNM Talk Highlight

Thumbnail of the video “College of Naturopathic Medicine - Relative Risk Reduction vs. Absolute Risk Reduction - Dr Malhotra - A CNM Talk Highlight”
Community upload. AI output has not been independently verified.
Author: College of Naturopathic Medicine
Categories: Health
Tags: health
Views: 2 · Last viewed: 2026-10-16 20:32 UTC

Short Summary

Main recommendation: when communicating medical benefits, use absolute risk reduction (the number needed to treat) rather than relative risk reduction, because relative figures make interventions look far more impressive than they are. Using a statin example, the speaker argues that a 48 percent relative reduction in stroke corresponds to a much smaller real-world benefit, and that medical journals often mix framings to favor the drug being studied.

Key Points

  • A 48 percent relative risk reduction in stroke over four years, from a statin trial in people with type 2 diabetes, corresponds to a drop from 28 to 15 strokes per 1,000 people.
  • The absolute benefit is 13 fewer strokes per 1,000 people, or 1.3 percent, which the speaker expresses as one in 77 people benefiting.
  • Relative and absolute figures for the same data can lead lay people and doctors to overestimate the benefit of medical interventions.
  • Medical journals often report benefits in relative terms but harms in absolute terms; the speaker's example shows a 30 percent relative reduction paired with a 0.3 percent absolute increase in harm, using identical data.
  • The speaker cites an analysis of articles from The Lancet, the BMJ and JAMA that found about a third of sampled articles used this mismatched framing.
  • The speaker links this to financial ties, noting that drug companies can pay journals for reprints of their articles, which drug reps then use as marketing material.

Details Worth Noting

  • Concrete instructions: When discussing a treatment's benefit with a patient, state the absolute figure (for example, "one in 77 chance it will prevent you having a stroke" over four years if taken daily) and note that about 76 of 77 people get no benefit. Present benefits and harms in the same framing so the comparison is balanced.
  • The speaker says statins are used to reduce cardiovascular risk irrespective of cholesterol levels, not only to lower cholesterol.
  • The trial used a placebo ("dummy pill") with participants blinded to which they were taking, which the speaker describes as the basis for more rigorous conclusions.
  • The speaker presents the one-in-77 framing as a well-validated way for patients and doctors to understand these statistics, and describes it as more ethical and honest.
  • The speaker frames the journal framing problem as a major issue, and the financial relationship between drug companies and journals as a further problem that needs addressing.
  • The speaker's claims about the trial and journal analysis are reported as stated in the talk and were not independently verified here.

Bottom Line

Relative risk figures can make a medical benefit look several times larger than the absolute change in outcomes, so checking the absolute numbers, and the framing used for harms, is essential before drawing conclusions.