0
Editor's Correspondence |

The Number Needed to Be Exposed: A Potential Use for Quantifying the Strength of an Individual Risk Factor Including a Protective Factor in a Cohort Study

Huai yong Cheng, MD, MPH
Arch Intern Med. 2007;167(15):1690-1691. doi:10.1001/archinte.167.15.1690-a.
Text Size: A A A
Published online

Extract

A recent cohort study in the Archives showed that higher recreational physical activity in postmenopausal women was independently associated with low incidence of breast cancer after adjusting for multiple confounders.1 Based on the data reported by Bardia et al,1 there were 4.7 (dividing 1216 by 259 247) and 4.1 (dividing 582 by 141 180) breast cancer cases per 1000 person-years among women who had low- and high-recreational physical activity, respectively, at baseline. Compared with low-recreational physical activity, high-recreational physical activity was associated with a reduced breast cancer incidence by 0.6 per 1000 person-years (4.7 per 1000 person-years minus 4.1 per 1000 person-years). The potential limitation of such a small absolute risk reduction of breast cancer incidence related to high-recreational physical activity was not quantified and fully discussed.1 Based on the concept and calculation of the number needed to treat, “the number needed to be exposed” (NNE) was recently developed.2 The NNE is defined as the number of study participants who have a harm exposure (ie, have a risk factor) that is needed to be associated with 1 outcome, or NNE is defined as the number of study participants who have a beneficial exposure (ie, have a protective factor) that is needed to be associated with 1 less outcome. In assuming that the difference of breast cancer incidence between the low- and high-recreational physical activity groups was solely owing to the level of physical activity, the NNE in women who had high-recreational physical activity for 1 less case of breast cancer is 1667 (dividing 1000 by 0.6). However, a cohort study always has multiple confounders. The following adjusted NNE was proposed for a risk factor (harmful exposure)2:

Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview

Figures

Tables

Interactive Graphics

Video

Country-Specific Mortality and Growth Failure in Infancy and Yound Children and Association With Material Stature

Use interactive graphics and maps to view and sort country-specific infant and early dhildhood mortality and growth failure data and their association with maternal

References

Correspondence

CME
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s “Cited By” API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 1

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Topics
Jobs
JAMAevidence.com

Users' Guides to the Medical Literature
Table 9.2-2 Refuted Evidence From Studies of Physiologic or Surrogate Endpoints

The Rational Clinical Examination
Make the Diagnosis: Breast Cancer