What is a quick and easy way to calculate the NNT

What is the different between Absolute and Relative risk reduction

https://heart.bmj.com/content/108/12/964

https://www.ahajournals.org/doi/10.1161/JAHA.116.003815



We have a study that says leads to increase all cause death with calcium supplements

We have a study that says calcium supplement leads to increase in coronary artery calcium

Foods that are high in calcium besides dairy include things like kale, spinach, broccoli, chia sees, collard greens…

Hard for me to believe someone with a diet of excess kale and spinach will have an increase in all cause mortality anytime soon.

It is easy for me to believe that supplements in a pill don’t fix the problems like we wish—we see this all the time with some many electrolytes and nutrients—there is a difference between taking a pill and eating a nutritious diet

https://evidence.nejm.org/doi/full/10.1056/EVIDoa2300311

Peanut consumption, starting in infancy and continuing to age 5 years, provided lasting tolerance to peanut into adolescence irrespective of subsequent peanut consumption, demonstrating that long-term prevention and tolerance can be achieved in food allergy. (Funded by the National Institute of Allergy and Infectious Diseases and others; ITN070AD, ClinicalTrials.gov number, NCT03546413.)

https://jamanetwork.com/journals/jama/article-abstract/2819352


Conclusions and Relevance  In this study, 10 years after diagnosis, 49% of men remained free of progression or treatment, less than 2% developed metastatic disease, and less than 1% died of their disease. Later progression and treatment during surveillance were not associated with worse outcomes. These results demonstrate active surveillance as an effective management strategy for patients diagnosed with favorable-risk prostate cancer.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11179824/


This study did something smart in that they broke it down by white black Chinese and then also had 36 lab test they were looking at and they then found look for a black male this one particular blood test apo2 or whatever had better predictive value but that is cherry picking data with lots of data points and we don’t have risk calculators just for black or just for white or just for Chinese population.

Blood test are hot things – we want to be able to drill down someone risk to a factions of a nats rear end but that just isn’t life—all the test and decision tools give us a rough estimate—the goal is to know are we looking at an 8% risk, an 18% risk or a 28% risk. It doesn’t really matter if it is 8.2  or 8.3 or 8.4

Botoom line—I get it we want to do more and be more precise but by getting extra blood test we are also costing the system more money and more energy so until you give me a study that shows it better with then a usuable risk calculator for that particular lab I think the use of these extra lipid labs should stay on the shelf or in the research only setting.

https://www.nejm.org/doi/full/10.1056/NEJMoa2309002
In this placebo-controlled trial, postexposure prophylaxis with nirmatrelvir–ritonavir for 5 or 10 days did not significantly reduce the risk of symptomatic SARS-CoV-2 infection.


https://www.nejm.org/doi/full/10.1056/NEJMoa2309003

https://www.nejm.org/doi/full/10.1056/NEJMoa2118542


Pfizer has some serious problems! #pfizer

this paper out in JAMA makes you think this is an issue but likely just too much noise with only 17 patietns and didnt control for confounders

https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2820255

Be careful, most observational data have a large amount of confounders not accounted for and even when accounted for you can never account for all the confounders

https://www.ahajournals.org/doi/10.1161/CIR.0000000000001251. 

Diagnosis:

• To establish a PAD diagnosis, the resting ankle–brachial index (ABI) remains the initial test of choice in patients with suggestive history or exam findings. The ABI result should be reported as normal (1–1.4), borderline (0.91–0.99), abnormal (≤0.9) or noncompressible (>1.4).

TREATMET

• In pts with symptomatic PAD—single antiplatelet with clopidogrel 75mg daily (NOT ASPIRIN) to lower risk of MACE. If the patient can’t get clopidogrel then aspirin will work but clopidogrel preferred!

• In patients with PAD and type 2 diabetes, the use of glucagon-like peptide-1 (GLP-1) agonists and sodium–glucose cotransporter-2 (SGLT-2) inhibitors are effective to reduce MACE.