LETTER
Misoprostol and Gastrointestinal Complications in Patients Taking Nonsteroidal Anti-Inflammatory Drugs for Rheumatoid Arthritis
R. Madhok;
A. McEntegart; and
N. Maiden
15 May 1996 | Volume 124 Issue 10 | Page 926
TO THE EDITOR:
I read with interest the report by Silverstein and colleagues [1]. As presented, the data are perhaps more optimistic than is justified. An alternative and perhaps more useful presentation of results for the clinician is the number of patients requiring treatment to prevent one complication [2].
I calculated that to prevent any complication, 286 patients would require treatment. Misoprostol treatment would be required in 586 patients to prevent one perforation and in 500 patients to avoid one serious complication excluding perforation.
Because the manner in which study results are presented can influence physician judgment about the treatment of patients, the presentation of the data in such a format conveys both statistical and clinical significance to the physician [3].
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Author and Article Information
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Glasgow Royal Infirmary; Glasgow, the United Kingdom
1. Silverstein FE, Graham DY, Senior JR, Wyn Davies H, Struthers BJ, Bittman RM, et al. Misoprostol reduces serious gastrointestinal complications in patients with rheumatoid arthritis receiving nonsteroidal anti-inflammatory drugs. A randomized, double-blind, placebo-controlled trial. Ann Intern Med. 1995; 123:241-9.
2. Cook RJ, Sackett DL. The number needed to treat: a clinically useful measure of treatment effects. BMJ. 1995; 310:452-4.
3. Forrow L, Taylor WC, Arnold MR. Absolutely relative: how research results are summarised can affect treatment decisions. Am J Med. 1992; 19:121-4.
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