[Medical treatment can become more efficient].

Abstract

A substantial part of our expenditure on medical treatment aims to cure the patient from the disease. The effectiveness of these treatments has been proven by Evidence Based Medicine and is assessed by comparing groups of patients. However, not all individual patients benefit from the treatment. In trials this effect is measured by calculating the number needed to treat (NNT). The NNT can be seen as a proxy for the inefficiency of a medical intervention. Usually the NNT is 5 to 50 for both medical and non-medical interventions, which means that a substantial number of patients will not reach the primary endpoint. This is accompanied by adverse effects and costs and is in conflict with our intention to do no further harm. An increase in phase IV post marketing research is needed to reduce the inefficiency of medical treatment. Doctors, government and others should prioritize this type of research.