Number needed to treat and cost-effectiveness in the prevention of ventilator-associated pneumonia
Department of Adult Critical Care, Guy's and St Thomas' NHS Foundation Trust, St Thomas' Hospital, 1st Floor East Wing, Lambeth Palace Road, London, SE1 7EH, UK
Critical Care 2012, 16:430 doi:10.1186/cc11346Published: 7 June 2012
First paragraph (this article has no abstract)
While clinicians continue to redefine ventilator-associated pneumonia (VAP), numerous innovations that claim to reduce pulmonary microaspiration and its consequences - that is, novel endotracheal cuff shapes and cuff materials, subglottic drainage, automatic cuff pressure controllers, oral anti-septics, selective digestive decontamination (SDD), and devices to combat biofilm formation within the lumen of the tracheal tube - are coming to the market [1,2]. There are two questions that clinicians ask when deciding whether to incorporate a new product or intervention into a VAP prevention bundle. Firstly, what are its efficacy and effectiveness? In other words, what is the relative risk reduction (RRR) and therefore the number needed to treat (NNT) to prevent one additional VAP. Secondly, is this new intervention cost-effective in my local patients?