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Medicine
HARM
Dr. Juliandi Harahap, MA
HARM/RISK
Prognostic factors:
conditions that,
when present in
persons already
known to have
disease, are
associated with an
outcome of the
disease
Prognosis
Relatively frequent
events
The event: Death,
complications,
disability, suffering,
etc.
Prognostic factors
are not necessarily
the same as risk
factors for a given
disease
Harmless
Efficacious
Harmful
Treatment
Harmless
Not efficacious
Harmful
Efficacious
Medical intervention
Harm
Validity
Importan Applicabili
ce
ty
HARM WORKSHEET
A Cohort Study
Adverse outcome
Prese Absent
nt
(contro
(case)
ls)
A
B
Totals
Exposed to
A+B
treatment
(RCT or cohort)
Not exposed to
C
D
C+D
treatment
(RCTof
orparticipants
cohort)
A group
who are exposed (a+b)
to the putative harmful
agent and
a group
or
B+D
A+B+C
totals A+C
participants who arent exposed (c+d) to it+D
are
followed for the development of the outcome of
interest (a or c)
Short term
Long-term
>20% lost
1549 person-years
of taking Ca
antagonist
47 cancer
1502 No
cancer
Cohort Study
Adverse outcome
Prese Absent
nt
(contro
(case)
ls)
20
980
Exposed to
treatment
(RCT or cohort)
Not exposed to
2
998
treatment
Cohort Study
(RCT or cohort)
RELATIVE RISK
(RR) =totals
A/(A+B)22
: C/(C+D)
1978
RR=10
This means that patients receiving the
treatment are 10 times more likely to
experience the outcome as patients not
Totals
1000
1000
2000
Case control
study
Adverse outcome
Prese Absent
nt
(contro
(case)
ls)
A
B
Totals
Exposed to
A+B
treatment
(RCT or cohort)
Not exposed to
C
D
C+D
treatment
Case control
(RCT or cohort)
study
ODDS RATIO
ODDS)
A+C
B+D
A+B+C
totals(RELATIVE
OR = AD/BC
+D
OR > 4
Cohort
RR > 3
adjustment
If OR <
1 {PEER x (1 - OR)}
1 NNH = ----------------------------(1 - PEER) x PEER x (1 - OR)
If OR >
PEER =
Patient
Expected
Event Rate
(the adverse
event rate
among
individuals
who are not
2.
3.
4.
Thank you