Concepts to be considered when appraising applicability of evidence to older people - number needed to harm

Definition

Number needed to harm (NNH) - the number of patients who would need to receive a treatment/exposure for one additional patient to experience a specified adverse outcome, compared with a control - the harm-side counterpart to number needed to treat
NNH is reported far less consistently than NNT in both trial publications and clinical guidelines, despite being equally important for a genuinely balanced risk-benefit judgement, particularly in older patients where treatment burden and adverse effect risk are often higher

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