illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache说明风险差异和数量需要治疗的随机对照试验的脊髓操纵cervicogenic头痛.pdfVIP

Haas et al. Chiropractic Osteopathy 2010, 18:9 /content/18/1/9 R E S E A R C H Open Access Research Illustrating risk difference and number needed to treat from a randomized controlled trial of spinal manipulation for cervicogenic headache 1 2 1 Mitchell Haas* , Michael Schneider and Darcy Vavrek Abstract Background: The number needed to treat (NNT) for one participant to benefit is considered a useful, clinically meaningful way of reporting binary outcomes from randomized trials. Analysis of continuous data from our randomized controlled trial has previously demonstrated a significant and clinically important difference favoring spinal manipulation over a light massage control. Methods: Eighty participants were randomized to receive spinal manipulation or a light massage control (n = 40/ group). Improvements in cervicogenic headache pain (primary outcome), disability, and number in prior four weeks were dichotomized into binary outcomes at two thresholds: 30% representing minimal clinically important change and 50% representing clinical success. Groups were compared at 12 and 24-week follow-up using binomial regression (generalized linear models) to compute the adjusted risk difference (RD) between groups and number needed to treat (NNT) after adjusting for baseline differences between groups. Results were compared to logistic regression results. Results: For headache pain, clinically important improvement (30% or 50%) was more likely for spinal manipulation: adjusted RD = 17% to 27% and NNT = 3.8 to 5.8 (p = .005 to .028). Some statistically significant results favoring manipulation were found for headache disability and number. Conclusion: Spinal manipulation demonstrated a benefit in terms of a clinically important improvement of cervico