TY  - JOUR
T1  - IMproving the health of patients and populations requires humility, uncertainty, and collaboration
AU  - Oxman AD
Y1  - 2012/10/24
N1  - 10.1001/jama.2012.14477
JO  - JAMA
SP  - 1691
EP  - 1692
VL  - 308
IS  - 16
N2  - 
In this issue of JAMA Pereira and colleagues2 report on an analysis of 3082 Cochrane reviews that included a total of 85 002 forest plots of meta-analyses. They found only 1 intervention with more than a 5-fold reduction in the odds of dying (extracorporeal membrane oxygenation [ECMO] compared with conventional ventilatory support for severe respiratory failure in newborns).3 Although this is, by their definition, a “very large effect,” the reduction in the risk (as opposed to the odds) of dying before discharge home was only a halving (risk ratio, 0.44; 95% CI, 0.31 to 0.61). This corresponds to a risk difference of −32% (95% CI, −44% to −20%), which means that 3 babies would need to be treated with ECMO rather than conventional ventilation to prevent 1 death.

SN  - 0098-7484
M3  - doi: 10.1001/jama.2012.14477
UR  - http://dx.doi.org/10.1001/jama.2012.14477
ER  -