Rule 3-30


UKAS’s obsession and need for expansion obliges it to pursue metrical perfectionism and uncertainty of measurement.  However, in the real world things can be different for clinical decision making.  Prof. Enrique Sanchez-Delgado has written:

“After analyzing hundreds of trials, I recognized a pattern, which I tested and confirmed to simplify the evaluation of the evidence. I called this pattern: THE 3-30 RULE OF EVIDENCE BASED MEDICINE.

“Basically it means that the trials that are clinically significant and/or cost- effective fulfill at least two of the following characteristics: a Relative Risk Reduction of 30% or more (not less than 20%), an Absolute Risk Reduction of 3% or more (not less than 2%), and a Number Needed to Treat or NNT of 30 or less (not more than 50), that is, for every 30 patients that we treat, compared with controls, we save a life or avoid one clinical event.”

Sanchez-Delgado, E.  An excellent example of the Rule 3-30 for clinical decision making.  BMJ. (Posted 2 May 2011)

All treatments are not necessarily helpful.  Even effective treatments can do harm.  Read about it here.

Visual Rx Cates Plot Example

What is the Number Needed to Treat for accreditation to be worthwhile?

What is the Number Needed to Harm?

Why has nobody asked?

If these figures are incalculable for accreditation, where is the imperative to impose it?

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