To treat or not . . .

As mentioned in my previous post of malnutrition, one of the major aspects that most of us doctors forget is the innate ability of the body to heal itself.

What happens if you don’t treat your pneumonia. Yes, there is a higher chance of dying and getting complications in the absence of treatment. However, there is a good chance of escaping unscathed even without medicines. Maybe, there would be delay in your getting better. Of course, there are major determinants of spontaneous healing like non-extremes of age, good nutrition, hygienic environs etc.

As public health consultants, we’ve been taught in school about risks and benefits. One of terms that helped me quite a lot was the concept of number needed to treat (NNT).

I was so happy to see a website called TheNNT.com where one can find out more about the concept. Recently, there was a good article about it. I’m sure you’re going to get quite a few surprises about many of the traditional treatment protocols that we commonly use.

Some of my favorites . . . 

- Combined inhalers vs Steroid Inhalers for Adults with Asthma

- Coronary Heart Bypass for Prevention of Death

- Diagnostic testing for patient reassurance

- Vitamin D for fracture prevention

- Screening mammography for reducing deaths

- Routine health checkups for reducing mortality and morbidity

- Anti-hypertensives for cardiovascular event prevention in mild hypertension

So, do check out if you really need to prescribe something about which you're not really sure about. You save a lot of money for your patient and maybe even prevent unnecessary complications . . .