過剰リスク

WordNet

more than is needed, desired, or required; "trying to lose excess weight"; "found some extra change lying on the dresser"; "yet another book on heraldry might be thought redundant"; "skills made redundant by technological advance"; "sleeping in the spare room"; "supernumerary ornamentation"; "it was supererogatory of her to gloat"; "delete superfluous (or unnecessary) words"; "extra ribs as well as other supernumerary internal parts"; "surplus cheese distributed to the needy" (同)extra, redundant, spare, supererogatory, superfluous, supernumerary, surplus
immoderation as a consequence of going beyond sufficient or permitted limits (同)excessiveness, inordinateness
a quantity much larger than is needed (同)surplus, surplusage, nimiety
expose to a chance of loss or damage; "We risked losing a lot of money in this venture"; "Why risk your life?"; "She laid her job on the line when she told the boss that he was wrong" (同)put on the line, lay on the line
a venture undertaken without regard to possible loss or injury; "he saw the rewards but not the risks of crime"; "there was a danger he would do the wrong thing" (同)peril, danger
the probability of being exposed to an infectious agent (同)risk of exposure
the probability of becoming infected given that exposure to an infectious agent has occurred (同)risk of infection
newly come into prominence; "a rising young politician"
advancing or becoming higher or greater in degree or value or status; "a rising trend"; "a rising market"

PrepTutorEJDIC

〈U〉《時にan~》(…の…に対する)超過《+『of』+『名』+『over』+『名』》 / 〈U〉(…の)『不節制』《+『at』+『名,』+『in』 do『ing』》;《複数形で》度を超えた行為,不行跡;暴飲,暴食 / 超過の,余分の
『危険』;危害(損害)を受ける可能性《+『of』+『名』(do『ing』)》 / 〈生命など〉‘を'『危険にさらす』 / …‘を'危険(失敗,損失など)を覚悟してする
〈U〉(…が)上がること,(…の)上昇;昇進《+『of』+『名』》 / 〈U〉起床 / 〈C〉蜂起,反乱 / 上がる,強まる,高まる / 成長する,発達中の,上り坂にある
ほぼ(…)歳

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/05/29 23:55:21」(JST)

wiki en

In epidemiology, the absolute risk reduction, risk difference or absolute effect is the change in the risk of an outcome of a given treatment or activity in relation to a comparison treatment or activity.^[1]^[2] It is the inverse of the number needed to treat.^[3]

In general, absolute risk reduction is the difference between one treatment comparison group's event rate (EER) and another comparison group’s event rate (CER). The difference is usually calculated with respect to two treatments A and B, with A typically a drug and B a placebo. For example, A could be a 5-year treatment with a hypothetical drug, and B is treatment with placebo, i.e. no treatment. A defined endpoint has to be specified, such as a survival or a response rate. For example: the appearance of lung cancer in a 5-year period. If the probabilities p_A and p_B of this endpoint under treatments A and B, respectively, are known, then the absolute risk reduction is computed as (p_B − p_A).

The inverse of the absolute risk reduction, NNT, is an important measure in pharmacoeconomics. If a clinical endpoint is devastating enough (e.g. death, heart attack), drugs with a low absolute risk reduction may still be indicated in particular situations. If the endpoint is minor, health insurers may decline to reimburse drugs with a low absolute risk reduction.

Presenting results

Consider a hypothetical drug which reduces the relative risk of colon cancer by 50% over five years. Even without the drug, colon cancer is fairly rare, maybe 1 in 3,000 in every five-year period. The rate of colon cancer for a five-year treatment with the drug is therefore 1/6,000, as by treating 6,000 people with the drug, one can expect to reduce the number of colon cancer cases from 2 to 1.

The raw calculation of absolute risk reduction is a probability (0.003 fewer cases per person, using the colon cancer example above). Authors such as Ben Goldacre believe that this information is best presented as a natural number in the context of the baseline risk ("reduces 2 cases of colon cancer to 1 case if you treat 6,000 people for five years").^[4] Natural numbers, which are used in the number needed to treat approach, are easily understood by non-experts. Absolute measures, such as the risk difference, are superior to relative measures in the context of patients or physicians deciding on treatment options (relative measures tend to exaggerate estimations of effectiveness).^[5]

Worked example

	Example 1: risk reduction			Example 2: risk increase
	Experimental group (E)	Control group (C)	Total	(E)	(C)	Total
Events (E)	EE = 15	CE = 100	115	EE = 75	CE = 100	175
Non-events (N)	EN = 135	CN = 150	285	EN = 75	CN = 150	225
Total subjects (S)	ES = EE + EN = 150	CS = CE + CN = 250	400	ES = 150	CS = 250	400
Event rate (ER)	EER = EE / ES = 0.1, or 10%	CER = CE / CS = 0.4, or 40%		EER = 0.5 (50%)	CER = 0.4 (40%)

Equation	Variable	Abbr.	Example 1	Example 2
EER − CER	< 0: absolute risk reduction	ARR	(−)0.3, or (−)30%	N/A
EER − CER	> 0: absolute risk increase	ARI	N/A	0.1, or 10%
(EER − CER) / CER	< 0: relative risk reduction	RRR	(−)0.75, or (−)75%	N/A
(EER − CER) / CER	> 0: relative risk increase	RRI	N/A	0.25, or 25%
1 / (EER − CER)	< 0: number needed to treat	NNT	(−)3.33	N/A
1 / (EER − CER)	> 0: number needed to harm	NNH	N/A	10
EER / CER	relative risk	RR	0.25	1.25
(EE / EN) / (CE / CN)	odds ratio	OR	0.167	1.5
EER − CER	attributable risk	AR	(−)0.30, or (−)30%	0.1, or 10%
(RR − 1) / RR	attributable risk percent	ARP	N/A	20%
1 − RR (or 1 − OR)	preventive fraction	PF	0.75, or 75%	N/A

References

^ "An overview of measurements in epidemiology" (PDF). Retrieved 2010-02-01.
^ GET-IT Glossary http://getitglossary.org/search/absolute+risk+reduction. Retrieved 7 October 2015. Missing or empty |title= (help)
^ Laupacis, A; Sackett, DL; Roberts, RS (1988). "An assessment of clinically useful measures of the consequences of treatment.". The New England Journal of Medicine 318 (26): 1728–33. doi:10.1056/NEJM198806303182605. PMID 3374545.
^ Ben Goldacre (2008). Bad Science. New York: Fourth Estate. pp. 239–260. ISBN 0-00-724019-8.
^ Stegenga, J. (2015). "Measuring Effectiveness". Studies in History and Philosophy of Biological and Biomedical Sciences 54: 62–71. doi:10.1016/j.shpsc.2015.06.003.

External links

Measures of effect size of an intervention – unmc.edu.

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