Related Experiment Video
Updated: Jun 20, 2026

Inverse Probability of Treatment Weighting (Propensity Score) using the Military Health System Data Repository and National Death Index
Published on: January 8, 2020
Net efficacy adjusted for risk: further developments
1University of La Laguna, Tenerife, Spain. boadajuarez@gmail.com
Background:
'Net efficacy adjusted for risk' (NEAR) is a simple quantitative indicator integrating risk and benefit in one measure. NEAR considers that, in a clinical trial (CT), the drug with the best risk:benefit profile corresponds to that causing the greatest number of patients to respond favourably without suffering adverse drug reactions. This number is only exceptionally reported; thus, a NEAR estimate is obtained by calculating expected frequencies. NEAR is designed to compare two drugs and may be expressed as odds ratio or relative risk with their 95% CIs.
Objective:
To analyse the influence of using either intention-to-treat (ITT) or per-protocol (PP) populations in NEAR results. The use of NEAR as 'effect size' in performing meta-analyses is posed.
Method:
By analyzing several examples, differences between NEAR calculated by considering either ITT or PP populations are presented. Likewise, an example of meta-analysis by using NEAR as effect size is shown.
Conclusions:
NEAR results may be optimised by considering the type of population analysed, ITT or PP. Meta-analyses using NEAR as effect size provide new insights into CT results. Last, correcting certain deficits in adverse drug reactions reporting is required in CT risk assessment.
Related Concept Videos
Types of Biopharmaceutical Studies: Controlled and Non-Controlled Approaches
Non-controlled studies, commonly employed for initial exploration, lack a control group, rendering them susceptible to biases and external influences. In contrast, controlled...
Relative Risk
Production Efficiency
Dose-Response Relationship: Potency and Efficacy
Kaplan-Meier Approach
Regression Toward the Mean