Do drug treatment POEMs report data in clinically useful ways?

To provide the best care, physicians must determine what published information is relevant, valid, and clinically useful. Patient-Oriented Evidence that Matters (POEMs) defines relevance as information that addresses clinical questions, measures clinical outcomes, and has the potential to change practice. The most useful clinical information is presented in terms of absolute risk reduction (ARR), number needed to treat (NNT), and number needed to harm (NNH). The purpose of this study was to estimate the percentage of drug treatment articles published in major medical journals that provide a calculated ARR, NNT, or NNH.

We independently reviewed all drug treatment articles in 7 journals during a 6-month period for relevance, validity, and clinical usefulness. (Journals included Journal of the American Medical Association [JAMA], Archives of Internal Medicine [Arch Intern Med], British Medical Journal [BMJ], New England Journal of Medicine, Lancet, Obstetrics and Gynecology [Obstet Gynecol], and Pediatrics.) We assessed clinical usefulness by recording whether the articles reported ARR, NNT, or NNH.

Of the 995 articles we reviewed, only 2.4% met relevance criteria. Fewer than 1% of all drug therapy articles were POEMs with calculated ARR, NNT, or NNH. Arch Intern Med, JAMA, and BMJ published the most drug therapy POEMs: 33%, 20%, and 17%, respectively. JAMA, BMJ, and Obstet Gynecol were the only journals that published POEMs with clinically useful information.

Most major journals that address primary care issues do not publish drug therapy POEMs; those that do rarely present information in a clinically useful manner. Editors should require authors to provide ARRs, NNTs, and NNHs to help clinicians provide the best medical care for their patients.