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Number needed to screen: development of a statistic for disease screening
1Cardiovascular Division, Department of Internal Medicine, University of Virginia Health Sciences Center, Charlottesville, Virginia 22908, USA. crembold@viginia.edu
BMJ (Clinical Research Ed.)
|July 31, 1998
Summary
Screening for dyslipidemia and hypertension offers the most significant clinical benefit, preventing one death for every 418 people screened for dyslipidemia and 274-1307 for hypertension. These findings aid in prioritizing effective disease screening strategies.
Area of Science:
- Public Health
- Preventive Medicine
- Biostatistics
Background:
- National disease screening strategies require robust statistical measures for effective implementation.
- The 'number needed to screen' (NNS) is a proposed statistic to evaluate screening efficacy.
Purpose of the Study:
- To develop and apply the NNS statistic to assess various disease screening strategies.
- To compare the clinical benefits of different screening interventions.
Main Methods:
- NNS was calculated directly from clinical trials measuring screening strategy effects.
- NNS was estimated using data from trials measuring treatment benefits and disease prevalence.
- A standard literature review was conducted.
Main Results:
- Screening for dyslipidemia (NNS=418) and hypertension (NNS=274-1307) demonstrated the largest clinical benefit in preventing mortality over 5 years with treatment.
- Hemoccult screening (NNS=1374) and mammography (NNS=2451) reduced cancer-specific mortality but not total mortality.
Conclusions:
- The NNS statistic provides a valuable tool for clinicians to prioritize screening strategies.
- Screening for and treating dyslipidemia and hypertension yield the greatest clinical benefits among the evaluated strategies.