What is the number needed to treat when exercise training heart failure patients?
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Debate exists on the number needed to treat (NNT) to prevent one mortality with exercise training in heart failure patients. The primary aim of this work was to conduct a sensitivity analysis, removing outlying mortality data from a published meta-analysis of exercise training in heart failure patients. A sensitivity analysis was conducted by removing data from one randomized controlled trial that reported particularly high mortality rates and may be considered a data outlier. Annualized NNTs were subsequently calculated for mortality data from a meta-analysis of exercise training in heart failure patients. Sensitivity analysis showed that the mortality benefit reported by Piepoli was greatly influenced by Belardinelli’s data. Moreover Belardinelli’s data may be considered an outlier because of the increased mortality rate and therefore favorable odds ratio in comparison to the other 8 included studies. This working example highlights that reporting of NNTs can be misleading. Exercise training remains a relatively safe, non-pharmacological therapy for people with heart failure.
This document has been peer reviewed.