American Board of Internal Medicine (ABIM) Certification Practice Exam

What differentiates NNT from NNH in clinical outcomes?

1. NNT is a higher value than NNH

2. NNT assesses preventative outcomes while NNH assesses harmful outcomes

3. NNT is only for surgical treatments

4. There is no difference; they are interchangeable

The correct answer is: NNT assesses preventative outcomes while NNH assesses harmful outcomes

The correct answer emphasizes the fundamental differences in how NNT (Number Needed to Treat) and NNH (Number Needed to Harm) are applied in clinical outcomes. NNT is used to determine how many patients need to be treated for one patient to benefit from the treatment; it typically assesses preventative outcomes, such as the effectiveness of a medication in preventing disease or complications. In contrast, NNH quantifies how many patients need to be exposed to a treatment before one experiences a harmful side effect—thereby focusing on adverse events associated with a treatment. In clinical practice, these metrics serve different purposes. NNT provides valuable insight into the potential benefits of a treatment, helping clinicians evaluate the effectiveness of an intervention. NNH provides information about the safety of the treatment by illustrating potential risks, enabling the healthcare provider to weigh the benefits against the risks when making treatment decisions. The other options misrepresent the relationship between NNT and NNH or the contexts in which they are utilized. For instance, NNT and NNH are not interchangeable; using one in place of the other would lead to misinterpretations about treatment benefits and harms. Thus, understanding that NNT pertains to the evaluation of beneficial outcomes while NNH addresses harmful outcomes clarifies their distinct roles in