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Definition and axioms of net treatment benefit

as the relative risk reduction; its inverse, relative risk; the absolute risk reduction; or its reciprocal, the numbers needed to treat. Usually, only one of these values is used to express treatment benefit, the selection of which often depends on current trends or simply the number that is most convincing.1-3 However, expressions of therapeutic benefit, although they are most often presented in isolation, are interrelated. These relationships are reflected in the concept of net treatment benefit, which can be defined by a simple linear algebraic expression. The expression may be graphed and a series of observations can be made that expand our understanding of the benefits and risks of treatment. These observations gain additional importance with the current trend of treatment of individuals and populations with ever-decreasing risk. The basic mathematical relationship intuitively equates the net benefit of treatment to treatment good (GOOD) minus treatment harm (HARM) or the following: