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Absolute and Relative Risk LAST UPDATED: 21ST APRIL 2019

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Outcome event No outcome event Total

Treatment a b a+b
Absolute and Relative Risk
Evidence Based Medicine Control c d c+d

FRCEM Success Total a+c b+d n=a+b+c+d

N.B. The 'outcome event' always refers to the worst outcome

Absolute Risk and Absolute Risk Reduction

The absolute risk (AR) is the risk of an outcome event occurring over a set time period (the incidence rate of the
outcome event). It is calculated by dividing the number of outcome events that occur by the total number of people at
risk of that event occurring.

The absolute risk reduction (ARR) is the di erence between the absolute risk of outcome event in the control group
(ARC) and the absolute risk of outcome event in the treatment group (ART).
KEYWORDS
Absolute Risk Absolute Risk Reduction ARC = c/(c + d)

NNT Number Needed to Treat ART = a/(a+b)

Relative Risk Relative Risk Reduction
ARR = ARC – ART

RELATED TOPICS Relative Risk and Relative Risk Reduction

Evidence Based Medicine
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Statistics
The relative risk (RR) is the ratio of  the risk of outcome event in the treatment group compared to the risk of outcome
event in the control group.
RR = ART/ARC

A risk ratio of 1 indicates no di erence in risk between groups.

If the risk ratio of an outcome event is > 1, the rate of that event is increased in the treatment group compared to
the control group.
If the risk ratio is < 1, the rate of that outcome event is reduced in the treatment group compared to the control
group.

The relative risk reduction (RRR) is the proportional reduction in rates of outcome event between the control group and
the treatment group.

RRR = (ARC - ART)/ARC or 1 – RR

Number Needed To Treat

The number needed to treat (NNT) is the number of patients who need to be treated with the intervention, compared
with the control, in order for one extra patient to experience a bene cial e ect.

It is the reciprocal of the absolute risk reduction and therefore gives us information about absolute bene t.

NNT = 1/ARR

NNT is always a number between 1 and in nity. The ideal NNT is 1, where everyone that receives the treatment receives
bene t. In theory, the higher the NNT, the less e ective the treatment, because more people need to receive the
treatment to see a bene t in one but NNT should be interpreted in clinical context. Comparisons between NNTs can only
be made if the baseline risks are the same.

A negative number would indicate that the treatment has a harmful e ect and would therefore represent the number
needed to harm (NNH), de ned as the number of patients who need to be treated for one extra patient to experience a
harmful e ect. The lower the NNH, the higher the rate of harmful e ects. The NNH:NNT ratio is indicative of the
risk/bene t ratio.