Stephen Senn
Head of Competence Center for Methodology and Statistics (CCMS)
Luxembourg Institute of Health
Twitter @stephensenn
Painful dichotomies
The tweet read “Featured review: Only 10% people with tension-type headaches get a benefit from paracetamol” and immediately I thought, ‘how would they know?’ and almost as quickly decided, ‘of course they don’t know, they just think they know’. Sure enough, on following up the link to the Cochrane Review in the tweet it turned out that, yet again, the deadly mix of dichotomies and numbers needed to treat had infected the brains of researchers to the extent that they imagined that they had identified personal response. (See Responder Despondency for a previous post on this subject.)
The bare facts they established are the following:
The International Headache Society recommends the outcome of being pain free two hours after taking a medicine. The outcome of being pain free or having only mild pain at two hours was reported by 59 in 100 people taking paracetamol 1000 mg, and in 49 out of 100 people taking placebo.
and the false conclusion they immediately asserted is the following
This means that only 10 in 100 or 10% of people benefited because of paracetamol 1000 mg.
To understand the fallacy, look at the accompanying graph. Continue reading