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Retired NBME 27 Answers

nbme27/Block 3/Question#32 (reveal difficulty score)
In a historical study, 4753 nulliparous women ...
100 ๐Ÿ” / ๐Ÿ“บ / ๐ŸŒณ / ๐Ÿ“–
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submitted by โˆ—shak360(20)
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Absolute risk reduction (ARR) is the difference in risk (not the proportion) attributable to the intervention as compared to a control.

If 8% of people who receive a placebo vaccine develop the flu vs 2% of people who receive a flu vaccine develop the flu, then ARR=8%-2%=6% or 0.06.

The Number needed to treat (NNT) is the number of patients who need to be treated for 1 patient to benefit. A lower number implies a better treatment. It is the inverse of ARR.

If ARR is 0.06, then the NNT for the flu vaccine is 1/0.06=16.66 or about 17 people.


In this question, using the trace element group as a control group, we are asked how many nulliparous women with confirmed pregnancies would have to be treated with folic acid to prevent one congenital abnormality.

Here, 2.3% of people (nulliparous women with confirmed pregnancies) who received the placebo (trace elements) developed a congenital abnormality vs 1.3% of people who received folic acid (the treatment), then ARR=2.3%-1.3%=1% or 0.01.

The NNT is then 1/0.01=100.

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