Sneaky Research? Absolute Versus Relative Risk Reduction: The Way It Can Be Used To Trick You

Caution: confusing video! Watch it a couple of times!
In this video the surgeons discuss some statistical terms that my help viewers to understand medical studies. They discuss absolute risk reduction, relative risk reduction, meta analysis, confidence intervals and other topics.
Please see the complete user agreement at talkingwithdocs.com
Medical emergency
Do NOT use the Video for medical emergencies. If you have a medical emergency, call a physician or qualified healthcare provider, or CALL 911 immediately. Under no circumstances should you attempt self-treatment based on anything you have seen or read on the Video.
General information is not medical advice
The general information provided on the Video is for informational purposes only and is not professional medical advice, diagnosis, treatment, or care, nor is it intended to be a substitute therefore. Always seek the advice of your physician or other qualified health provider properly licensed to practise medicine or general healthcare in your jurisdiction concerning any questions you may have regarding any information obtained from this Video and any medical condition you believe may be relevant to you or to someone else. Never disregard professional medical advice or delay in seeking it because of something you have read on this Video. Always consult with your physician or other qualified healthcare provider before embarking on a new treatment, diet, or fitness program. Information obtained on the Video is not exhaustive and does not cover all diseases, ailments, physical conditions, or their treatment.

[@dboutier5636]

Retired math teacher here.😁😁😁😁😁😁 You guys get an A+ + for a very interesting and clear explanation. One of my favorite books is: how to lie with statistics. The relative and absolute statistics are a great example. If I still taught I would be sharing this with my students. Can’t wait for your cholesterol video. A few years ago I was hospitalized with a severe vestibular neuritis attack. I had just had a physical a few weeks previous. All of my cholesterol numbers were good. The hospital physician wanted put me on cholesterol medication. I asked if the numbers have changed and he said no but it was recommended that everybody over 65 take cholesterol medicine. For the three more days I was in the hospital I just palmed the pill every day when they gave it to me. Went back to my primary because I needed some referrals and mentioned the cholesterol medicine. He laughed. I have no family stroke or heart attack history In my blood pressure is usually around 90/60.He said I was the last person he would give the medicine to. And that the risk especially dizziness way outweighed any slight benefit for me. Love my primary. He uses common sense.

[@TalkingWithDocs]

Hi D. Common sense. Just not that common anymore. Thanks for sharing your experience. Thanks for watching and subscribing

[@skykingimagery899]

Proving medicine is more dogma than "science." There was no risk/reward management considered. "We just do that."

[@youthrevisitedagain]

Thank you, doctors. Very interesting & informative. You two never fail to deliver. Humor always helps, too.

[@TalkingWithDocs]

Thanks ME! Thanks for watching and subscribing

[@wesadrian6981]

Funded by Big Chicken? Do you mean Big Bird from Sesame Street?😂

[@TalkingWithDocs]

Ha Wes. Nicely played. Thanks for watching and subscribing

[@chrishackenbrack343]

I hammered into my children how important, and honestly life changing, it was for me to learn statistics. Such an important video. Cannot wait for the next video!

[@TalkingWithDocs]

That’s awesome Chris. Thanks for watching and subscribing

[@debbiebatten6021]

Thank you once again for helping us to navigate all the misinformation out there. You are such excellent presenters with the ability to be clear and concise, and with the added benefit of your excellent humor! I am always excited when I see that you have posted a new video. Looking forward to many more!!!

[@TalkingWithDocs]

Thanks so much Debbie. Happy to try and educate our viewers. Thanks for watching and subscribing

[@smatta2]

Love this one, gentlemen! Thanks again for taking the time to share what you know or have learned. This will help to be a bit more discerning when reading - as opposed to simply calling BS on anything put out by big pharma.

[@TalkingWithDocs]

Exactly! Thanks for watching and subscribing

[@terrybouck5192]

Statistics lie, have some wings! Omg you two . Know your info source and their credentials . Love watching.

[@TalkingWithDocs]

For sure Terry. Thanks for watching and subscribing

[@kubotajordan9502]

Hello to my 2 favorite Canadian docs . So true with this video my oncologist told me to be carful with Dr. Google . Y'all have a splendid weekend .

[@TalkingWithDocs]

You too Kubota!! Thanks for watching and subscribing

[@ebutuoyebutouy]

Canadian? I thought it was mandatory to end every sentence w a EH?

[@buffalogal9139]

Loved the video, I watched it over and over until I now understand absolute vs. relative risk and it makes me feel smart. Seriously, thank you very, very much. I don't know where I would have ever found this out otherwise and it is indeed quite important and useful. However, I'm not too sure I know anyone else of importance in my life that would understand what I am talking about so as to enable a conversation with productive results.

[@jamiecraswell9368]

I want to say thank you to all the doc,s across our country for putting up with all those folks with there Doctor Google degrees it’s got to be very challenging especially in these times with health care across our country in extreme difficult times!

[@TalkingWithDocs]

Ha jamie it can be. Thanks for watching and subscribing

[@ChrisCapoccia]

There are more papers published open access than ever, but it takes a lot of experience, education, time, etc to read them well, analyzing for weaknesses or errors, comparing with other research or whatever. That's why many people rely on general coverage of research in the news

[@TalkingWithDocs]

Yes Chris. That’s the problem. Facebook. Reddit. Fox. Thanks for watching and subscribing

[@dogsrgodsspelledbackwards3340]

Awesome info guys. Just like always, you crack me up and I learn something about relative and absolute. Now, looking forward to next video.

[@TalkingWithDocs]

We love that we crack you up! Thanks for watching and subscribing

[@lbar9720]

Wow!! That's interesting. Thank you so much for offering this education. Knowledge is power!

[@TalkingWithDocs]

It sure is L! Very welcome. Thanks for watching and subscribing

[@TheNewsJenorator]

Who’s on first? Abbott or Costello… lol Seriously this is ABSOLUTE Greek to me …. But you guys are fun to watch .. I’ll replay to help with my dyslexia. 🙏🏼💃

[@TalkingWithDocs]

Deal Jennifer. Love that skit. I don’t know is on third. Thanks for watching and subscribing

[@amyburwell5005]

Thanks for all you guys do for us..Stay Blessed:)

[@TalkingWithDocs]

Thanks so much Amy. Thanks for watching and subscribing

[@nubbyrose87]

I watched this after I saw your Journal Club: Statins video. I skipped this initially because I didn’t see why I would need to know this. 😬 Great explanation - clear and not boring. Well done🙏

[@TalkingWithDocs]

Yay not boring! Thanks for watching and subscribing

[@OmegaSeraphim]

excellent information. even doctors you go to don't know the difference between the two. but most of them will repeat the relative stats.

[@DrSteveQatar]

Thanks again for informative video. I was a group risk director for a large global insurance broker. Aggregate risk, combining all the risks of a system is a real challenge statistically, the individual risks often do not happen together but could - think dominos falling over or several acute rare diseases in a person. Risk reduction decisions for aggregate risk are tricky as combining absolute risk is not easy unless the system interactions are well known. Mitigating aggregate risk is equally hard. Maybe Artificial Intelligence and Machine learning will do this with processing power eventually - think self driving cars. What I am trying to understand is my aggregate risk and aggregate mitigations for blood pressure, ageing, previous DVT, internal bleeding from anticoagulants, taking statins to reduce cholesterol or not etc. Absolute risk mitigation helps for each but is not the full story. Studies that are published are reductionist, like your chicken wings example, (too hard to research and publish full system study), although meta analysis and systematic review do help, finding a way to study and fund aggregate absolute risk and mitigations may be possible soon with AI and ML to help with clinical decisions of risk treatment. Looking forward to the cholesterol journal review as this sounds like a study that is considering aggregate risks.

[@TalkingWithDocs]

Thanks for sharing your unique expertise Dr Steve! Thanks for watching and subscribing

[@JohnEllis-wt1ij]

Thank you. This was a good review since taking statistics in grad school 50 years ago.

[@Manacharitra]

Relative risk makes sense only when there is significant absolute risk. Also the stats for same risk factor also change because occurence need not to be exact,hence there has to be significant difference. A layman can understand better if you put forward both absolute and relative risk,because they have common sense.

[@ankebachmann4833]

Excellent video! Thank you for bringing this to our attention. Like you said be watchful for who is presenting the data; what is their prerogative, the who, why, what. Follow the money and you will understand why the salesperson is presenting different data from the scientist.

[@TalkingWithDocs]

Glad you liked it Anke. Thanks for watching and subscribing

[@tinkwilkinson9446]

Good video, used stats lot in my career. Good concise explanations.

[@TalkingWithDocs]

Thanks Tink. They are very important. Thanks for watching and subscribing

[@seismo99]

Thank you! Absolute versus relative risk reduction was just my question after watching your statin video.

[@TalkingWithDocs]

Very welcome. Thanks for watching and subscribing

[@zanzibarandgrill6484]

I have been eating turkey wings once a week for 2 years and haven't seen my unemployed obnoxious brother in-law since June 2020. Don't tell me that's just a coincidence.

[@TalkingWithDocs]

Ha Zanzibar. Very funny. Thanks for watching and subscribing

[@oceantide8084]

Excellent info!!!

[@TalkingWithDocs]

Glad you liked it Ocean. Thanks for watching and subscribing

[@irneseip2592]

Mrs Sofia is the best, recommending her to all beginners who wants to recover from their losses and gain more like I did through her strategies.

[@janeddins3405]

Yes I'm also a living testimony of expert Mrs sofia

[@scottmorrison670]

Thanks for the recommendation

[@scottmorrison670]

I just contacted her and she attends to me nicely

[@laurence9857]

Wow I just make my second withdraw again today trading with expert Mrs sofia

[@helenleahy4396]

I remember friends calling me crazy when I started but now I shut up them with my four figure weekly returned

[@lonniemcintosh6239]

Chicken wings you didn't say how many pounds of chicken wings a week should I start at one pound or two pounds LOL Great video !

[@TalkingWithDocs]

Hi Lonnie. Let’s start slow. 1 pound with some tiny carrot and celery sticks on the side. Thanks for watching and subscribing

[@davidpescod7573]

A brilliantly clear description explained in an interesting way. I must say, since following “Talking With Docs” it will be interesting to know the statistical probability of ‘chicken wings’ cropping up in the next video?

[@TalkingWithDocs]

Hi David. High to very high. 😀. Thanks for watching and subscribing

[@toryberch]

That was a very interesting statistical lesson 🐝🐝

[@TalkingWithDocs]

Glad you liked it Tory. Now you know! Thanks for watching and subscribing

[@toryberch]

@@TalkingWithDocs Yes I do, but now I need to brush up on my math 😀🤣

[@luiginayerino592]

Good Discussion. On another topic, had a Dexascan. Watched your video on osteoarthritis and osteoporosis. Have you had time yet to make the video on osteoporosis? I'd like to have your viewpoint as I begin discussions with my PCP concerning my results.

[@TalkingWithDocs]

We have not yet Luigina but it is on the list! Best of luck. Thanks for watching and subscribing

[@darlenericotta7550]

Thanks Docs ! Have good weekend!😇😇😇😋

[@TalkingWithDocs]

You too Darlene. Thanks for watching and subscribing

[@darlenericotta7550]

@@TalkingWithDocs Thanks Docs! I love watching your channel and I learn so much from you as well!

[@Bill-ph8hg]

Agreed that it is better to look at the scientific literature than to rely on mass media. But it is not as easy to do so as you imply. Most medical journals require a subscription for anything beyond the abstract. That's fine for faculty members or maybe practicing docs and people with hospital affiliations, but for the rest of us trying to access the journal literature is very frustrating.

[@imaprinta]

I look forward to the next video. I can't imagine it will be an easy task to tell the people that statins might not be as effective for everyone as doctors were first led to believe, if that's where the stats lead from those studies. Both from a colleague point of view and the pushback from the pharmaceuticals industry. Having already read the studies aggravate statistics and conclusions of those professionals, I wait with great interest to see the Docs conclusions.

[@TalkingWithDocs]

Yes it is a bit of a tightrope. Thanks for watching and subscribing

[@skykingimagery899]

Great, you got it. The point of using relative risk is to "sell you the results." Because absolute risk demonstrates "real risk." And no one really gets this. No medical or scientific journal demands this.

[@TalkingWithDocs]

We thought it was an important point to get across !

[@GreggBB]

Great video!! Data is so important. So is valid data lol. For Dr's who work in a setting like a hospital or a large clinic, do the individual Dr's figure all this out, or is there a department that has that responsibility, and that information is provided to all the Dr's? Does a certain level of peer reviewing need to exist for a study to be considered valid, no matter how good the scientific method looks? One thing I would offer about eating chicken wings once a week-----it would seem there is very low risk in doing that, so why not do it--just in case? LOL

[@TalkingWithDocs]

Hi Gregg. So the editorial boards of the journals review the articles. The better the journal the tougher the criteria to get published. Often the hospitals don’t provide the info but the governing bodies of the different specialties come up with regional or national recommendations. But many doctors do their own investigating as well. Thanks for watching and subscribing

[@GreggBB]

@@TalkingWithDocs Ah, ok, thanks for clearing that up. I think a high percentage of people don't realize how many hours Dr's spend on things besides direct patient care. Thanks for keeping your humor included in the videos

[@zanereese4796]

Thank you Doctors for this. I only found a NIH study, and I ran through this math when my doctor prescribed a statin for me. My question was, statistically speaking, how much longer will I live if I take a statin? Will I feel better, or worse, taking the statin? I'm still figuring on this, but leaning towards no. I'm looking forward to the next video.

[@TalkingWithDocs]

Hard to know the answer Zane. Tune in next week. Thanks for watching and subscribing

[@patrickhoban3002]

I'll volunteer for the treatment group!

[@TalkingWithDocs]

Ha Patrick. No one would want the control. Thanks for watching and subscribing

[@cdogbones]

Excellent video and great info. Reminiscent of some Phizer trial data I reviewed not long ago.

[@TalkingWithDocs]

Glad you liked it Chrisn

[@sassysandie2865]

Sadly, the journals have become corrupted. I just read Butchered by Healthcare. Pretty eye opening about the medical and pharmaceutical industries.

[@TalkingWithDocs]

Will have to check that out Sassy. Thanks for watching and subscribing

[@PatLyoutubepage]

Great explanation. After applying this understanding to statins I made the conclusion that it does nothing beneficial. Or worse cause unnecessary harm. Nnt number is practically a fail.

[@TalkingWithDocs]

Yes P L. There is probably a population of patients who really benefit - prior event, strong family history, multiple risk factors. But it’s not for healthy people

[@dsmith3731]

Thanks!

[@TalkingWithDocs]

Thank you so much ! That is so kind of you !

[@kennybolt8329]

Old chicken men never die ! They just chicken out !

[@TalkingWithDocs]

So true Kenny. Thanks for watching and subscribing

[@susanbaker-schloth1152]

Si, si...

[@caseykittel]

9:00 but the study could be repeated many times by different institutions and still be junk if the funding all came from industry or other conflicts of interest exist. especially potential conflicts that are not disclosed. this stuff happens all too often.

[@lindaking9222]

Ok Doc’s …this was a funny presentation but I appreciate the scientific info on the “medical studies”….by the way..I don’t even eat chicken wings..could I substitute chocolate..lol

[@TalkingWithDocs]

You sure can Linda. Enjoy it on a Friday night. Thanks for watching and subscribing

[@marciaborg77]

Thanks doc's how about a topice on the top of your metatarsal foot that you get pain and it aches sometimes it hurts too. I had it along time ago with my new balance shoes then got custom orthotics then switched to dansko shoe's for a long time and now it's come back again. I was wondering about a topic on this doc's. 🤔 thanks

[@TalkingWithDocs]

We can add it to the list Marcia. Thanks for watching and subscribing

[@SusanaXpeace2u]

I will be searching for a video about interpreting cholesterol testing results. Mine don't mention APOb or c reative protein. I feel like I don't have the facts to decide if I need statins or not but the GPs are kind of ''shaming'' me when I pause on statins and ask for more blood tests.

[@osmrducks1]

Ever heard the Statin efficacy quoted at a 35% decrease in risk? Case in point, this is a relative quote intended to deceive. The actual absolute efficacy is < 2% using the same meta study. In fact a 2002 JAMA published study has clarified yet the vast majority of medical professionals still tell their patients the absurd 35% without clarifying. In my opinion a statin should be secondary treatment only.

[@osmrducks1]

BTW… the side effects are more extreme than the reward.

[@michelenichele294]

Gee Docs, my head is full!🙁

[@TalkingWithDocs]

Yes this one will do that. Thanks for watching and subscribing

[@aelaan12]

But.... there were 3 people out of 2000 that got sick - so how does that relate?

[@TalkingWithDocs]

Good point Al. The incidence of the disease is actually an important factor. The more common the disease is the easier it is to impact the outcome typically and often lowers the NNT. Thanks for watching and subscribing

[@sharongodbout3275]

interesting! can't wait for the next one.... closer to my.... Heart! lol

[@TalkingWithDocs]

Yes Sharon! Thanks for watching and subscribing

[@mdevorah6833]

Don't you need to know who is funding the study? Meaning that someone trying to "push" their product, vs a controlled study where no financial benefactors are involved.

[@TalkingWithDocs]

That certainly can be part of it. It is disclosed at the end of the publication. Thanks for watching and subscribing

[@joseenoel8093]

So you guys know Amazon has an on-line doc now, how sad is that!

[@TalkingWithDocs]

No we didn’t know that but are not surprised. Thanks for watching and subscribing

[@sharongreenberg4953]

They just announced they are withdrawing from health care

[@walterhoward5686]

Wow ! Now I know why I've never had chicken pox ! It must be the chicken wings thanks Dr's ! Great episode guys. Eat more oats people !!!!!!!

[@TalkingWithDocs]

Glad you liked it Walter. Thanks for watching and subscribing

[@vernekelley9356]

Been trying for days to get this to load without success. I have no other KZbin problems.

[@TalkingWithDocs]

Not sure what to tell you Verne. Been watched by thousands so far. Weird. Hope it eventually worked out. Thanks for watching and subscribing

[@vernekelley9356]

@@TalkingWithDocs I shall defeat the problem and watch it on a different PC! I do not want to miss even one episode! Thanks.

[@veganath]

6:49 *_QUESTION:_* Absolute Risk in the case of 500/1000 in control group getting chicken pox compared to 250/1000 getting chick pox .Is the absolute risk in this case of 50%-25% = 25% ??? One could claim I have a 25% less chance of contracting chick pox if I eat chicken wings at the rate of the treatment group???

[@TalkingWithDocs]

Your math seems to work! Thanks for watching and subscribing

[@jamesparlane9289]

Someone who allocates the funding has to make an ethical decision in the case of each disease. What number is acceptable as the incidence in the population. If 1 in a million get the disease the other 999999 didn't get it. Should funding be given on the basis of years of life that can be saved so if there is a 20 year old and a 70 year old who need a donated heart, who gets it? Therefore those may be the practical level of OK in the population. Also should valuable medical resources be spent [wasted] on smokers or drug addicts? Is a woman of child bearing age who has 6 kids and wants 6 more a better prospect than a man who has had the snip? Someone has to work out the budget for each patient. Also there is the issue of qualitative vs quantitative data. Qualitative is "Are you in pain?" Quantative is on a scale of 1 to 10 how much pain are you in?

[@TalkingWithDocs]

Hi James. It is tricky for sure. But if you are quick to exclude smokers or drug addicts who have the medical problem of addiction what about people who drink too much or eat too much? Equally negative to their health. There would be no one left. That moral decision is much too complicated for this channel. Thanks for watching and subscribing

[@jamesparlane9289]

@@TalkingWithDocs Yes a line has to be drawn somewhere. Illegality is as good a place as any. There is an argument that us fatties can't help being fat or sex addicts can't help wanting sex. When the boy asked Doc Martin if he was going to die he said "yes we all die but not today" That was based on stats.

[@stevewilson3791]

Love the absurd hats. Likewise the blue garb. What no stethoscopes?

[@josephshaddix6119]

Ever heard of a whiteboard?

[@JoJo-ps4ml]

Who paid for Statin studies? Why Statin producers never publish all the data?

[@alidavalentinagosgnach700]

Very informative video docs as usual! Could anyone get the relative risk reduction? Or the absolute risk reduction? Have a splendid weekend!😊

[@TalkingWithDocs]

Yes Alida technically but these studies often over simplify the outcomes. Thanks for watching and subscribing

[@pijnto]

So Hypothetically if you eat Monkey feet will that reduce the risk of catching Monkey Pox ( sorry could not resist)

[@TalkingWithDocs]

Seems natural! Thanks for watching and subscribing

[@ChrisCapoccia]

But what's the p value on this chicken wing reduction? Doesn't sound like reduction of 1 is statistically significant

[@TalkingWithDocs]

Ha likely not 0.05. Thanks for watching and subscribing

[@terrybouck5192]

Not an easy topic to understand

[@TalkingWithDocs]

Nope Terry. Thanks for watching and subscribing

[@marnasorensen988]

Please let me know if you find a study of reduction in the urge to yell at people if you consume massive amounts of ice cream. Many thanks. On a lighter note, the severity of the disease being treated makes all stats irrelevant to most patients.

[@TalkingWithDocs]

That’s funny Marna. Thanks for watching and subscribing

[@Birdylockso]

So, what's the NNT for the Statin study?

[@TalkingWithDocs]

It depends on the study but it’s high. Please see our video on the recent meta analysis about the true benefit of this class of drugs

[@Birdylockso]

@@TalkingWithDocs I've watched it already, and that's why I found this video that talks about NNT, which was not mentioned in the meta study video. So, was there a NNT number for the meta study?

[@TalkingWithDocs]

So calculating an NNT from a meta analysis is inherently biased and not particularly useful

[@Birdylockso]

@@TalkingWithDocs Regarding a meta-analysis study being potentially biased, I've noticed that some of the meta-analysis studies, while reporting no conflict of interests, often use plenty of studies with conflicts of interests! As such, these meta-analysis studies are in fact biased, as probably as much as 80+% of statin studies are sponsored by big pharma. Would you agree?

[@barrykamin8776]

Don’t get information from mainstream media? Hoping you meant to say social media. Very different.

[@TalkingWithDocs]

Hi Barry. We would include some of the news venues as well. Really depends on the source. But obviously social media too. Use real scientific articles. Thanks for watching and subscribing

[@darlenericotta7550]

I guess I should eat more chicken wings!🤗

[@TalkingWithDocs]

Ha Darlene. We would say probably not. Thanks for watching and subscribing

[@barbaraebner5889]

Sensation sells! Panic sells! As you say, “ listen to your own body”. All of us are different. P.S. I never liked my statistics courses.

[@TalkingWithDocs]

Ha Barbara. No need to panic but we get it. Thanks for watching and subscribing

[@michellebarbour5777]

Great film ..if only it was 4 films! Start with what CHANCE is..throw some dice! Move onto percentages and what 95% chance is...think lottery hopes! Move onto Confidence levels...no way could anyone who didn't already understand what this means, grasp any meaning from the speed of this. If this was just to prove you are clever, we already knew it!...I love your films but I'd give this a D- (all the rest were A's!). Explaining complicated things is your skill set. Don't try to appeal to the informed, what's the point? This is clever, entertaining for a rare few but 'could definitely do better' as general info and I look forward to all the clear follow-ups. Edits - scrolling down and reading comments, maybe you intend to impress the already informed (and have done this) and if so, I am mistaken in my comment. If so, apologies. Hoping I'm wrong?

[@TalkingWithDocs]

Hi Michelle. No this is to help people become informed. The real take away is the absolute vs relative risk. Sorry if it missed the mark. Thanks for watching and subscribing

[@LynnSuthers]

🧐🤔🤨🙄😠

[@TalkingWithDocs]

Thanks for watching and subscribing

[@stevewilson3791]

Get to the point.