What does a Relative Risk (RR) of 0.70 with a 95% Confidence Interval (CI) of 0.50 to 0.98 indicate about the effectiveness of a treatment?

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Interpretation of Relative Risk 0.70 with 95% CI of 0.50 to 0.98

A relative risk (RR) of 0.70 with a 95% confidence interval of 0.50 to 0.98 indicates a statistically significant 30% reduction in risk with the intervention compared to the control group.

Understanding the Key Components

Relative Risk (RR) of 0.70

  • Indicates that the risk of the outcome in the intervention group is 30% lower than in the control group
  • Formula: RR = (Risk in intervention group) ÷ (Risk in control group)
  • RR < 1.0 suggests a protective effect (reduced risk)
  • RR = 0.70 means the intervention group has 70% of the risk compared to the control group

95% Confidence Interval (CI) of 0.50 to 0.98

  • Provides the range within which the true RR is likely to fall with 95% confidence
  • The CI does not cross 1.0, making this result statistically significant
  • Lower bound (0.50): Best-case scenario - up to 50% risk reduction
  • Upper bound (0.98): Worst-case scenario - minimal (2%) risk reduction

Clinical Significance Assessment

Statistical vs. Clinical Significance

  • This result is statistically significant because the CI doesn't include 1.0 1
  • Clinical significance depends on:
    • The baseline risk of the outcome
    • The severity of the outcome being prevented
    • The costs, risks, and burdens of the intervention

Absolute Risk Reduction (ARR)

  • Cannot be calculated directly from the RR without knowing baseline risk
  • For example:
    • With a 10% baseline risk: ARR = 10% × (1 - 0.70) = 3% (NNT = 33)
    • With a 20% baseline risk: ARR = 20% × (1 - 0.70) = 6% (NNT = 17)

Strength of Evidence Assessment

Quality Considerations

  • The American Gastroenterological Association guidelines use the GRADE approach to evaluate evidence quality 1:
    • High: Very confident the true effect is close to the estimate
    • Moderate: Moderately confident in the effect estimate
    • Low: Limited confidence; true effect may differ substantially
    • Very low: Very little confidence; true effect likely substantially different

Precision of the Estimate

  • The width of the CI (0.50-0.98) suggests moderate precision
  • The upper bound is close to 1.0, indicating the effect could be minimal
  • The lower bound suggests the potential for a substantial 50% risk reduction

Common Pitfalls in Interpretation

Avoid These Mistakes

  1. Confusing RR with absolute risk reduction: RR is a relative measure and doesn't tell you how many people benefit
  2. Ignoring the confidence interval: The CI provides crucial information about precision and significance
  3. Assuming causality: Association doesn't prove causation; other factors may explain the relationship
  4. Generalizing beyond the study population: Results may not apply to different populations

Proper Context is Essential

  • Consider the study design, population characteristics, and intervention details
  • Evaluate for potential biases and confounding factors
  • Compare with other studies examining similar interventions

Application to Clinical Decision-Making

When applying this evidence to clinical practice:

  • Consider both statistical significance and clinical importance
  • Weigh potential benefits against harms, costs, and patient preferences
  • Recognize that even a modest 30% risk reduction may be valuable for serious outcomes
  • Use the confidence interval to communicate the range of plausible effect sizes to patients

In summary, this RR of 0.70 (95% CI 0.50-0.98) represents a statistically significant protective effect of moderate magnitude, with reasonable confidence that the intervention reduces risk by between 2% and 50%.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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