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Patient-oriented evidence that matters: POEMs


Mammography plus ultrasound also resulted in significantly more recommendations for biopsy (84 vs 276), possibly resulting in both physical and emotional harm to those women with false positive screening test results. Because the prevalence of breast cancer is much lower in the general population of women aged 40 to 50 years than in this high-risk group (0.04% vs 1.5%, respectively), we need more patient-oriented evidence of benefit before routinely recommending both tests for all women in this age group. Patients in the active treatment group had lower rates of fatal stroke (absolute risk reduction [ARR] 0.42%/year, P = .046, number needed to treat [NNT] = 240/year), allcause mortality (ARR 1.2%, P = .02, NNT= 80/year), heart failure (ARR 0.95%, P .001, NNT= 105), and any cardiovascular event (ARR 1.7%, P .001, NNT= 59).

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