Measures of Association and Public Health Impact (36 points)

67 Preventing Infection Match the practices with the correct principles for surgical asepsis. A. A sterile item can only touch another sterile item.
November 13, 2019
28. Minor blows to the head never lead to long-term brain injury.
November 13, 2019

Measures of Association and Public Health Impact (36 points)

You recently assisted a US team of investigators in determining the association between inter-partner violence (IPV) and fetal brain damage. Now, a group of investigators from New Zealand are looking to test a new intervention coined “Partners Unite” which they hope will reduce the level of IPV-associated fetal brain damage during pregnancy. The New Zealand team conducted a randomized trial using the current “standard of care” as the control. Consented pregnant mothers were randomized to either the new intervention or the standard of care. A total of 3,800 participants were enrolled with equal frequency to each of the study arms. Following enrollment, fifteen women in the treatment arm and 20 in the control arm were excluded for the following reasons: fetal death before ultrasound exams, congenital malformation, and loss to follow-up. Follow-up included a series of fetal brain ultrasounds to determine fetal brain size. A cut-off at the fifth percentile of the fetal brain size distribution curve, adjusted for gestational age, was used to denote reduced fetal brain size. At the end of the trial, the relative risk (as measured by the risk ratio) of fetal brain reduction in the treatment group as compared to the standard of care was 0.571. If 35% of the pregnant women in the “standard of care” control group had positive ultrasound findings for fetal brain reduction, answer the following

What was the efficacy of the clinical trial? (3 points)

Compute the NNT (number needed to treat in order to prevent one additional case of reduced fetal brain size using the new intervention instead of standard of care). Also, how many people do we need to treat how many pregnant women to prevent 10 additional cases of reduced fetal brain size, using the “Partners Unite” intervention instead of the standard of care. (4 points)

Based on your answer in #3, is the new intervention efficacious? Why or why not? (3 points)

 

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