Relative versus absolute risk of comorbidities in patients with psoriasis - 18/04/17
Abstract |
Background |
Psoriasis is associated with numerous comorbidities, often reported in terms of relative risk. Both doctors and the general population tend to overestimate the effects of exposures when presented in relative terms, leading to anxiety and potentially poor treatment decisions. Absolute risks might provide a better basis for risk assessment.
Objective |
To characterize and compare relative and absolute risks of comorbidities in patients with psoriasis.
Methods |
A systematic review using Medline identified comorbidities associated with psoriasis, their relative risks, and information for calculating absolute risks.
Results |
The comorbidities associated with psoriasis with the highest relative risk were nonmelanoma skin cancer, melanoma, and lymphoma, with relative risks of 7.5, 6.12, and 3.61, respectively; the attributable risk for these 3 conditions were 0.64, 0.05, and 0.17 per 1000 person-years, respectively. To attribute 1 event of these conditions to psoriasis would require seeing 1551; 20,135; and 5823 patients, respectively.
Limitations |
Database studies might not fully account for confounders, resulting in overestimates of the risk impact of comorbidities.
Conclusions |
Presenting attributable risk in the form of the number needed to harm provides a clearer picture of the magnitude of risk and a basis for wiser medical decision making and patient education.
Le texte complet de cet article est disponible en PDF.Key words : attributed risk, excess risk, measurements, perception, systematic review
Abbreviations used : AAA, afib, CHD, COPD, MI, NOS, NNH
Plan
Funding source: The Center for Dermatology Research is supported by an unrestricted educational grant from Galderma Laboratories, LP. |
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Conflict of interest: Dr Feldman is a speaker for Janssen and Taro. He has received research, speaking, and consulting support from a variety of companies including Galderma, GSK/Stiefel, Almirall, Leo Pharma, Baxter, Boehringer Ingelheim, Mylan, Celgene, Pfizer, Valeant, AbbVie, Cosmederm Bioscience Inc, Anacor Pharmaceuticals Inc, Astellas Pharma, Janssen Pharmaceutical, Eli Lilly and Company, Merck, Merz, Novartis, Qurient Therapeutics, National Biological Corporation, Caremark, Advance Medical, Suncare Research, Informa, UpToDate, and National Psoriasis Foundation. He is the founder and majority owner of www.DrScore.com. He is founder and part owner of Causa Research, a company dedicated to enhancing patients' adherence to treatment. Mohammed D. Saleem and Chelsea Kesty have no conflicts to disclose. |
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Reprints not available from the authors. |
Vol 76 - N° 3
P. 531-537 - mars 2017 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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