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The number needed to treat (NNT) was introduced into the medical literature as an easily understood and useful measure of treatment effect for clinical trials in which the main outcome variable is binary. It has been argued that it is more easily understood by practising physicians than more statistically based measures. In this paper we review the claims made for the NNT and question whether it is truly understandable to physicians, and look at issues around determining a confidence interval, or a Bayesian interval, for the NNT. Copyright © 2003 John Wiley & Sons, Ltd.