Are you involved in guideline development or policy making and interested in trying out TNT in a more structured way? Contact us – we would like your help in developing the method.
Learn more about TNT in this BMJ paper.
What is TNT?
Time Needed to Treat (TNT) is a new method to help facilitate for guideline panels and other relevant stakeholders to consider clinicians´ time as a finite resource when issuing recommendations. Specifically, TNT offers a structured approach to estimate the clinician time needed to implement a specific intervention.
TNT can be expressed as:
- the clinician time needed to improve the outcome for one person (TNTNNT)
- the clinician time needed to provide the intervention for all eligible in a population (absolute TNT)
- the proportion of the total clinician time available for patient care needed to implement the intervention for everyone eligible (relative TNT)
Why estimate TNT?
Clinicians face a barrage of guideline recommendations that in total are impossible to implement. As a result, clinicians must prioritize which recommendations to follow in which patients. Without guidance, and under the pressure of time, prioritizing decisions at the point of care may be implicit, variable, and likely often misguided.
The ultimate goal of estimating TNT is to avoid that clinicians and patients spend their limited time together on recommendations with smaller rather than greater importance to the individual patient, as well as to improve access to care for patients with the greatest need of medical attention.
Read more about why TNT is needed.
How you can estimate TNT
Check out our repository with estimates of TNTs for different guideline recommendations.
Have you estimated TNTs? Contact us – we would like to publish your estimates in the repository.
We plan for a range of projects to develop and refine the TNT method as well as to try out the usability of the concept. Specifically, we aim to explore:
- how TNT fits with current frameworks for guideline development
- for which kinds of recommendations that TNT is most relevant – and for which it may not be relevant at all
- how more sophisticated measures for efficiency can be incorporated into TNT estimates
- how TNT can be used to prioritize across guidelines
- to develop a “patient-TNT” – with the aim to help patients prioritize how to spend their (often) limited time for healthcare
Do you want to join this work?
Below a list of things you can do – if you have other ideas – reach out to us!
- Are you involved in guideline development or policy making and interested in trying out TNT in a more structured way? Contact us – we would like your help in developing the method
- Anyone can estimate TNTs for local/regional/national or international guidelines (contact us if you need help) – we would like to hear and learn from your experiences using the method – and publish your estimates in our TNT repository
- TNT estimates could be used to make policy makers aware of recommendations which pose unreasonable demands on clinician time – which might be especially important if such recommendations are tied to financial incentives or quality metrics for clinicians. If you are concerned about a specific guideline recommendation – make your own TNT estimates, or reach out to us if you need help – and maybe these estimates can be of use in the communication with your policy maker?
- Do you have other ideas? Let us know!