Peripheral Neuropathy — Stratified Response-Ratio Table
Bayesian Causal Atlas · longevityresearch.ca · 2026-07-21
Why this is not a Pareto-optimum reduction. Every other oracle in the atlas reports a single combined endpoint reduction. This one cannot, and the reason is in the evidence, not the code.
Only 5 of 17 interventions carry a ratio-scale estimate at all; the rest are annualised risk differences, standardised mean differences, NNTs, bare response rates, or narrative verdicts (“Improves”, “Uncertain”, “Conflicting”, “Mixed”). More decisively, the ratios that do exist are responder ratios above 1 (e.g. RR 1.73 = 1.73× as likely to reach ≥50% pain reduction), not hazard ratios below 1, and they sit on different endpoints in different populations — incident neuropathy in T1DM, pain response in diabetic neuropathy, disability-grade improvement in Guillain–Barré, relapse in CIDP.
Multiplying them together would yield a number with no referent. So the interventions are presented stratified by population, ranked within stratum, and never composed. Rows are comparable within a block and not across blocks.
CIDP (1)
Best comparable ratio in stratum: IV immunoglobulin (IVIG) RR ≈ 2.6
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| IV immunoglobulin (IVIG) | ≥1-pt INCAT improvement, maintained @24wk | RR ≈ 2.6 | RR | higher = better (responder ratio) | 3 | — | high |
Painful DPN (4)
Best comparable ratio in stratum: Capsaicin 8% patch OR 2.28
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Capsaicin 8% patch | ≥30% pain relief | OR 2.28 | OR | higher = better (responder ratio) | — | 3.99 | mod |
| Duloxetine 60 mg | ≥50% pain relief @12wk | RR 1.73 | RR | higher = better (responder ratio) | 5 | 2.85 | mod |
| Gabapentin ≥1200 mg | ≥50% pain relief | RR 1.7 | RR | higher = better (responder ratio) | 6.6 | 2.79 | mod |
| Pregabalin 300–600 mg | ≥50% pain relief | NNT ≈ 5 | NNT | not ratio-scale — not comparable | 5 | — | mod |
GBS (severe) (2)
Best comparable ratio in stratum: Plasma exchange RR 1.64
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Plasma exchange | ≥1-grade improvement @4wk | RR 1.64 | RR | higher = better (responder ratio) | — | — | high |
| IV immunoglobulin (IVIG) | Recovery (7-grade disability) | ≈ Plasma exchange | narrative | not ratio-scale — not comparable | — | — | mod |
CIDP (IVIG-responsive) (1)
No ratio-scale estimate in this stratum — narrative or non-ratio evidence only.
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Subcutaneous immunoglobulin (SCIg) | Relapse/withdrawal over 24wk | 33% vs 63% | response rate | not ratio-scale — not comparable | 3 | — | high |
DPN (4)
No ratio-scale estimate in this stratum — narrative or non-ratio evidence only.
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Structured exercise | Nerve conduction, balance | Improves | narrative | not ratio-scale — not comparable | — | — | mod |
| Alpha-lipoic acid | Total Symptom Score | Conflicting | narrative | not ratio-scale — not comparable | — | — | low |
| Vitamin B12 / methylcobalamin | Symptoms / conduction | Mixed | narrative | not ratio-scale — not comparable | — | — | low |
| Acetyl-L-carnitine | Pain (SMD) | SMD −0.45 | SMD | not ratio-scale — not comparable | — | — | vlow |
Neuropathic pain (1)
No ratio-scale estimate in this stratum — narrative or non-ratio evidence only.
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Amitriptyline | Pain relief | Uncertain | narrative | not ratio-scale — not comparable | — | — | vlow |
Painful CIPN (2)
No ratio-scale estimate in this stratum — narrative or non-ratio evidence only.
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Duloxetine 60 mg (CIPN) | Avg pain (BPI 0–10) | MD 0.73 | MD | not ratio-scale — not comparable | — | — | mod |
| Capsaicin 8% patch (CIPN) | Clinician-rated relief | ≈44% | response rate | not ratio-scale — not comparable | — | — | low |
T1DM (1)
No ratio-scale estimate in this stratum — narrative or non-ratio evidence only.
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Intensive glycaemic control | Incident neuropathy | −1.84%/yr | risk difference | not ratio-scale — not comparable | — | — | high |
T2DM (1)
No ratio-scale estimate in this stratum — narrative or non-ratio evidence only.
| Intervention | Endpoint | Effect | Metric | Interpretation | NNT | E-value | Grade |
|---|
| Intensive glycaemic control | Incident neuropathy | −0.58%/yr | risk difference | not ratio-scale — not comparable | — | — | low |
Reading the table. Where the metric is RR or OR above 1, higher is better — these are the odds of reaching a responder threshold versus placebo. NNT is the number needed to treat for that same threshold. E-value is the minimum unmeasured-confounder strength needed to explain the result away. Grade is the source rating carried in the oracle.
What would change this. A combined optimum becomes computable only if the catalogue gains hazard ratios on a shared endpoint within a single population — not by parsing the existing text more cleverly.
Generated 2026-07-21 · every figure read directly from the oracle's own DATA catalogue; nothing derived or imputed