Estimating the relative risk in cohort studies and clinical trials of common outcomes.
Logistic regression yields an adjusted odds ratio that approximates the adjusted relative risk when disease incidence is rare (<10%), while adjusting for potential confounders. For more common outcomes, the odds ratio always overstates the relative risk, sometimes dramatically. The purpose of this paper is to discuss the incorrect application of a proposed method to estimate an adjusted relative risk from an adjusted odds ratio, which has quickly gained popularity in medical and public health research, and to describe alternative statistical methods for estimating an adjusted relative risk when the outcome is common. Hypothetical data are used to illustrate statistical methods with readily accessible computer software.
Department of Epidemiology, School of Public Health, University at Albany, State University of New York, Rensselaer, NY 12144, USA. lam08@health.state.ny.us
Louise-Anne
LA
McNutt
Chuntao
C
Wu
Xiaonan
X
Xue
Jean Paul
JP
Hafner
D002986:Clinical Trials as Topic / Q000379:methods*; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003627:Data Interpretation, Statistical; D006302:Health Services Research / Q000379:methods; D006801:Humans; D016017:Odds Ratio; D017063:Outcome Assessment, Health Care / Q000379:methods*; D016012:Poisson Distribution; D012306:Risk