Prevalence odds ratio versus prevalence ratio: choice comes with consequences
Odds ratio, risk ratio, and prevalence ratio are some of the measures of association which are often reported in research studies quantifying the relationship between an independent variable and the outcome of interest. There has been much debate on the issue of which measure is appropriate to repor...
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| Published in | Statistics in medicine Vol. 35; no. 30; pp. 5730 - 5735 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Blackwell Publishing Ltd
30.12.2016
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 0277-6715 1097-0258 |
| DOI | 10.1002/sim.7059 |
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| Abstract | Odds ratio, risk ratio, and prevalence ratio are some of the measures of association which are often reported in research studies quantifying the relationship between an independent variable and the outcome of interest. There has been much debate on the issue of which measure is appropriate to report depending on the study design. However, the literature on selecting a particular category of the outcome to be modeled and/or change in reference group for categorical independent variables and the effect on statistical significance, although known, is scantly discussed nor published with examples. In this article, we provide an example of a cross‐sectional study wherein prevalence ratio was chosen over (Prevalence) odds ratio and demonstrate the analytic implications of the choice of category to be modeled and choice of reference level for independent variables. Copyright © 2016 John Wiley & Sons, Ltd. |
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| AbstractList | Odds ratio, risk ratio, and prevalence ratio are some of the measures of association which are often reported in research studies quantifying the relationship between an independent variable and the outcome of interest. There has been much debate on the issue of which measure is appropriate to report depending on the study design. However, the literature on selecting a particular category of the outcome to be modeled and/or change in reference group for categorical independent variables and the effect on statistical significance, although known, is scantly discussed nor published with examples. In this article, we provide an example of a cross‐sectional study wherein prevalence ratio was chosen over (Prevalence) odds ratio and demonstrate the analytic implications of the choice of category to be modeled and choice of reference level for independent variables. Copyright © 2016 John Wiley & Sons, Ltd. Odds ratio (OR), risk ratio (RR), and prevalence ratio (PR) are some of the measures of association which are often reported in research studies quantifying the relationship between an independent variable and the outcome of interest. There has been much debate on the issue of which measure is appropriate to report depending on the study design. However, the literature on selecting a particular category of the outcome to be modeled and/or change in reference group for categorical independent variables and the effect on statistical significance, although known, is scantly discussed nor published with examples. In this article, we provide an example of a cross-sectional study wherein PR was chosen over (Prevalence) OR and demonstrate the analytic implications of the choice of category to be modeled and choice of reference level for independent variables. Odds ratio, risk ratio, and prevalence ratio are some of the measures of association which are often reported in research studies quantifying the relationship between an independent variable and the outcome of interest. There has been much debate on the issue of which measure is appropriate to report depending on the study design. However, the literature on selecting a particular category of the outcome to be modeled and/or change in reference group for categorical independent variables and the effect on statistical significance, although known, is scantly discussed nor published with examples. In this article, we provide an example of a cross-sectional study wherein prevalence ratio was chosen over (Prevalence) odds ratio and demonstrate the analytic implications of the choice of category to be modeled and choice of reference level for independent variables. |
| Author | Westfall, Andrew O. Cutter, Gary R. Burkholder, Greer A. Tamhane, Ashutosh R. |
| AuthorAffiliation | 1 Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA 2 Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA |
| AuthorAffiliation_xml | – name: 2 Department of Biostatistics, University of Alabama at Birmingham, Birmingham, Alabama, USA – name: 1 Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, Alabama, USA |
| Author_xml | – sequence: 1 givenname: Ashutosh R. surname: Tamhane fullname: Tamhane, Ashutosh R. email: tamhane@uab.edu, Correspondence to: Ashutosh R Tamhane, Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, U.S.A., tamhane@uab.edu organization: Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, AL, Birmingham, U.S.A – sequence: 2 givenname: Andrew O. surname: Westfall fullname: Westfall, Andrew O. organization: Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, Birmingham, AL, U.S.A – sequence: 3 givenname: Greer A. surname: Burkholder fullname: Burkholder, Greer A. organization: Department of Medicine, Division of Infectious Diseases, University of Alabama at Birmingham, AL, Birmingham, U.S.A – sequence: 4 givenname: Gary R. surname: Cutter fullname: Cutter, Gary R. organization: Department of Biostatistics, University of Alabama at Birmingham, AL, Birmingham, U.S.A |
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| Keywords | association prevalence odds ratio odds ratio prevalence ratio risk ratio |
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| References | Nurminen M. To use or not to use the odds ratio in epidemiologic analysis? European Journal of Epidemiology 1995; 11:365-371. Zhang J, Yu K. What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. Journal of the Americal Medical Association 1998; 280(19):1690-1691. Newman S. Biostatistical Methods in Epidemiology. John Wiley & Sons: New York, NY, 2001. Zocchetti C, Consonni D, Bertazzi P. Relationship between prevalence rate ratios and odds ratios in cross-sectional studies. International Journal of Epidemiology 1997; 26:220-223. Walter SD. Choice of effect measure for epidemiological data. Journal of Clinical Epidemiology 2000; 53:931-939. Miettinen OS, Cook EF. Confounding: essence and detection. American Journal of Epidemiology 1981; 114:593-603. Lee J, Chia K. Prevalence odds ratio v prevalence ratio-a response. Occupational and Environmental Medicine 1995; 52:781-782. Cook T. Advanced statistics: up with odds ratios! a case for odds ratios when outcomes are common. Academic Emergency Medicine 2002; 9(12):1430-1434. Bland JM, Altman D. The odds ratio. British Medical Journal 2000; 320(7247):1468. Gordis L. Epidemiology (4th edn). Saunders Elsevier: USA, 2004. Axelson O, Fredriksson M, Ekberg K. Use of the prevalence ratio v the prevalence odds ratio in view of confounding in cross sectional studies. Occupational and Environmental Medicine 1995; 52:494-496. Greenland S. Interpretation and choice of effect measures in epidemiologic analysis. American Journal of Epidemiology 1987; 125:761-768. Stromberg U. Prevalence odds ratio v prevalence ratio. Occupational and Environmental Medicine 1994; 51:143-144. Kleinbaum D, Kupper L, Morgenstern H. Epidemiologic Research. Principles and Quantitative Methods: Lifetime Learning Publications: Belmont, California, 1982. Lee J, Chia K. Estimation of prevalence rate ratios for cross-sectional data: an example in occupational epidemiology. British Journal of Industrial Medicine 1993; 50:861-862. Schmidt C, Kohlmann T. When to use the odds ratio or the relative risk? International Journal of Public Health 2008; 53:165-167. Hughes K. Odds ratios in cross-sectional studies. International Journal of Epidemiology 1995; 24:463-464. Szklo M, Nieto FJ. Epidemiology Beyond the Basics (2nd edn). Jones and Bartlett: USA, 2007. Zocchetti C, Consonni D, Bertazzi P. Estimation of prevalence rate ratios from cross-sectional data. International Journal of Epidemiology 1995; 24:1064-1065. Thompson M, Myers J, Kriebel D. Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occupational and Environmental Medicine 1998; 55:272-277. Osborn J, Cattaruzza M. Odds ratio and relative risk for cross-sectional data. International Journal of Epidemiology 1995; 24:464-465. Eckerman S, Corry M, Willan A. Indirect comparison: relative risk fallacies and odds solution. Journal of Clinical Epidemiology 2009; 62:1031-1036. Senn S, Walter S, Olkin I. Odds ratio revisited. Evidence Based Medicine. 1998; 3:71. Lee L, Chia K. Use of the prevalence ratio v the prevalence odds ratio as a measure of risk in cross sectional studies. Occupational and Environmental Medicine 1994; 51:841. Zou G. A modified poisson regression approach to prospective studies with binary data. American Journal of Epidemiology 2004; 159(7):702-706. Lee J. Estimation of prevalence rate ratios from cross sectional data: a reply. International Journal of Epidemiology 1995; 24:1066-1067. Lee J. Odds ratio or relative risk for cross-sectional data. International Journal of Epidemiology 1994; 23:201-203. Stromberg U. Prevalence odds ratio v prevalence ratio-some further comments. Occupational and Environmental Medicine 1995; 42:143. Kleinbaum D, Sullivan K, Barker N. A Pocket Guide to Epidemiology. Springer: USA, 2007. Cumminngs P. The relative merits of risk ratios and odds ratios. Archives of Pediatrics & Adolescent Medicine 2009; 163(5):438-445. McNutt L, Wu C, Xue X, Hafner J. Estimating the relative risk in cohort studies and clinical trials of common outcomes. American Journal of Epidemiology 2003; 157(10):940-943. 1995; 52 1998; 280 2009; 62 2002; 9 1987; 125 1997; 26 1995; 11 1994; 23 2007 2004 2008; 53 2003; 157 1995; 42 2004; 159 2001 1993; 50 1981; 114 1995; 24 2000; 53 1998; 3 1982 2009; 163 2000; 320 1994; 51 1998; 55 28872254 - Stat Med. 2017 Oct 15;36(23):3760. doi: 10.1002/sim.7375 |
| References_xml | – reference: Zhang J, Yu K. What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes. Journal of the Americal Medical Association 1998; 280(19):1690-1691. – reference: Lee J, Chia K. Prevalence odds ratio v prevalence ratio-a response. Occupational and Environmental Medicine 1995; 52:781-782. – reference: Lee L, Chia K. Use of the prevalence ratio v the prevalence odds ratio as a measure of risk in cross sectional studies. Occupational and Environmental Medicine 1994; 51:841. – reference: Nurminen M. To use or not to use the odds ratio in epidemiologic analysis? European Journal of Epidemiology 1995; 11:365-371. – reference: Greenland S. Interpretation and choice of effect measures in epidemiologic analysis. American Journal of Epidemiology 1987; 125:761-768. – reference: Stromberg U. Prevalence odds ratio v prevalence ratio. Occupational and Environmental Medicine 1994; 51:143-144. – reference: Cumminngs P. The relative merits of risk ratios and odds ratios. Archives of Pediatrics & Adolescent Medicine 2009; 163(5):438-445. – reference: Cook T. Advanced statistics: up with odds ratios! a case for odds ratios when outcomes are common. Academic Emergency Medicine 2002; 9(12):1430-1434. – reference: Hughes K. Odds ratios in cross-sectional studies. International Journal of Epidemiology 1995; 24:463-464. – reference: Osborn J, Cattaruzza M. Odds ratio and relative risk for cross-sectional data. International Journal of Epidemiology 1995; 24:464-465. – reference: Senn S, Walter S, Olkin I. Odds ratio revisited. Evidence Based Medicine. 1998; 3:71. – reference: Lee J. Estimation of prevalence rate ratios from cross sectional data: a reply. International Journal of Epidemiology 1995; 24:1066-1067. – reference: Kleinbaum D, Kupper L, Morgenstern H. Epidemiologic Research. Principles and Quantitative Methods: Lifetime Learning Publications: Belmont, California, 1982. – reference: Zocchetti C, Consonni D, Bertazzi P. Estimation of prevalence rate ratios from cross-sectional data. International Journal of Epidemiology 1995; 24:1064-1065. – reference: Zocchetti C, Consonni D, Bertazzi P. Relationship between prevalence rate ratios and odds ratios in cross-sectional studies. International Journal of Epidemiology 1997; 26:220-223. – reference: Walter SD. Choice of effect measure for epidemiological data. Journal of Clinical Epidemiology 2000; 53:931-939. – reference: Schmidt C, Kohlmann T. When to use the odds ratio or the relative risk? International Journal of Public Health 2008; 53:165-167. – reference: Newman S. Biostatistical Methods in Epidemiology. John Wiley & Sons: New York, NY, 2001. – reference: Zou G. A modified poisson regression approach to prospective studies with binary data. American Journal of Epidemiology 2004; 159(7):702-706. – reference: Kleinbaum D, Sullivan K, Barker N. A Pocket Guide to Epidemiology. Springer: USA, 2007. – reference: Thompson M, Myers J, Kriebel D. Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? Occupational and Environmental Medicine 1998; 55:272-277. – reference: Miettinen OS, Cook EF. Confounding: essence and detection. American Journal of Epidemiology 1981; 114:593-603. – reference: Szklo M, Nieto FJ. Epidemiology Beyond the Basics (2nd edn). Jones and Bartlett: USA, 2007. – reference: Lee J. Odds ratio or relative risk for cross-sectional data. International Journal of Epidemiology 1994; 23:201-203. – reference: Eckerman S, Corry M, Willan A. Indirect comparison: relative risk fallacies and odds solution. Journal of Clinical Epidemiology 2009; 62:1031-1036. – reference: Stromberg U. Prevalence odds ratio v prevalence ratio-some further comments. Occupational and Environmental Medicine 1995; 42:143. – reference: Bland JM, Altman D. The odds ratio. British Medical Journal 2000; 320(7247):1468. – reference: Axelson O, Fredriksson M, Ekberg K. Use of the prevalence ratio v the prevalence odds ratio in view of confounding in cross sectional studies. Occupational and Environmental Medicine 1995; 52:494-496. – reference: Gordis L. Epidemiology (4th edn). Saunders Elsevier: USA, 2004. – reference: Lee J, Chia K. Estimation of prevalence rate ratios for cross-sectional data: an example in occupational epidemiology. British Journal of Industrial Medicine 1993; 50:861-862. – reference: McNutt L, Wu C, Xue X, Hafner J. Estimating the relative risk in cohort studies and clinical trials of common outcomes. American Journal of Epidemiology 2003; 157(10):940-943. – volume: 3 start-page: 71 year: 1998 article-title: Odds ratio revisited publication-title: Evidence Based Medicine. – volume: 52 start-page: 494 year: 1995 end-page: 496 article-title: Use of the prevalence ratio v the prevalence odds ratio in view of confounding in cross sectional studies publication-title: Occupational and Environmental Medicine – volume: 24 start-page: 464 year: 1995 end-page: 465 article-title: Odds ratio and relative risk for cross‐sectional data publication-title: International Journal of Epidemiology – volume: 23 start-page: 201 year: 1994 end-page: 203 article-title: Odds ratio or relative risk for cross‐sectional data publication-title: International Journal of Epidemiology – volume: 55 start-page: 272 year: 1998 end-page: 277 article-title: Prevalence odds ratio or prevalence ratio in the analysis of cross sectional data: what is to be done? publication-title: Occupational and Environmental Medicine – year: 2007 – year: 2001 – volume: 114 start-page: 593 year: 1981 end-page: 603 article-title: Confounding: essence and detection publication-title: American Journal of Epidemiology – volume: 125 start-page: 761 year: 1987 end-page: 768 article-title: Interpretation and choice of effect measures in epidemiologic analysis publication-title: American Journal of Epidemiology – volume: 157 start-page: 940 issue: 10 year: 2003 end-page: 943 article-title: Estimating the relative risk in cohort studies and clinical trials of common outcomes publication-title: American Journal of Epidemiology – volume: 24 start-page: 1066 year: 1995 end-page: 1067 article-title: Estimation of prevalence rate ratios from cross sectional data: a reply publication-title: International Journal of Epidemiology – volume: 9 start-page: 1430 issue: 12 year: 2002 end-page: 1434 article-title: Advanced statistics: up with odds ratios! a case for odds ratios when outcomes are common publication-title: Academic Emergency Medicine – volume: 51 start-page: 143 year: 1994 end-page: 144 article-title: Prevalence odds ratio v prevalence ratio publication-title: Occupational and Environmental Medicine – volume: 50 start-page: 861 year: 1993 end-page: 862 article-title: Estimation of prevalence rate ratios for cross‐sectional data: an example in occupational epidemiology publication-title: British Journal of Industrial Medicine – volume: 51 start-page: 841 year: 1994 article-title: Use of the prevalence ratio v the prevalence odds ratio as a measure of risk in cross sectional studies publication-title: Occupational and Environmental Medicine – volume: 163 start-page: 438 issue: 5 year: 2009 end-page: 445 article-title: The relative merits of risk ratios and odds ratios publication-title: Archives of Pediatrics & Adolescent Medicine – volume: 11 start-page: 365 year: 1995 end-page: 371 article-title: To use or not to use the odds ratio in epidemiologic analysis? publication-title: European Journal of Epidemiology – volume: 26 start-page: 220 year: 1997 end-page: 223 article-title: Relationship between prevalence rate ratios and odds ratios in cross‐sectional studies publication-title: International Journal of Epidemiology – volume: 53 start-page: 931 year: 2000 end-page: 939 article-title: Choice of effect measure for epidemiological data publication-title: Journal of Clinical Epidemiology – year: 1982 – volume: 53 start-page: 165 year: 2008 end-page: 167 article-title: When to use the odds ratio or the relative risk? publication-title: International Journal of Public Health – volume: 52 start-page: 781 year: 1995 end-page: 782 article-title: Prevalence odds ratio v prevalence ratio—a response publication-title: Occupational and Environmental Medicine – year: 2004 – volume: 62 start-page: 1031 year: 2009 end-page: 1036 article-title: Indirect comparison: relative risk fallacies and odds solution publication-title: Journal of Clinical Epidemiology – volume: 320 start-page: 1468 issue: 7247 year: 2000 article-title: The odds ratio publication-title: British Medical Journal – volume: 159 start-page: 702 issue: 7 year: 2004 end-page: 706 article-title: A modified poisson regression approach to prospective studies with binary data publication-title: American Journal of Epidemiology – volume: 42 start-page: 143 year: 1995 article-title: Prevalence odds ratio v prevalence ratio—some further comments publication-title: Occupational and Environmental Medicine – volume: 24 start-page: 463 year: 1995 end-page: 464 article-title: Odds ratios in cross‐sectional studies publication-title: International Journal of Epidemiology – volume: 280 start-page: 1690 issue: 19 year: 1998 end-page: 1691 article-title: What's the relative risk? A method of correcting the odds ratio in cohort studies of common outcomes publication-title: Journal of the Americal Medical Association – volume: 24 start-page: 1064 year: 1995 end-page: 1065 article-title: Estimation of prevalence rate ratios from cross‐sectional data publication-title: International Journal of Epidemiology – reference: 28872254 - Stat Med. 2017 Oct 15;36(23):3760. doi: 10.1002/sim.7375 |
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| Title | Prevalence odds ratio versus prevalence ratio: choice comes with consequences |
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