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Presentation at a Training
Program on Biostatistics for physician managers working in Public Health
Administration, Qassim Province on May 1, 2013 by Professor Omar Hasan Kasule
Sr MB ChB (MUK), MPH (Harvard), DrPH (Harvard) EM: omarkasule@yahoo.com
Terminology
- Excess disease risk is measured as an absolute effect (Rate Difference or Risk Difference) or a relative effect (Odds Ratio and Rate Ratio).
- Other terms with meaning similar to rate ratio are relative risk and risk ratio
Data
lay out and definitions
- The following 2x2 contingency table shows the lay-out of data that can be used to define OR and RR.
Disease +
|
Disease -
|
time
|
||
Exposure
+
|
a
|
B
|
a
+ b
|
T+
|
Exposure
-
|
c
|
D
|
c
+ d
|
T-
|
a
+ c
|
b
+ d
|
N
|
T
|
- The Odds ratio is as OR = ad/bc by reference to the 2 x 2 contingency table above.
- The Rate Ratio is defined as RR = (a/T+) / (a/T-)
Interpretation
of the ratios
- A ratio of 1.0 is called the null value and is interpreted to mean that there is no relation between the disease and the exposure.
- A ratio above 1.0 means that the exposure increases the risk of disease
- A ratio below 1.0 means that the exposure protects from the disease.
- The OR and RR are often not very different numerically. The OR is used for case control studies and the RR is used for follow-up studies.