Evidence map›Paper›PMID 34380019›Full record

SynthesisJournal of clinical epidemiology2022

The Odds Ratio is "portable" across baseline risk but not the Relative Risk: Time to do away with the log link in binomial regression.

Suhail A Doi, Luis Furuya-Kanamori, Chang Xu, Tawanda Chivese, Lifeng Lin, Omran A H Musa, George Hindy, Lukman Thalib, Frank E Harrell

Abstract readMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Journal of clinical epidemiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 7 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
24citing papers in PubMed, 7 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

24 citing papers in PubMed, 7 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Trial
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

9 authors.

Suhail A DoiDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar. Electronic address: s.doi@gmx.net.
Luis Furuya-KanamoriResearch School of Population Health, College of Health and Medicine, Australian National University, Canberra, Australia.
Chang XuDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
Tawanda ChiveseDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
Lifeng LinDepartment of Statistics, Florida State University, Tallahassee, FL, USA.
Omran A H MusaDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
George HindyDepartment of Population Medicine, College of Medicine, QU Health, Qatar University, Doha, Qatar.
Lukman ThalibDepartment of Biostatistics, Faculty of Medicine, Istanbul Aydin University, Istanbul, Turkey.
Frank E HarrellDepartment of Biostatistics, Vanderbilt University School of Medicine, Nashville, TEN, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIn a recent paper we suggest that the relative risk (RR) be replaced with the odds ratio (OR) as the effect measure of choice in clinical epidemiology. In response, Chu, and colleagues raise several points that argue for the status quo. In this paper, we respond to their response. STUDY DESIGNS AND SETTINGS: We use the same examples given by Chu and colleagues to recompute estimates of effect and demonstrate the problem with the RR.

resultsWe reaffirm the following findings: a) the OR and RR measure different things and their numerical difference is only important if misinterpreted b) this potential misinterpretation is a trivial issue compared to the lack of portability of the RR c) the same examples reaffirm non-portability of the RR and demonstrate how misleading the results might be in contrast to the OR, which is independent of the baseline risk d) the concept of non-collapsibility for the OR should be expected in the presence of a non-confounding risk factor, and is not a bias e) the log link in regression models that generate RRs as well as the use of RRs in meta-analysis is shown to be problematic using the same examples.

conclusionThe OR should replace the RR in clinical research and meta-analyses though there should be conversion of the end product into ratios or differences of risk, solely, for interpretation. To this end we provide a Stata module (logittorisk) for this purpose.

Indexed as

Odds RatioHumansRiskBinary outcomeBinomial regressionEffect measureMeta-analysisNon-collapsibilityOdds ratioRelative riskRisk difference

Identifiers

PMID34380019

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.