SynthesisJournal of clinical epidemiology2022
Controversy and Debate: Questionable utility of the relative risk in clinical research: Paper 2: Is the Odds Ratio "portable" in meta-analysis? Time to consider bivariate generalized linear mixed model.
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 9 papers, 2 of them syntheses that pooled it.
What it found
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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.
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.
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Who cites it
9 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The normality assumption on between-study random effects was questionable in a considerable number of Cochrane meta-analyses.BMC medicine · 2023Pooled it
- Controversy and Debate : Questionable utility of the relative risk in clinical research: Paper 4 :Odds Ratios are far from "portable" - A call to use realistic models for effect variation in meta-analysis.Journal of clinical epidemiology · 2022Pooled it
- ZIBGLMM: Zero-inflated bivariate generalized linear mixed model for meta-analysis with double-zero-event studies.Research synthesis methods · 2025Article
- Advancing Interpretable Regression Analysis for Binary Data: A Novel Distributed Algorithm Approach.Statistics in medicine · 2024Article
- Variability of relative treatment effect among populations with low, moderate and high control group event rates: a meta-epidemiological study.BMC medical research methodology · 2024Article
- Tipping point analysis for the between-arm correlation in an arm-based evidence synthesis.BMC medical research methodology · 2024Article
- Review
- Meta-analysis with zero-event studies: a comparative study with application to COVID-19 data.Military Medical Research · 2021Article
- A review and comparison of arm-based versus contrast-based network meta-analysis for binary outcomes-Understanding their differences and limitations.Wiley interdisciplinary reviews. Computational statisticsArticle
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6 authors.
Funding
Abstract
objectivesA recent paper by Doi et al. advocated completely replacing the relative risk (RR) with the odds ratio (OR) as the effect measure in clinical trials and meta-analyses with binary outcomes. Besides some practical advantages of RR over OR, Doi et al.'s key assumption that the OR is "portable" in the meta-analysis, that is, study-specific ORs are likely not correlated with baseline risks, was not well justified. STUDY DESIGNS AND SETTINGS: We summarized Spearman's rank correlation coefficient between study-specific ORs and baseline risks in 40,243 meta-analyses from the Cochrane Database of Systematic Reviews.
resultsStudy-specific ORs tend to be higher in studies with lower baseline risks of disease for most meta-analyses in Cochrane Database of Systematic Reviews. Using an actual meta-analysis example, we demonstrate that there is a strong negative correlation between OR (RR or RD) with the baseline risk and the conditional effects notably vary with baseline risks.
conclusionsReplacing RR or RD with OR is currently unadvisable in clinical trials and meta-analyses. It is possible that no effect measure is "portable" in a meta-analysis. In addition to the overall (or marginal) effect, we suggest presenting the conditional effect based on the baseline risk using a bivariate generalized linear mixed model.
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Registered trials
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.