ArticleEuropean journal of epidemiology2025
How hazard ratios can mislead and why it matters in practice.
Article in European journal of epidemiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
11 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Work-focused cognitive behavioural therapy for common mental disorders: a systematic review and meta-analysis.BMC psychology · 2026Pooled it
- Adherence to the EAT-Lancet diet and neuropsychiatric disorders: a systematic review and meta-analysis.Psychological medicine · 2026Pooled it
- Capturing Heterogeneous Time-Variation in Covariate Effects in Non-Proportional Hazard Regression Models.Biometrical journal. Biometrische Zeitschrift · 2026Article
- The (Mis)interpretation of Hazard Ratios in Clinical Trials.Journal of the American Society of Nephrology : JASN · 2026Article
- Age-related modification of the association between arterial blood pH and intensive care unit mortality: a nationwide retrospective observational study using the Japanese Intensive Care Patient Database (JIPAD).Journal of intensive care · 2026Article
- Menopause hormone therapy and type 2 diabetes risk and prognosis: systematic review and meta-analyses.Diabetologia · 2026Review
- A simple and powerful test of vaccine waning.American journal of epidemiology · 2026Article
- DEEP LEARNING OF SEMI-COMPETING RISK DATA VIA A NEW NEURAL EXPECTATION-MAXIMIZATION ALGORITHM.The annals of applied statistics · 2026Article
- Reframing-renaming(?)-myelodysplastic syndromes/neoplasms and clonal hematopoiesis of indeterminate potential.Leukemia · 2026Review
- Prior Concussions and Risk of Disability for Patients After a Motor Vehicle Crash.JAMA network open · 2026Article
- Critical appraisal of the prognostic value of relative visceral fat area in localized clear cell renal cell carcinoma.Annals of medicine and surgery (2012) · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
2 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Hazard ratios are routinely reported as effect measures in clinical trials and observational studies. However, many methodological works have raised concerns about the interpretation of hazard ratios as causal effects. These concerns are often related to three points: (i) depletion of susceptible individuals leads to selection bias and complicates the causal interpretation of the hazard ratio, (ii) the hazard ratio is not collapsible, and (iii) the conventional proportional hazards assumption rarely holds in medical studies. We discuss the relation between these three points. We ground our presentation on an example about effect of endocrine therapy in reducing the risk of recurrence or death in a population of patients with breast cancer. We also describe why survival curves and risk differences do not exhibit any of the undesirable properties of hazard ratios.
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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.