Overestimation of risk ratios by odds ratios in trials and cohort studies: Alternatives to logistic regression

摘要

A cohort study evaluated the relation between changes in marital status of mothers and cannabis use by their children." Use of cannabis was reported by 48.6% of the participants at age 21. Table 1 presents the crude and adjusted odds ratios as reported in the paper for one to two changes in maternal marital status and the risk of cannabis use, and for three or more changes in maternal marital status and the risk of cannabis use. We calculated the corresponding crude and adjusted risk ratios (Table 1) based on the data provided in the article. The odds ratios and risk ratios were quite different: a modest increase of the risk by 50% (adjusted risk ratio is 1.5) was observed, whereas the "risk" seemed more than doubled when the odds ratio was interpreted as a risk ratio (adjusted odds ratio is 2.3).