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Relative risks (RRs) and prevalence ratios (PRs) are measures of association that are more intuitively interpretable than odds ratios (ORs). Many health science studies report OR estimates, however, even when their designs permit and study questions target RRs and/or PRs. This is, partially, attributable to the popularity and technical advantage (i.e. no restriction on the parameter space) of logistic regression for estimating ORs. To improve this practice, several biostatistical approaches for estimating RR/PR, adjusting for potential confounders, have been proposed. In this paper, we consider two RR/PR estimating methods: (1) the modification of log-binomial regression with the COPY method; and (2) an inverse-probability-of-treatment-weighted (IPTW) log-binomial regression we newly propose. For the COPY method, we rigorously establish the existence and uniqueness of the maximum-likelihood estimator, provided certain degeneracies in the data do not occur. Moreover, the global maximum of the COPY-modified likelihood is shown to occur at an interior point of the restricted parameter space. This result explains why the COPY method avoids convergence problems of log-binomial models frequently. For the IPTW estimator, we show that its simple procedure results in standardized estimates of RR/PR, and discuss its potential challenges, extensions, and an improvement through propensity-score-based grouping of observations. Furthermore, we compare the performances of four RR/PR estimation methods, including the COPY method and IPTW log-binomial regression, on simulated data. We demonstrate a lack of robustness of the COPY method against misspecification of the true relationship between binary outcome and explanatory variables, and show robustness of the IPTW approach in this regard.
Department of Public Health Sciences, University of Alberta, 3-12 University Terrace, Edmonton, AB T6G2T4, Canada.
This article was published in the following journal.
Name: Statistics in medicine
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The ratio of two odds. The exposure-odds ratio for case control data is the ratio of the odds in favor of exposure among cases to the odds in favor of exposure among noncases. The disease-odds ratio for a cohort or cross section is the ratio of the odds in favor of disease among the exposed to the odds in favor of disease among the unexposed. The prevalence-odds ratio refers to an odds ratio derived cross-sectionally from studies of prevalent cases.
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The qualitative or quantitative estimation of the likelihood of adverse effects that may result from exposure to specified health hazards or from the absence of beneficial influences. (Last, Dictionary of Epidemiology, 1988)
The waist circumference measurement divided by the hip circumference measurement. For both men and women, a waist-to-hip ratio (WHR) of 1.0 or higher is considered "at risk" for undesirable health consequences, such as heart disease and ailments associated with OVERWEIGHT. A healthy WHR is 0.90 or less for men, and 0.80 or less for women. (National Center for Chronic Disease Prevention and Health Promotion, 2004)
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