5M-EBM2011-08 03 Relative Risk

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5 MINUTES:: 

5 MINUTES: Today: RELATIVE RISK

RR – Relative Risk: 

RR – Relative Risk Risk of an event relative to exposure Event can be disease or death Exposure can be to exposure to therapy or environmental exposure

Here’s the 2x2 table again: 

Here’s the 2x2 table again interesting outcome Present Absent total Exposed a b a+b Not exposed c d c+d Total a+c b+d a+b+c+d

How to calculate the RR: 

How to calculate the RR interesting outcome Present Absent total Exposed a b a+b Not exposed c d c+d Total a+c b+d a+b+c+d [ a/( a+b ) ] / [ c/( c+d ) ] a/( a+b ) c /( c+d )

Example: “July Effect “ : 

Example: “July Effect “ Review “July Effect”: Impact of the Academic Year-End Changeover on Patient Outcomes. A Systematic Review John Q. Young , MD, MPP; Sumant R. Ranji , MD; Robert M. Wachter , MD; Connie M. Lee , MD; Brian Niehaus , MD; and Andrew D. Auerbach , MD, MPH

“July Effect” and mortality: 

“July Effect” and mortality interesting outcome (mortality) Present Absent (dead) (not dead) total Exposed a (36) b (964) a+b (1000) (July admission) Not exposed c (3) d (997) c+d (1000) (admission out of July) Total a+c b+d a+b+c+d [ a/( a+b ) ] / [ c/( c+d ) ] 36/1000 3/1000 =12

What does the RR mean?: 

What does the RR mean? = 1  no difference > 1  more likely to occur in test group < 1  less likely to occur in test group [a/( a+b )] / [c/( c+d )]

RR – remember:: 

RR – remember: Use in RCT and cohort studies Need group of people with and without exposure Cannot use if case-control study No information about the actual risk

Slide 9: 

That’s it. Thanks.