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Hazard rate ratio and prospective epidemiological studies.
1Department of Biostatistics, CB #7420, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599-7420, USA. symons@bios.unc.edu
Journal of Clinical Epidemiology
|October 24, 2002
Summary
Epidemiologic measures like hazard rate ratio and relative risk diverge with longer follow-up and higher risks. Accurate terminology is crucial, using hazard rate ratio with Cox regression and odds ratio with logistic regression.
Area of Science:
- Epidemiology
- Biostatistics
Background:
- Prospective follow-up data analysis often employs Cox regression models.
- Epidemiologic measures such as hazard rate ratio, relative risk, and odds ratio are frequently used to interpret these models.
Purpose of the Study:
- To clarify the distinctions and relationships between hazard rate ratio, relative risk, and odds ratio.
- To emphasize the factors influencing the divergence of these measures and advocate for precise terminology.
Main Methods:
- Analysis of prospective follow-up data using Cox regression models.
- Comparison of hazard rate ratio, relative risk, and odds ratio under varying conditions.
Main Results:
- Hazard rate ratio consistently exceeds relative risk and is less than the odds ratio when greater than 1.0.
- Divergence increases with follow-up length, endpoint occurrence rate, and risk magnitude (especially risks > 2.5).
- Measures approximate each other with shorter follow-up, rarer endpoints, and risks near 1.0.
Conclusions:
- Consistent use of terminology is recommended: hazard rate ratio for Cox regression, odds ratio for logistic regression.
- Relative risk is appropriate when it is the specific modeling objective, such as with Poisson regression.
- Understanding the divergence factors is key for accurate interpretation of epidemiologic measures.