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Related Experiment Videos

Distributional interaction: Interpretational problems when using incidence odds ratios to assess interaction.

Ulka B Campbell1, Nicolle M Gatto1, Sharon Schwartz1

  • 1Department of Epidemiology, Mailman School of Public Health at Columbia University, New York, USA.

Epidemiologic Perspectives & Innovations : EP+I
|March 5, 2005
PubMed
Summary
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See all related articles

Incidence odds ratios can inaccurately estimate interaction effects, even for rare diseases, leading to "distributional interaction." Researchers must use caution when interpreting interaction estimates based on odds ratios, especially when disease risk is not negligible.

Area of Science:

  • Epidemiology
  • Biostatistics
  • Medical Research

Background:

  • Incidence odds ratios approximate risk ratios for rare diseases.
  • This approximation fails when assessing interaction, even for rare diseases.
  • Discrepancies can lead to misinterpretations in epidemiologic research.

Purpose of the Study:

  • Quantify the relationship between interaction odds ratios and interaction risk ratios.
  • Examine conditions causing divergence between these two estimates.
  • Discuss implications for assessing effect modification on additive and multiplicative scales.

Main Methods:

  • Derived a formula to quantify differences between odds ratios and risk ratios for effect modification.
  • Analyzed conditions under which these estimates diverge.

Related Experiment Videos

  • Expanded the discussion to additive effect modification.

    • Main Results:

    • Introduced "distributional interaction" where odds ratios show interaction not present in risk ratios.
    • Demonstrated that distributional interaction is possible even with low disease risk (<5%).
    • Illustrated the phenomenon with a literature example.

    Conclusions:

    • Caution is needed when interpreting interaction estimates derived from incidence odds ratios.
    • Distributional interaction can occur whenever outcome risk is non-negligible.
    • Accurate assessment of effect modification requires careful consideration of the ratio scale used.