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Relative and Attributable Risks. Absolute Risk. Involves people who contract disease due to an exposure Doesn’t consider those who are sick but haven’t been exposed. Calculating Excess Risk. Relative Risk. Definition:
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Absolute Risk • Involves people who contract disease due to an exposure • Doesn’t consider those who are sick but haven’t been exposed
Relative Risk Definition: A measure of the strength of association based on prospective studies (cohort studies).
Relative Risk in Case-Control Studies • Can’t derive incidence from case-control studies • Begin with diseased people (cases) and non-diseased people (controls) • Therefore, can’t calculate relative risk directly • But, we can use another method called an odds ratio
When is the Odds Ratio a Good Estimate of Relative Risk? • When cases are representative of diseased population • When controls are representative of population without disease • When the disease being studied occurs at low frequency
REMEMBER !!! • An odds ratio is a useful measure of association • In a cohort study, the relative risk can be calculated directly • In a case-control study the relative risk cannot be calculated directly, so an odds ratio is used instead
Attributable Risk Definition: The amount of disease that can be attributed to a certain exposure.
Attributable Risk for an Exposed Group (cont.) From previous relative risk example: OR, expressed as a proportion:
Calculation for Proportional Incidence in Total Population First calculate A-R for group from Formulas 11.1 & 11.2 (previous slide), then use Formula 11.3 For proportion of the incidence in the total population, use Formula 11.4
Summary • Relative risk and odds ratio are important as measures of the strength of association • Important for deriving causal inference • Attributable risk is a measure of how much disease risk is attributed to a certain exposure • Useful in determining how much disease can be prevented • Therefore: • Relative risk is valuable in etiologic studies of disease • Attributable risk is useful for Public Health guidelines and planning