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Distribution of risk of the outcome among scenarios for which the calculated odds ratio and confidence interval coincide with the published values.
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In medical and epidemiological studies, the odds ratio is a commonly applied measure to approximate the relative risk or risk ratio in cohort studies. It is well known tha such an approximation is poor and can generate misleading conclusions, if the incidence rate of a study outcome is not rare. However, there are times when the incidence rate is n...
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Context 1
... answer this question, we obtain the rounded odds ratio and confidence interval if they coincide with the published values, then plot the corresponding risk of the study outcome in the control and treatment groups, respectively. Figure 1 suggests that, although the incidence rate is unknown from the published data, there is a clear evidence that the incidence is high (>18%) in both the control and treatment groups. Consequently, the reported odds ratio in Table 2 can potentially overestimate the true risk ratio. ...
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Citations
... Specifically, it uses the OR as the primary epidemiological measure and aligns it with the commonly used BMD modeling framework for regulatory risk assessment. The objective of this study is to investigate and compare two approaches: the "effective count" based BMD modeling approach (Allen et al., 2020b), combined with the Wang algorithm (Wang, 2013), and the adjusted OR-based BMD analysis approach (Shao et al., 2021). ...
... Model epidemiological data as dichotomous data This model works in two steps. Initially, data are pre-treated to derive the "effective counts" based on an approach following Allen et al. (2020b) and the Wang algorithm (Wang, 2013), that is, the effective number of cases A and of controls B obtained as we consider the OR and the interval of its SEs both varying with respect to the different dose groups. Eventually, the effective counts are modeled as dichotomous data to calculate BMDs as outlined in Shao and Shapiro (2018). ...
... where W symbolizes the Wang algorithm, N is the total number of subjects counting for all dosage groups, the bar symbol operator represents the mean over all the odds ratios and their lower and upper bound of the confidence interval at the 95% level, and SS is a sum of squares as defined in Wang (2013). Eventually, we derive the full number of effective counts for the treatment groups (that is, for all remaining dosage groups) by exploiting the previously mentioned condition on the number of subjects and, similarly, an equivalence of ORs between ...
Following a previous article that focused on integrating epidemiological data from prospective cohort studies into toxicological risk assessment, this paper shifts the focus to case‐control studies. Specifically, it utilizes the odds ratio (OR) as the main epidemiological measure, aligning it with the benchmark dose (BMD) methodology as the standard dose–response modeling approach to determine chemical toxicity values for regulatory risk assessment. A standardized BMD analysis framework has been established for toxicological data, including input data requirements, dose–response models, definitions of benchmark response, and consideration of model uncertainty. This framework has been enhanced by recent methods capable of handling both cohort and case‐control studies using summary data that have been adjusted for confounders.
The present study aims to investigate and compare the “effective count” based BMD modeling approach, merged with an algorithm used for converting odds ratio to relative risk in cohort studies with partial data information (i.e., the Wang algorithm), with the adjusted OR‐based BMD analysis approach. The goal is to develop an adequate BMD modeling framework that can be generalized for analyzing published case‐control study data. As in the previous study, these methods were applied to a database examining the association between bladder and lung cancer and inorganic arsenic exposure. The results indicate that estimated BMDs and BMDLs are relatively consistent across both methods. However, modeling adjusted OR values as continuous data for BMD estimation aligns better with established practices in toxicological BMD analysis, making it a more generalizable approach.
... Also, to convert the results reported in RR to OR, the following conversion was used(25): ...
Introduction
Air pollution is widely acknowledged as a significant factor in respiratory outcomes, including coughing, wheezing, emergency department (ED) visits, and even death. Although several literature reviews have confirmed the association between air pollution and respiratory outcomes, they often did not standardize associations across different studies and overlooked other increasingly impactful pollutants such as trace metals. Recognizing the importance of consistent comparison and emissions of non-exhaust particles from road traffic, this study aims to comprehensively evaluate the standardized effects of various criteria pollutants and trace metals on respiratory health.
Methods
We conducted a comprehensive meta-analysis of peer-reviewed journal articles on air pollution and respiratory outcomes published between 1 January 2000, and 1 June 2024. The study included children (age < 18 years), adults (age ≥ 18 years), and all age groups exposed to criteria pollutants established by the US Environmental Protection Agency National Ambient Air Quality Standards and over 10 trace metals. Using databases, such as PubMed, MEDLINE, Web of Science Core Collection, and Google Scholar, we identified 579 relevant articles. After rigorous screening and quality assessment using the Newcastle-Ottawa Scale, 50 high-quality studies were included. We converted various reported outcomes (e.g., odds ratios, relative risk, and percent increase) to a standardized odds ratio (OR) for comparability and performed meta-analyses using R 4.4.0 and related packages, ensuring the robustness of our findings.
Results
Our meta-analysis indicated significant associations between air pollutants and respiratory outcomes. For particulate matter with diameter ≤ 2.5 μm (PM2.5), the overall ORs for children, adults, and combined age groups were 1.31, 1.10, and 1.26, respectively, indicating a consistent positive association. Similar positive associations were observed for particulate matter with diameter ≤ 10 μm (PM10) and other pollutants, with children showing higher susceptibility than adults. The analysis of trace metals also showed significant associations; however, these findings require cautious interpretation due to the small number of studies.
Conclusion
Our study supports associations between air pollutants, including non-exhaust trace metals, and respiratory outcomes across different age groups. The findings underscore the need for stringent environmental health policies and further research, especially in regions with higher pollution levels. The future studies should consider long-term and short-term exposures separately and include diverse populations to improve the accuracy and generalizability of the results.
... time-to-first opioid prescription) or incidence rates (number of opioid prescriptions over time), we will convert the HR or RR to an OR using a baseline risk (i.e. proportion of patients in the non-chiropractic care control group who had the events) before pooling [32]. Continuous outcomes such as pain intensity, physical and emotional functioning, sleep quality, or morphine equivalent dose will be pooled as weighted mean differences (WMDs) with associated 95% CIs after converting different instruments that report on the same domain (e.g. ...
Background
In recent studies, receipt of chiropractic care has been associated with lower odds of receiving prescription opioids and, among those already prescribed, reduced doses of opioids among patients with non-cancer spine pain. These findings suggest that access to chiropractic services may reduce reliance on opioids for musculoskeletal pain.
Objective
To assess the impact of chiropractic care on initiation, or continued use, of prescription opioids among patients with non-cancer spine pain.
Methods
We will search for eligible randomized controlled trials (RCTs) and observational studies indexed in MEDLINE, Embase, AMED, CINAHL, Web of Science, and the Index to Chiropractic Literature from database inception to June 2024. Article screening, data extraction, and risk-of-bias assessment will be conducted independently by pairs of reviewers. We will conduct separate analyses for RCTs and observational studies and pool binary outcomes (e.g. prescribed opioid receipt, long-term opioid use, and higher versus lower opioid dose) as odds ratios (ORs) with associated 95% confidence intervals (CIs). When studies provide hazard ratios (HRs) or relative risks (RRs) for time-to-event data (e.g. time-to-first opioid prescription) or incidence rates (number of opioid prescriptions over time), we will first convert them to an OR before pooling. Continuous outcomes such as pain intensity, sleep quality, or morphine equivalent dose will be pooled as weighted mean differences with associated 95% CIs. We will conduct meta-analyses using random-effects models and explore sources of heterogeneity using subgroup analyses and meta-regression. We will evaluate the certainty of evidence of all outcomes using the GRADE approach and the credibility of all subgroup effects with ICEMAN criteria. Our systematic review will follow the PRISMA statement and MOOSE guidelines.
Discussion
Our review will establish the current evidence informing the impact of chiropractic care on new or continued prescription opioid use for non-cancer spine pain. We will disseminate our results through peer-reviewed publication and conference presentations. The findings of our review will be of interest to patients, health care providers, and policy-makers.
Trial registration
Systematic review registration: PROSPERO CRD42023432277.
... , where σ X is the standard deviation of the independent variable and σ Y is standard deviation of the dependent variable. When risk ratios (RRs) were reported, we transformed them into odds ratios (ORs) using the following formula (Wang, 2013): ...
Background: Evidence of racism's health harms among children and youth is rapidly increasing, though attention to impacts on physical health and biomarker outcomes is more emergent. We performed a systematic review of recent publications to examine the association between racism and health among children and youth, with a meta-analysis of the specific relationships between racism and physical health and biomarkers.
Methods: We conducted a systematic literature search using four databases: Medline, PsycINFO, PubMed, and ERIC. Four inclusion criteria were used to identify eligible studies: (1) exposure was experiences of racism, (2) outcome was health and wellbeing, (3) quantitative methods were used to estimate the association between racism and health outcomes, and (4) the effect size of associations between racism and health and wellbeing was reported for participants aged 0-24 years. Correlation coefficients were used to report the pooled effect size for each outcome indicator.
Results: There were 463 eligible studies included in the screening process, with 42 studies focusing on physical health or biomarker outcomes. Random-effects meta-analysis found minimal to moderate positive associations between racism and C-reactive protein, Interleukin 6, body mass index (BMI), obesity, systolic blood pressure, salivary cortisol, asthma, and somatic symptoms. There were marginal positive associations between racism and Tumour Necrosis Factor-α, cortisol collected via saliva, urine and hair, BMI-z score, and diastolic blood pressure, with imprecise estimates and wide confidence intervals.
Conclusions: Racism is associated with negative physical health and biomarker outcomes that relate to multiple physiological systems and biological processes in childhood and adolescence. This has implications for health and wellbeing during childhood and adolescence and future chronic disease risk. Collective and structural changes to eliminate racism and create a healthy and equitable future for all children and youth are urgently required.
... In studies that reported the measure of association as a hazard ratio (HR) or risk ratio (RR), we converted them to ORs using the outcome prevalence reported in the studies. [14][15]. When measures of association were not provided for dichotomous variables, we used the crude event rate to calculate ORs. ...
Introduction
One of the challenges in managing patients with hantavirus infection is accurately identifying individuals who are at risk of developing severe disease. Prompt identification of these patients can facilitate critical decisions, such as early referral to an intensive care unit. The identified prognostic factors could be incorporated into predictive models to enhance the management of hantavirus infection.
Objective
To identify and evaluate prognostic factors associated with mortality in hantavirus infection, providing a basis for a risk assessment model for hantavirus mortality
Methods
We conducted a systematic review following the 'Preferred Reporting Items for Systematic Reviews and Meta-Analyses' (PRISMA) guidelines. We conducted a comprehensive search in PubMed/MEDLINE, Cochrane Central Register of Controlled Trials (CENTRAL), and Embase from their inception to January 2024. Furthermore, we included studies evaluating individual prognostic factors or risk assessment models of hantavirus infections, with no restrictions on study design, publication status, or language. When feasible, we conducted meta-analyses for prognostic factors using the inverse variance-based method with random effect model. We assessed the certainty of the evidence using the GRADE approach,
Results
We included 30 studies with a total of 92,183 participants. We identified the following key prognostic factors which predicted and increased mortality and disease severity: over 15 years, female gender, elevated creatinine levels (>1.4 mg/dL), increased hematocrit (>42%), and presence of infiltrates on chest radiographs.
Discussion
Our systematic review not only sheds light on the pivotal prognostic factors for hantavirus infection but also sets the stage for the development of comprehensive management strategies that are informed by robust empirical evidence. These strategies, underpinned by predictive modeling and regional customization, can significantly enhance outcomes for individuals at risk of severe hantavirus disease, aligning with global health objectives aimed at zoonotic disease control and prevention.
... We standardized each risk factor by log-transformation and unifying the direction of the predictors [15]. In studies that reported the measure of association as hazard ratio or risk ratio, we converted them to OR using the baseline risk reported in the studies [16,17]. We conducted a meta-analysis of associations using the generic inverse variance-based method to produce an overall measure of association. ...
Background
Thrombolysis-related intracranial hemorrhage has a high mortality rate, and many factors can cause intracranial hemorrhage. Until now, systematic reviews and assessments of the certainty of the evidence have not been updated.
Aim
We conducted a systematic review to identify risk factors for thrombolysis-related intracranial hemorrhage.
Method
The protocol for this systematic review was prospectively registered with PROSPERO (CRD42022316160). All English studies that met the inclusion criteria published before January 2022 were obtained from PubMed, EMBASE, Web of Science, and Cochrane Library. Two researchers independently screened articles, extracted data, and evaluated the quality and evidence of the included studies. Risk factors for intracranial hemorrhage were used as the outcome index of this review. Random or fixed-effect models were used in statistical methods.
Results
Of 6083 citations, we included 105 studies in our analysis. For intracranial hemorrhage, moderate-certainty evidence showed a probable association with age, National Institutes of Health stroke scale, leukoaraiosis, hypertension, atrial fibrillation, diabetes, total cholesterol, proteinuria, fibrinogen levels, creatinine, homocysteine, early infarct signs, antiplatelet therapy and anticoagulant therapy; In addition, we found low-certainty evidence that there may be little to no association between risk of intracranial hemorrhage and weight, sex, platelet count, uric acid, albumin and white matter hyperintensity. Leukoaraiosis, cardiovascular disease, total cholesterol, white blood cell count, proteinuria, fibrinogen levels, creatinine, homocysteine and early CT hypodensities are not included in most intracranial hemorrhage risk assessment models.
Conclusion
This study informs risk prediction for thrombolysis-related intracranial hemorrhage, it also informs guidelines for intracranial hemorrhage prevention and future research.
... We used RRs instead of ORs because when the outcome is not rare, ORs tend to overestimate the strength of association (18). When ORs for post-AMI all-cause mortality were reported instead of RRs, the unadjusted RRs were calculated from the study sample size, number of men or women with and without diabetes, the sexspecific crude post-AMI all-cause mortality rates by diabetes status using a R package (orsk) (19). ...
Background
The prevalence of diabetes and its impact on mortality after acute myocardial infarction (AMI) are well-established. Sex-specific analyses of the impact of diabetes on all-cause mortality after AMI have not been updated and comprehensively investigated.
Objective
To conduct a systematic review and meta-analysis that examined sex-specific short-term, mid-term and long-term all-cause mortality associated with diabetes among AMI survivors (diabetes versus non-diabetes patients in men and women separately), using up-to-date data.
Methods
We systematically searched Embase and MEDLINE for studies that were published from inception to November 14, 2021. Studies were included if (1) they studied post-AMI all-cause-mortality in patients with and without diabetes, (2) sex-specific all-cause mortality at short-term (in-hospital or within 90 days after discharge), mid-term (>90 days and within 5 years), and/or long-term (>5 years) were reported. From eligible studies, we used random effects meta-analyses models to estimate pooled unadjusted and adjusted sex-specific risk ratio (RR) of all-cause mortality at short-, mid-, and long-term follow-up for adults with diabetes compared with those without diabetes.
Results
Of the 3647 unique studies identified, 20 studies met inclusion criteria. In the unadjusted analysis (Total N=673,985; women=34.2%; diabetes patients=19.6%), patients with diabetes were at a higher risk for all-cause mortality at short-term (men: RR, 2.06; women: RR, 1.83); and mid-term follow-up (men: RR, 1.69; women: RR, 1.52) compared with those without diabetes in both men and women. However, when adjusted RRs were used (Total N=7,144,921; women=40.0%; diabetes patients=28.4%), the associations between diabetes and all-cause mortality in both men and women were attenuated, but still significantly elevated for short-term (men: RR, 1.16; 95% CI, 1.12-1.20; women: RR, 1.29; 95% CI, 1.15-1.46), mid-term (men: RR, 1.39; 95% CI, 1.31-1.46; women: RR, 1.38; 95% CI, 1.20-1.58), and long-term mortality (men: RR, 1.58; 95% CI, 1.22-2.05; women: RR, 1.76; 95% CI, 1.25-2.47). In men, all-cause mortality risk associated with diabetes tended to increase with the duration of follow-up (p<0.0001).
Conclusions
Diabetes has substantial and sustained effects on post-AMI all-cause mortality at short-term, mid-term and long-term follow-up, regardless of sex. Tailoring AMI treatment based on patients’ diabetes status, duration of follow-up and sex may help narrow the gap in all-cause mortality between patients with diabetes and those without diabetes.
... We reported the adjusted relative risks (aRRs) with 95% confidence intervals (CIs) that were converted from odds ratios in an established method. [13,14] ...
Background
Our recent observational study showed that regular consumption of cow’s milk (CM) formula during early infancy (3–6 months old) was associated with a reduced risk of CM allergy (CMA) at 12 months old. However, the long-term association is unclear. The present study was aimed to examine how long this inverse association persists after 12 months old.
Methods
This study used the dataset of an ongoing nationwide prospective cohort, the Japan Environment and Children’s Study, in which participants were registered between January 2011 and March 2014. We analyzed 65,568 children followed-up until 36 months old. The exposure factors were the consumption statuses of formula milk from 0–3, 3–6, and 6–12 months old. The primary outcome was the prevalence of CMA at 6, 12, 18, 24 and 36 months old. CMA was defined as an allergic reaction and sensitization to CM protein in an individual with no or limited intake of this protein at the evaluation time, combined with physician-diagnosed food allergy. Multivariable regression models were used to estimate the association between the periods of formula consumption and the prevalence of CMA.
Results
The prevalence of CMA increased with a peak of 1.51% at 18 months old and then declined to 0.79% at 36 months old. Formula milk from 3–6 months old was associated with a reduced risk of CMA throughout the first 3 years of life, although the extent of the reduction was mitigated with age (adjusted relative risk: [95% confidence interval]: 0.19 [0.10–0.34] at 12 months old, 0.23 [0.16–0.33] at 18 months old, 0.41 [0.26–0.64] at 24 months old, and 0.47 [0.26–0.80] at 36 months old). The association between early formula and CMA were observed in both children with and without eczema, but more prominent and long-lasting in the former than the latter.
Conclusions
Regular exposure to CM protein during infancy was associated with a reduced prevalence of CMA during early childhood. At present, however, this observational study does not necessarily encourage formula feeding, and randomized controlled trials are warranted to confirm the findings and their significance.
... The log odds ratio output from the glm() was converted into a relative risk score and accompanying 95% confidence interval using the function odds_to_rr() from the sjstats package. This function uses the equation: Zhang and Yu (1998), Wang (2013) and Grant (2014). ...
Background
Newcastle disease (ND) is an economically important viral disease affecting the poultry industry. In Kerala, a state in South India, incidences of ND in commercial and backyard poultry have been reported. But a systematic statewide study on the prevalence of the disease has not been carried out.
Objectives
A cross‐sectional survey was performed to detect the presence of Newcastle disease virus (NDV) in suspect cases and among apparently healthy commercial flocks and backyard poultry, in the state and to identify risk factors for NDV infection.
Methods
Real‐time reverse transcription‐PCR (RT‐PCR) was used to detect the M gene of NDV in choanal swabs and tissue samples collected from live and dead birds, respectively and the results were statistically analysed.
Results
The predominant clinical signs of the examined birds included mild respiratory signs, huddling together and greenish diarrhoea. Nervous signs in the form of torticollis were noticed in birds in some of the affected flocks. On necropsy, many birds had haemorrhages in the proventriculus and caecal tonsils which were suggestive of ND. Of the 2079 samples tested, 167 (8.0%) were positive for the NDV M‐gene by RT‐PCR. Among 893 samples collected from diseased flocks, 129 (14.5%), were positive for M gene with pairwise relative risk (RR) of 15.6 as compared to apparently healthy flocks where 6 out of 650 (0.9%) samples were positive. All positive samples were from poultry; none of the ducks, pigeons, turkey and wild birds were positive. Commercial broilers were at higher risk of infection than commercial layers (RR: 4.5) and backyard poultry (RR: 4.9). Similarly, birds reared under intensive housing conditions were at a higher risk of being infected as compared to those reared under semi‐intensive (RR: 6.7) or backyard housing (RR: 2.1). Multivariable analysis indicated that significantly higher risk of infection exists during migratory season and during ND outbreaks occurring nearby. Further, lower risk was observed with flock vaccination and backyard or semi‐intensive housing when compared to intensive housing. When the M gene positive samples were tested by RT‐PCR to determine whether the detected NDV were mesogenic/velogenic, 7 (4.2%) were positive.
Conclusions
In Kerala, NDV is endemic in poultry with birds reared commercially under intensive rearing systems being affected the most. The outcome of this study also provides a link between epidemiologic knowledge and the development of successful disease control measures. Statistical analysis suggests that wild bird migration season and presence of migratory birds influences the prevalence of the virus in the State. Further studies are needed to genotype and sub‐genotype the detected viruses and to generate baseline data on the prevalence of NDV strains, design better detection strategies, and determine patterns of NDV transmission across domestic poultry and wild bird populations in Kerala.
... Table 1 was later transformed to two by two simple contingency table, in which antenatal women that uptake partial and optimal IPTp SP were categorizes as exposed group, while those with 0-Dose were unexposed group. The odds ratio is the probability that an event will happened divided by the probability that an event will not happened [14]. This research intended to determine the odds that malaria in pregnancy will occur among women who were exposed to IPTp and the magnitude of the effect. ...
