# Relative risk, Risk difference and Odds ratio

When the data to be analyzed consist of counts in a cross-classification of two groups (or conditions) and two outcomes, the data can be represented in a fourfold table as follows:

Group 1 | Group 2 | Total | |
---|---|---|---|

Number with positive outcome | a | c | a+c |

Number with negative outcome | b | d | b+d |

Total | a+b | c+d | a+b+c+d |

Several statistics can be calculated such as relative risk and risk difference, relevant in prospective studies, and odds ratio, relevant in retrospective case controls studies.

## How to calculate Relative Risk

The relative risk (RR), its standard error and 95% confidence interval are calculated as follows (Altman, 1991).

The relative risk or risk ratio is given by

with the standard error of the log relative risk being

and 95% confidence interval

## Risk difference

The risk difference (RD) and its 95% confidence interval are calculated according to Newcombe & Altman (2000)

The recommended method for the calculation of the risk difference, which is a difference between proportions, requires the calculation of the confidence intervals of the two proportions separately. MedCalc calculates exact binomial confidence intervals for proportions (Armitage et al., 2002). With l_{1} to u_{1} being the 95% CI of the first proportion p_{1} and l_{2} to u_{2} being the 95% CI of the second proportion p_{2}, the 95% confidence interval for the difference is given by

In the context of meta-analysis, the standard error and 95% confidence interval are calculated according to Deeks & Higgins (2010), where the standard error is defined as

and 95% confidence interval

## How to calculate Odds Ratio

The odds ratio (OR), its standard error and 95% confidence interval are calculated as follows (Altman, 1991).

The formula for odds ratio is:

with the standard error of the log odds ratio being

and 95% confidence interval

## Notes

Where zeros cause problems with computation of effects or standard errors, 0.5 is added to all cells (a, b, c, d) (Pagano & Gauvreau, 2000; Deeks & Higgins, 2010).

In meta-analysis for relative risk and odds ratio, studies where a=c=0 or b=d=0 are excluded from the analysis (Higgins & Thomas, 2021).

## Literature

- Altman DG (1991) Practical statistics for medical research. London: Chapman and Hall.
- Armitage P, Berry G, Matthews JNS (2002) Statistical methods in medical research. 4
^{th}ed. Blackwell Science. - Deeks JJ, Higgins JPT (2010) Statistical algorithms in Review Manager 5. Retrieved from https://training.cochrane.org/
- Higgins JPT, Thomas J (editors) (2021) Cochrane Handbook for Systematic Reviews of Interventions Version 6.2. The Cochrane Collaboration, 2021. Available from https://training.cochrane.org
- Newcombe RG, Altman DG (2000) Proportions and their differences. In: Altman DG, Machin D, Bryant TN, Gardner MJ (Eds) Statistics with confidence, 2
^{nd}ed. BMJ Books, 2000. - Pagano M, Gauvreau K (2000) Principles of biostatistics. 2
^{nd}ed. Belmont, CA: Brooks/Cole.

## Recommended book

## Principles of Biostatistics

M Pagano, K Gauvreau

Buy from Amazon US - CA - UK - DE - FR - ES - IT

Principles of Biostatistics is aimed at students in the biological and health sciences who wish to learn modern research methods.

The book is divided into three parts. The first five chapters deal with collections of numbers and ways in which to summarize, explore, and explain them. The next two chapters focus on probability and introduce the tools needed for the subsequent investigation of uncertainty. It is only in the eighth chapter and thereafter that the authors distinguish between populations and samples and begin to investigate the inherent variability introduced by sampling, thus progressing to inference. Postponing the slightly more difficult concepts until a solid foundation has been established makes it easier for the reader to comprehend them.