Odds Ratio or Prevalence Ratio? An Overview of Reported Statistical Methods and Appropriateness of Interpretations in Cross-sectional Studies with Dichotomous Outcomes in Veterinary Medicine.
Odds Ratio or Prevalence Ratio? An Overview of Reported Statistical Methods and Appropriateness of Interpretations in Cross-sectional Studies with Dichotomous Outcomes in Veterinary Medicine.
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DOI：
10.3389/fvets.2017.00193
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发表时间：
2017
影响因子：
3.2
通讯作者：
Corbellini LG
中科院分区：
文献类型：
--
作者：
Martinez BAF;Leotti VB;Silva GSE;Nunes LN;Machado G;Corbellini LG
兽医学中最常用的观察性研究设计之一是具有二元结局的横断面研究。为了测量与暴露的相关性，可以使用患病率比（PR）或比值比（OR）。在人类流行病学中，已经讨论了很多关于将OR专门用于病例对照研究的问题，一些作者报告说，当疾病的患病率很高时，没有很好的理由来拟合logistic回归，其中OR高估了PR。OR的解释是困难的，因为混淆风险和几率可能导致对数据的不正确的定量解释，例如“风险是X倍大，”这在使用OR的研究中常见。本研究的目的是审查具有横断面设计的文章，以评估所使用的统计方法和对估计的相关性指标的解释的适当性，并说明直接估计PR的替代统计方法的使用。使用系统性综述和荟萃分析（PRISMA）指南的首选报告项目对统计方法及其解释进行了概述，并使用PubMed作为搜索引擎纳入了兽医科学领域的各种同行评审期刊。从每篇文章中，使用的统计方法和适当的解释估计的关联措施进行了登记。此外，使用我们自己的牛病毒性腹泻病毒横断面研究数据集，对四种直接估计PR的逻辑回归替代模型进行了测试。初始检索策略发现62篇文章，其中6篇文章被排除，因此56项研究用于总体分析。该综述显示，独立于报告的患病率水平，96%的文章采用logistic回归，从而估计OR。多变量模型的结果表明，逻辑回归是最高估PR的方法。本研究的结果表明，虽然有直接估计PR的方法，但兽医科学中的许多研究并不使用这些方法，并误解了逻辑回归估计的OR。
One of the most commonly observational study designs employed in veterinary is the cross-sectional study with binary outcomes. To measure an association with exposure, the use of prevalence ratios (PR) or odds ratios (OR) are possible. In human epidemiology, much has been discussed about the use of the OR exclusively for case–control studies and some authors reported that there is no good justification for fitting logistic regression when the prevalence of the disease is high, in which OR overestimate the PR. Nonetheless, interpretation of OR is difficult since confusing between risk and odds can lead to incorrect quantitative interpretation of data such as “the risk is X times greater,” commonly reported in studies that use OR. The aims of this study were to review articles with cross-sectional designs to assess the statistical method used and the appropriateness of the interpretation of the estimated measure of association and to illustrate the use of alternative statistical methods that estimate PR directly. An overview of statistical methods and its interpretation using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines was conducted and included a diverse set of peer-reviewed journals among the veterinary science field using PubMed as the search engine. From each article, the statistical method used and the appropriateness of the interpretation of the estimated measure of association were registered. Additionally, four alternative models for logistic regression that estimate directly PR were tested using our own dataset from a cross-sectional study on bovine viral diarrhea virus. The initial search strategy found 62 articles, in which 6 articles were excluded and therefore 56 studies were used for the overall analysis. The review showed that independent of the level of prevalence reported, 96% of articles employed logistic regression, thus estimating the OR. Results of the multivariate models indicated that logistic regression was the method that most overestimated the PR. The findings of this study indicate that although there are methods that directly estimate PR, many studies in veterinary science do not use these methods and misinterpret the OR estimated by the logistic regression.
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DOI：
10.1136/bmj.b2535
发表时间：
2009-07-21
期刊：
BMJ (Clinical research ed.)
影响因子：
--
作者：
Moher D;Liberati A;Tetzlaff J;Altman DG;PRISMA Group
通讯作者：
PRISMA Group
影响因子：
--
作者：
Levin, Kate Ann
通讯作者：
Levin, Kate Ann
影响因子：
2.1
作者：
Carter, RE;Lipsitz, SR;Tilley, BC
通讯作者：
Tilley, BC
影响因子：
5.4
作者：
Chu, Haitao;Cole, Stephen R.
通讯作者：
Cole, Stephen R.
影响因子：
1.7
作者：
Blizzard, L;Hosmer, DW
通讯作者：
Hosmer, DW