1. Relative and Attributable Risks

2. Absolute Risk Involves people who contract disease due to an exposure Doesn’t consider those who are sick but haven’t been exposed

3. Calculating Excess Risk

4. Relative Risk Definition: A measure of the strength of association based on prospective studies (cohort studies).

5. Determining Relative Risk

6. Interpreting Relative Risk

7. Relative Risk Calculations

8. Relative Risk Calculations (cont.)

9. 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

10. Odds Ratio in Prospective (Cohort) Studies

11. Odds Ratio in Case-Control Studies

12. Odds Ratio in Case-Control Studies (cont.)

13. 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

14. 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

15. Attributable Risk Definition: The amount of disease that can be attributed to a certain exposure.

16. Concept of Attributable Risk

17. Attributable Risk for an Exposed Group

18. OR, expressed as a proportion: Attributable Risk for an Exposed Group (cont.) From previous relative risk example:

19. 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

20. Calculations for Attributable Risks (cont.)

21. 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