===== Tutorial stuff =====
Risk ratio = occurrence in exposed group / occurrence in non-exposed group
Odds ratio = odds in exposed group / odds in non-exposed group
Lung cancer | No cancer | |
Smoker | a | b |
Nonsmoker | c | d |
Odds ratio = ad/bc
* ((a/b)/(c/d))
* i.e.
Risk ratio = (a/(a+b)) / (c/(c+d))
* i.e. chance of getting lung cancer in smokers / chance of getting lung cancer in non-smokers
Strong association
Temporal relationship
Biological reason?
Dose-response
RR only tells association, NOT causation.
NNT = 1 / absolute risk reduction
1. Formulate question
2. Search evidence
3. Assess level of evidence
4. Apply to patients
5. Self-assessment
Levels of evidence
Level 1 - meta-analysis
Level 2 - randomised controlled trials
Level 3 - other well conducted experimental studies
Level 4 - expert panels
metaanalysis
subject to publication bias
expensive
studies may have different questions, duplications, different designs