BMJ  2006;333:1248 (16 December), doi:10.1136/bmj.38985.564317.7C (published 23 October 2006)

Research

Ratio measures in leading medical journals: structured review of accessibility of underlying absolute risks

¹ Veteran Affairs Outcomes Group, White River Junction, VT 05009, USA, ² Dartmouth Medical School, Hanover, NH

Objective To examine the accessibility of absolute risk in articles reporting ratio measures in leading medical journals.

Design Structured review of abstracts presenting ratio measures.

Setting Articles published between 1 June 2003 and 1 May 2004 in Annals of Internal Medicine, BMJ, Journal of the American Medical Association, Journal of the National Cancer Institute, Lancet, and New England Journal of Medicine.

Participants 222 articles based on study designs in which absolute risks were directly calculable (61 randomised trials, 161 cohort studies).

Main outcome measure Accessibility of the absolute risks underlying the first ratio measure in the abstract.

Results 68% of articles (150/222) failed to report the underlying absolute risks for the first ratio measure in the abstract (range 55–81% across the journals). Among these articles, about half did report the underlying absolute risks elsewhere in the article (text, table, or figure) but half did not report them anywhere. Absolute risks were more likely to be reported in the abstract for randomised trials compared with cohort studies (62% v 21%; relative risk 3.0, 95% confidence interval 2.1 to 4.2) and for studies reporting crude compared with adjusted ratio measures (62% v 21%; relative risk 3.0, 2.1 to 4.3).

Conclusion Absolute risks are often not easily accessible in articles reporting ratio measures and sometimes are missing altogether—this lack of accessibility can easily exaggerate readers' perceptions of benefit or harm.

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Rapid Responses:

Read all Rapid Responses

why not use the NNT?

Paul Young
bmj.com, 20 Nov 2006 [Full text]

Who will initiate?

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Comment

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Absolute risks as opposed to marketing gimmicks…

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Let's be fair to relative risk

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A natural measure!

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Get your basic statistics and study design right

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Pills in the sky

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