Odds Ratio (OR)

The Odds Ratio is a measure of association which compares the odds

of disease of those exposed to the odds of disease those unexposed.

OR = (odds of disease in exposed)

(odds of disease in the non-exposed)

▪ OR of 1 would suggests that there is no difference between the

groups; i.e. there would be no association between the suggested
exposure (fish) and the outcome (being ill)
▪ OR of > 1 suggests that the odds of exposure are positively

associated with the adverse outcome compared to the odds of not

being exposed
▪ OR of < 1 suggests that the odds of exposure are negatively

associated with the adverse outcomes compared to the odds of

not being exposed. Potentially, there could be a protective effect
In the example above, we can conclude that those who ate the fish
casserole (exposure) were 8.3 times more likely (OR = 8.3) to be ill
(outcome), compared to those who did not eat the fish casserole. Of
course this is an entirely ficticious example, and I have nothing
against fish

Advantages
 ▪ Appropriate to analyse associations between groups from case-
control and prevalent (or cross-sectional) data.
▪ For rare diseases (or diseases with long latency periods) the OR
can be an approximate measure to the RR (relative risk)
▪ Doesn’t require denominator (i.e. total number in population)
unlike measuring risk
▪ Good method to estimate the strength of an association between
exposures and outcomes
Disadvantages
▪ Association does not infer causation! *epidemiology golden rule*