Results

Odds ratio (95% CI) Chi-square DF P-value

Stratum 1 results 2.46 (1.13, 5.33) 5.29 1 0.021

Stratum 2 results 1.18 (0.55, 2.51) 0.18 1 0.672
Test of homogeneity1 - 1.79 1 0.181
Mantel-Haenszel analyses 1.69 (0.99, 2.88) 3.722 1 0.054

CI: Confidence Interval; DF: Degree of Freedom; 1Breslow-Day test; 2Cochran-Mantel Haenszel statistic

Interpretation
Stratum 1 results
The results suggest that odds of outcome in the exposure positive group are 2.46 times the odds in the exposure
negative group. Confidence interval indicates that we are 95% confident that the odds ratio in the population
(from where the sample was obtained) would be between 1.13 and 5.33. Since the odds ratio confidence interval
does not include the null value (i.e. 1), the association between exposure and outcome is statistically significant
at 5% level of significance, the conventionally used criterion to evaluate p-values. This is also evident from the
p-value for this stratum which is less than 0.05 (see the table of results above).

Stratum 2 results
Subjects in the exposure positive group have 1.18 times the odds of the outcome than those in the exposure
negative group. We are 95% confident that the odds ratio in the population is between 0.55 and 2.51. However,
the association between exposure and outcome is not statistically significant as the p-value for this stratum is not
less than 0.05 and the confidence interval includes 1 (see the table of results above). Therefore, the results
should be interpreted with caution.

Homogeneity of odds ratios

The p-value for the test of homogeneity (0.181) is not less than 0.05, the conventionally used criterion to
evaluate p-values, suggesting that the stratified odds ratios are not significantly different. In other words, the
stratifying variable does not modify the association between exposure and outcome and thus calculation of
pooled or Mantel-Haenszel odds ratios is justified. Note: Tests of homogeneity have low power and therefore
may fail to reject homogeneity even when heterogeneity is present. Some authors recommend using a higher
threshold for evaluating homogeneity p-values (e.g. 0.10 or even 0.20 instead of the conventional 0.05) when
evaluating these tests. Please interpret your results taking this into consideration.

Mantel-Haenszel Results
The best estimate of Mantel-Haenszel adjusted odds ratio is 1.69 suggesting that exposure positive subjects
have 1.69 times the odds of the outcome compared to exposure negative subjects, after adjusting or controlling
for the stratifying variable . Significance of pooled odds ratios was tested by performing a
Cochran-Mantel-Haenszel test. Consistent with the inclusion of the null value (i.e. 1) in the odds ratio confidence
interval, the adjusted odds ratio is statistically non-significant (P-value: 0.054). Note: Interpretation of results will
also depend on your study design. For example, interpretation of odds ratios is different for case control and
cross-sectional studies

Suggestions for reporting

Suggested text for inclusion in the methods section: Stratified analyses were conducted to investigate the
association between the exposure and the outcome after stratifying by the stratifying variable. Homogeneity
between the stratified odds ratios was tested using a chi-square test of homogeneity. If odds ratios were not
significantly different, they were pooled to calculate Mantel-Haenszel adjusted odds ratio. Significance of the
adjusted odds ratio was tested using Cochran-Mantel-Haesnzel test (Rothman and Greenland, 1998). A 5% level
of significance was used to evaluate significance of associations, i.e the p-value less than 0.05 were considered
significant. The analyses were conducted using Statulator, an online statistical program (Dhand and Khatkar,
2014).

Suggested text for inclusion in the results section:Theexposure variable was significantly associated with the
outcome for stratum 1(odds ratio [95% CI]: 2.46 [1.13, 5.33]; P-value: 0.021) but not for stratum 2 ( 1.18 [0.55,
2.51]; P-value: 0.672).Test of homogeneity was not significant at 5% level of significance, the conventionally
used criterion to evaluate p-values( P-value =0.181), therefore, the stratified odds ratios were pooled to calculate
MH adjusted odds ratio (1.69; 95% CI: 0.99, 2.88). The association between the exposure and the outcome was
not significant after adjusting for the stratifying variable (P-value: 0.054) . Note: Please modify the suggested text
before including in your report or journal article; do not copy verbatim.

References
Dhand, N. K., & Khatkar, M. S. (2014). Statulator - An online calculator that conducts statistical analyses and
interprets the results: Stratified Analyses. Retrieved 1 August 2023 from
http://statulator.com/stat/stratified-analyses. Rothman, K., & Greenland, S. (1998). Introduction to stratified
analysis. In K. Rothman & S. Greenland (Eds.), Modern Epidemiology (Second ed., pp. 253). Philadelphia.:
Lippincott Williams and Wilkins.