Two by two tables: the world

of Epidemiology

OR (95% Confidence Intervals)

Eskindir Loha, PhD

School of Public and Environmental Health,
Hawassa University
 Two by two tables
Obesity Hypertensive Normal Total

Yes a b a+b

No c d c+d

Total a+c a+d a+b+c+d

 Example
Water Diarrhoea No diarrhoea
supply Total
Unsafe 165 547 712
a b a+b
Safe 91 550 641
c d c+d
Total 256 1097 1353
a+c b+d a+b+c+d
• Relative risk (RR): RCT and cohort
RR= (a/(a+b)) / (c/(c+d))
• OR: case-control and cross-sectional
OR=ad/bc
• Both are effect measures (these measure
strength of association)
• We can also test hypothesis when we
calculate 95% CI
• As the prevalence of the disease becomes
below 5%, OR approaches RR
OR versus RR real-time example.xlsx
 (95% CI for OR)
• Change the OR into the natural log form
• Consider 1.96 as a reliability factor
• Calculate the standard error for lnOR
Use this formula to construct 95%
CI for OR
Back transformation using exp
function
 Interpretation of values
• OR/RR of 1 is called the null hypothesis value,
i.e no association between the exposure and the
outcome
• OR/RR >1 implies increased risk of developing
the disease if exposed
• OR/RR<1 implies the protective effect of the
exposure
• 1-RR is the protective efficacy
• If the 95% CI for OR/RR includes 1, p>0.05, i.e
no association
• As the value becomes far from one on both
sides the strength of association increases; as it
approaches 1, it decreases.
 Interpretation
• OR=(165*550)/(547*91)=1.82
• 95% CI for OR= 1.36-2.44, and hence
we can reject the null hypothesis as 1
is not included in this interval and we
can interpret the value of OR 1.82 as
there is 82% increased risk of
developing diarrhoea if one
consumes unsafe water.
 Interpret these value
• OR (95% CI): 0.56 (0.22-0.89)
• OR (95% CI): 1.45 (0.87-3.99)
• OR (95% CI): 2.4 (1.6-7.8)