Estimating the relative risk in cohort studies and clinical trials of common outcomes

Louise Anne McNutt, Chuntao Wu, Xiaonan Xue, Jean Paul Hafner

Research output: Contribution to journalArticlepeer-review

1590 Scopus citations


Logistic regression yields an adjusted odds ratio that approximates the adjusted relative risk when disease incidence is rare (<10%), while adjusting for potential confounders. For more common outcomes, the odds ratio always overstates the relative risk, sometimes dramatically. The purpose of this paper is to discuss the incorrect application of a proposed method to estimate an adjusted relative risk from an adjusted odds ratio, which has quickly gained popularity in medical and public health research, and to describe alternative statistical methods for estimating an adjusted relative risk when the outcome is common. Hypothetical data are used to illustrate statistical methods with readily accessible computer software.

Original languageEnglish (US)
Pages (from-to)940-943
Number of pages4
JournalAmerican Journal of Epidemiology
Issue number10
StatePublished - May 15 2003
Externally publishedYes


  • Clinical trials
  • Cohort studies
  • Odds ratio
  • Relative risk

ASJC Scopus subject areas

  • Epidemiology


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