Question 4 / 8:  Why do we use the odds ratio as the measure of association in a case-control study?
Answer: 
The investigator determines how many cases and controls will be in a study based

on sample size requirements. Hence, we cannot use these data to estimate incidence as

we can in cohort or RCT studies. Since we do not have incidence data, we cannot calculate

a relative risk and are, therefore, confined to calculating an odds ratio. The odds ratio

approximates the RR when the disease is rare. Since case-control studies are usually done

when outcomes are rare, the OR is a good measure of association for this study design.

(When the disease is not rare, the OR over-estimates the RR).

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Epidemiology & Biostatistics Case-control Studies

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Attribution:  Janet, E.A. Forrester, Kwan Ho Kenneth Chui, Steven Cohen, Michael D. Kneeland, Alice Tang, David Tybor. Epidemiology and Biostatistics 2010. (Tufts University OpenCourseWare), http://ocw.tufts.edu/Course/65/ (Accessed 3 May, 2014). License: Creative Commons BY-NC-SA
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