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Question 1: In a case-control study, 101 stroke patients were compared with 137

ID: 3059693 • Letter: Q

Question

Question 1:

In a case-control study, 101 stroke patients were compared with 137 healthy controls. Among the results were: Cigarette smoking by stroke patients and healthy controls

Smoker

Non smoker

Total

Case

71

30

101

Controls

36

101

137

Total

107

131

238

(a) Find the increase in odds for having a stroke among smokers compared to nonsmokers (ie find the odds ratio OR).

(b) Find the increase in risk for having a stroke among smokers compared to nonsmokers (ie find the risk ratio RR).

(c) Which measure of association should be reported, OR or RR?

(d) When the incidence is rare, the OR from a case-control study approximates the RR that would be obtained from a cohort study. To see this, suppose the incidence of stroke is 7 per 1,000. We can approximate this incidence by simply multiplying the controls row of the table by 100. Note that this does not change the value of the OR. Calculate the RR for this table.

Smoker

Non smoker

Total

Case

71

30

101

Controls

3600

10100

13700

Total

3671

10130

13801

Smoker

Non smoker

Total

Case

71

30

101

Controls

36

101

137

Total

107

131

238

Explanation / Answer

Result:

Question 1:

In a case-control study, 101 stroke patients were compared with 137 healthy controls. Among the results were: Cigarette smoking by stroke patients and healthy controls

Smoker

Non smoker

Total

Case

71

30

101

Controls

36

101

137

Total

107

131

238

(a) Find the increase in odds for having a stroke among smokers compared to nonsmokers (ie find the odds ratio OR).

Odds ratio = (71*101)/(36*30) =6.6398

(b) Find the increase in risk for having a stroke among smokers compared to nonsmokers (ie find the risk ratio RR).

RR = (71/107)/(30/131) =2.8975

(c) Which measure of association should be reported, OR or RR?

Since this is a case control study, we should report OR.

(d) When the incidence is rare, the OR from a case-control study approximates the RR that would be obtained from a cohort study. To see this, suppose the incidence of stroke is 7 per 1,000. We can approximate this incidence by simply multiplying the controls row of the table by 100. Note that this does not change the value of the OR. Calculate the RR for this table.

Smoker

Non smoker

Total

Case

71

30

101

Controls

3600

10100

13700

Total

3671

10130

13801

Odds ratio = (71*10100)/(3600*30) =6.6398

RR = (71/3671)/(30/10130) =6.5307

Smoker

Non smoker

Total

Case

71

30

101

Controls

36

101

137

Total

107

131

238

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