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Approaches for estimating prevalence ratios

J A Deddens^1,2, M R Petersen¹

¹ National Institute for Occupational Safety and Health, Cincinnati, Ohio, USA
² Department of Mathematical Sciences, University of Cincinnati, Cincinnati, Ohio, USA

Correspondence to:
James A Deddens, National Institute for Occupational Safety and Health, Mail Stop R15, 4676 Columbia Parkway, Cincinnati, OH 45226, USA; jad0@cdc.gov

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Recently there has been much interest in estimating the prevalence (risk, proportion or probability) ratio instead of the odds ratio, especially in occupational health studies involving common outcomes (for example, with prevalence rates above 10%). For example, if 80 out of 100 exposed subjects have a particular disease and 50 out of 100 non-exposed subjects have the disease, then the odds ratio (OR) is (80/20)/(50/50) = 4. However, the prevalence ratio (PR) is (80/100)/(50/100) = 1.6. The latter indicates that the exposed subjects are only 1.6 times as likely to have the disease as the non-exposed subjects, and this is the number in which most people would be interested. There is considerable literature on the advantages and disadvantages of OR versus PR (see Greenland,¹ Stromberg,² Axelson et al³ and others). In this article we will review the existing methods and give examples and recommendations on how to estimate the PR.

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Answers to the questions on Approaches for estimating prevalence ratios by J A Deddens and M R Petersen, on pages 501–6.
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