Objectives Occupational epidemiologists often analyse binary outcomes in cohort and cross-sectional studies using multivariable logistic regression models, yielding estimates of adjusted odds ratios. When the outcome is common the adjusted odds ratio will not closely approximate the covariate-adjusted risk or prevalence ratio. Consequently, investigators may decide to directly estimate the risk or prevalence ratio using a log-binomial regression model; however, such models tend to be unstable and may not converge.
Method A marginal structural log-binomial model can be used to estimate risk and prevalence ratios and differences. The approach reduces problems with model convergence typical of log-binomial regression by shifting all explanatory variables except the exposures of primary interest from the linear predictor of the outcome regression model to a propensity score model for the exposure. The approach also facilitates evaluation of departures from additivity in the joint effects of two exposures.
Results We illustrate the proposed approach using data from several illustrative occupational studies of common outcomes.
Conclusions The proposed approach facilitates analysis of risk or prevalence ratios and differences in cohort and cross-sectional studies with common outcomes.
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