Saturday, December 25, 2004

Relative risks less than two

A recent article in Annals of Internal Medicine claimed that Vit E increased the risk of death. The relative risk (RR) was 1.01. If a relative risk of 2 increases the risk of the outcome of interest two fold,then a relative risk of 1.01 increases the risk by 1/100. This is clearly a difference too small to really measure and too small to care about.
Relative risks of less than two are frequently published in medical journals and often represent more noise than signal but when repeated in the lay press alarms some,confuses others and generally give even more reason for folks to think that the medical profession is not too sure about much of anything.Of course, a relative risk even as "big" as two does not guarantee a causal relationship, but courts are beginning to accept a relative risk of 2 or more as fulfilling the "more likely than not" standard of proof for some types of civil litigation. Let's not forget the role of prior evidence and biological plausibility in considering what significance should be given to " statistically significant" RRs.

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