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American Journal of Epidemiology Vol. 150, No. 3: 279-282
Copyright © 1999 by The Johns Hopkins University School of Hygiene and Public Health

other

Relative Excess Risk: An Alternative Measure of Comparative Risk

Samy Suissa

From the Department of Epidemiology and Biostatistics, McGill Pharmacoepidemiology Research Unit, McGill University, Division of Clinical Epidemiology, Royal Victoria Hospital Montreal, Québec, Canada

Reprint requests to Dr. Samy Suissa, Division of Clinical Epidemiology, Royal Victoria Hospital, 687 Pine Avenue West, Ross 4.29, Montreal, Québec, Canada H3A 1A1.

The proverbial relative risk may not always be the most suitable measure to compare the risk of two exposures, since it inherently includes a background effect. An alternative comparative measure, the relative excess risk, is introduced. It applies to situations in which an "unexposed" reference group is included in addition to the two exposures under evaluation. This comparative measure is based soiely on the component of risk due to the exposures, since it removes the background risk. Estimators of the relative excess risk are presented, along with formulas for the confidence intervals under cohort and case-control designs, using both crude and adjusted rate rations. This new measure is illustrated with data from epidemiologic studies of the risks of oral contraceptives and antidiabetic drugs. Am J Epidemiol 1999; 150: 279-82.

case-control studies; cohort studies; relative risk; statistics


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