Roll no. 73, 74, 79, 80.

RELATIVE
RISK
Cohort Study
Cohort Study or Panel Study is a type of
analytical (observational) study usually
undertaken to obtain additional evidence
to prove or disprove the existence of an
association between suspected cause and
disease.
Elements of a Cohort Study
1. Selection of study subjects.
2. Obtaining data on exposure.
3. Selection of comparison
groups.
4. Follow-up.
5. Analysis.
Analysis
Data analyzed in terms of:
Incidence Rates.
Estimation of risk.
Relative Risk
Attributable Risk.
2 X 2 Table
DISEASE
RISK
FACTOR
PRESENT ABSENT
PRESENT
a b
ABSENT
c d
Relative Risk (RR)
Relative Risk is the ratio of the
incidence of the disease among exposed
and the incidence among the non-
exposed.
Aka risk ratio.

=






Note:
Numerator is not a part of the Denominator.
=

+

=

+




Interpretation
In a simple comparison between an
experimental group and a control group:
A relative risk of 1 means there is no
difference in risk between the two groups.
RR of < 1 means the event is less likely to
occur in the experimental group than in the
control group.
RR of > 1 means the event is more likely to
occur in the experimental group than in the
control group.

Examples
And their Interpretations
Cigarette Smoking and Lung Cancer
DEVELOPED
LUNG
CANCER
SMOKER
YES NO
YES
70 6930
NO
3 2997
RR Estimation and Interpretation
Lung cancer incidence among smokers =
70
70+6930

=
70
7000
= 10 per 1000

Lung cancer incidence among non-smokers =
3
3+2997

=
3
3000
= 1 per 1000

RR =

= 10

Smokers are 10 times at greater risk of
developing lung cancer than non-smokers.
Radiation Exposure and Cancer
CANCER

RADIATION
YES NO
YES
30 20
NO
10 90
RR Estimation and Interpretation
Cancer incidence among those exposed to radiation =
30
30+20

=
30
50
= 60 per 100

Cancer incidence among those not exposed to radiation =
10
10+90

=
10
100
= 10 per 100

RR =

= 6

Those exposed to radiation are 6 times at greater
risk of developing cancer than those not exposed.

Conclusion
Thus, Relative Risk (RR) is a good measure to
determine if a factor leads to an increase, decrease or
no effect on the development of some disease
symptom.


RR=1 No effect
RR<1 Protective effect
RR>1 Leads to development of the disease