Obtaining adjusted prevalence ratios from logistic regression models in cross-sectional studies

<p>In the last decades, the use of the epidemiological prevalence ratio (PR) instead of the odds ratio has been debated as a measure of association in cross-sectional studies. This article addresses the main difficulties in the use of statistical models for the calculation of PR: convergence p...

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Bibliographic Details
Main Authors: Leonardo Soares Bastos, Raquel de Vasconcellos Carvalhaes de Oliveira, Luciane de Souza Velasque
Format: Article
Language:English
Published: Escola Nacional de Saúde Pública, Fundação Oswaldo Cruz 2015-03-01
Series:Cadernos de Saúde Pública
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Online Access:http://www.scielosp.org/scielo.php?script=sci_arttext&pid=S0102-311X2015000300487&lng=en&tlng=en
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Summary:<p>In the last decades, the use of the epidemiological prevalence ratio (PR) instead of the odds ratio has been debated as a measure of association in cross-sectional studies. This article addresses the main difficulties in the use of statistical models for the calculation of PR: convergence problems, availability of tools and inappropriate assumptions. We implement the direct approach to estimate the PR from binary regression models based on two methods proposed by Wilcosky & Chambless and compare with different methods. We used three examples and compared the crude and adjusted estimate of PR, with the estimates obtained by use of log-binomial, Poisson regression and the prevalence odds ratio (POR). PRs obtained from the direct approach resulted in values close enough to those obtained by log-binomial and Poisson, while the POR overestimated the PR. The model implemented here showed the following advantages: no numerical instability; assumes adequate probability distribution and, is available through the R statistical package.</p>
ISSN:0102-311X