Open AccessDeath or survival, which you measure may affect conclusions: A methodological study
Author(s) -
Shannin Jake,
Brumback Babette A.
Publication year - 2022
Publication title -
health science reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.462
H-Index - 7
ISSN - 2398-8835
DOI - 10.1002/hsr2.905
Subject(s) - confounding , solvency , affect (linguistics) , bankruptcy , medicine , relative risk , odds ratio , odds , demography , confidence interval , psychology , economics , logistic regression , communication , finance , sociology , market liquidity
Background and Aims Considering the opposite outcome—for example, survival instead of death—may affect conclusions about which subpopulation benefits more from a treatment or suffers more from an exposure. Methods For case studies on death following COVID‐19 and bankruptcy following melanoma, we compute and interpret the relative risk, odds ratio, and risk difference for different age groups. Since there is no established effect measure or outcome for either study, we redo these analyses for survival and solvency. Results In a case study on COVID‐19 that ignores confounding, the relative risk of death suggested that 40–49‐year‐old Mexicans with COVID‐19 suffered more from their unprepared healthcare system, using Italy's system as a baseline, than their 60–69‐year‐old counterparts. The relative risk of survival and the risk difference suggested the opposite conclusion. A similar phenomenon occurred in a case study on bankruptcy following melanoma treatment. Conclusion To increase transparency around this paradox, researchers reporting one outcome should note if considering the opposite outcome would yield different conclusions. When possible, researchers should also report or estimate underlying risks alongside effect measures.