Kraemer Helena Chmura
Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA 94305, USA.
Stat Med. 2004 Jan 30;23(2):257-70. doi: 10.1002/sim.1714.
The odds ratio (OR) is probably the most widely used measure of 2x2 association in epidemiology, but it often produces results that are puzzling or misleading. Receiver operating characteristic (ROC) methods are used to take a fresh look at the OR and show where and why such puzzling results arise. When researchers choose to report a summary measure of association, the OR is one of many measures of association that might be considered, not one that should be considered the 'gold standard' of 2x2 measures of association. In a randomized clinical trial with binary outcome for success, either the success or failure rates in treatment and control groups might be reported separately or the number needed to treat to achieve one extra success, to emphasize the cost of unnecessary treatment needed to achieve a success. In studies assessing reliability or heritability, we recommend the intraclass kappa. In studies in which one binary variable is assessed against a binary criterion, we recommend the weighted kappa.
比值比（OR）可能是流行病学中最广泛用于衡量2×2关联的指标，但它常常得出令人困惑或有误导性的结果。受试者工作特征（ROC）方法用于重新审视比值比，并揭示这些令人困惑的结果在何处以及为何会出现。当研究人员选择报告关联的汇总指标时，比值比只是众多可能被考虑的关联指标之一，而非应被视为2×2关联指标“金标准”的指标。在一项以成功为二元结局的随机临床试验中，治疗组和对照组的成功率或失败率可能会分别报告，或者报告为实现额外一次成功所需的治疗人数，以强调实现成功所需的不必要治疗成本。在评估可靠性或遗传性的研究中，我们推荐组内kappa系数。在一项将一个二元变量与二元标准进行对照评估的研究中，我们推荐加权kappa系数。
