Rothman Kenneth J, Lanes Stephan, Sacks Susan T
Department of Epidemiology, Boston University Medical Center, 715 Albany Street, MA 02118, USA.
Pharmacoepidemiol Drug Saf. 2004 Aug;13(8):519-23. doi: 10.1002/pds.1001.
The proportional reporting ratio (PRR) is the proportion of spontaneous reports for a given drug that are linked to a specific adverse outcome, divided by the corresponding proportion for all or several other drugs. The PRR is similar to the proportional mortality ratio (PMR), an old epidemiologic measure calculated from death registries and constructed in similar fashion to the PRR. The PMR has important deficiencies, however, which the PRR shares. Miettinen and Wang demonstrated that the PMR could be improved by reformulating it as an odds ratio and applying the principles of a case-control study to the measure. In this paper, we review the problem with the PRR and show how the corresponding odds ratio represents an improvement over the PRR.
The method used is discussion and illustration by way of a hypothetical example.
The PRR does not estimate relative risk. If, however, a spontaneous report database is viewed as source data for a case-control study, the reporting odds ratio (ROR) can be used to estimate relative risk. Treating the data as source data for a case-control study allows for further reduction of bias by the judicious choice of controls.
Calculating the ROR in spontaneous report databases offers advantages over the PRR. It allows for estimation of the relative risk, and focuses attention on which people or reports should be included or excluded from the control series, permitting more deliberate elimination of biases. It also highlights the inherent weaknesses in spontaneous report data, which become more evident in light of the usual principles of control selection in case-control studies.
比例报告比（PRR）是某种特定药物与特定不良结局相关的自发报告比例，除以所有其他药物或几种其他药物的相应比例。PRR类似于比例死亡率（PMR），后者是一种根据死亡登记数据计算得出的古老流行病学指标，其构建方式与PRR相似。然而，PMR存在重要缺陷，PRR也存在同样的问题。米耶蒂宁和王证明，通过将PMR重新表述为比值比并将病例对照研究的原理应用于该指标，可以对其进行改进。在本文中，我们回顾了PRR存在的问题，并展示了相应的比值比如何比PRR有所改进。
所采用的方法是通过一个假设示例进行讨论和说明。
PRR无法估计相对风险。然而，如果将自发报告数据库视为病例对照研究的源数据，则报告比值比（ROR）可用于估计相对风险。将数据视为病例对照研究的源数据，通过明智地选择对照，可以进一步减少偏差。
在自发报告数据库中计算ROR比PRR具有优势。它可以估计相对风险，并将注意力集中在对照系列中应纳入或排除哪些人或报告，从而更有针对性地消除偏差。它还突出了自发报告数据中固有的弱点，根据病例对照研究中对照选择的通常原则，这些弱点会变得更加明显。
