Cited by 1,952Statistical Methods in EpidemiologyMeta-analysis and systematic reviewsStatistical Methods in Clinical Trials

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How Big is a Big Odds Ratio? Interpreting the Magnitudes of Odds Ratios in Epidemiological Studies

Chen, Henian, Cohen, Patricia, Chen, Sophie·2010·Communications in Statistics - Simulation and Computation

DOI 10.1080/03610911003650383

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Abstract

The odds ratio (OR) is probably the most widely used index of effect size in epidemiological studies. The difficulty of interpreting the OR has troubled many clinical researchers and epidemiologists for a long time. We propose a new method for interpreting the size of the OR by relating it to differences in a normal standard deviate. Our calculations indicate that OR = 1.68, 3.47, and 6.71 are equivalent to Cohen's d = 0.2 (small), 0.5 (medium), and 0.8 (large), respectively, when disease rate is 1% in the nonexposed group; Cohen's d < 0.2 when OR <1.5, and Cohen's d > 0.8 when OR > 5.

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10.1002/sim.1032 · DOI
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“80, which is between a small and medium effect size [148].”
Background
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Additional Evidence of Predictive Validity of SRSS-IE Scores With Elementary Students
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“We interpret standardized coefficient ( β ) effect sizes values using Chen et al. (2010) and Fey et al. (2023) who indicate that < .30 is small, .30 to .49 is medium, and > .50 is large.”
Method
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“To estimate these differences, we calculated Cohen’s d (for continuous variables) and odds ratios (for categorical variables); for odds ratios, trivial effects are < 1.68 (Chen et al., 2010).”
Influential
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Launching a Competency-Based Training Program in Evidence-Based Treatments for PTSD: Supporting Veteran-Serving Mental Health Providers in Texas
Dondanville, K. A., Fina, B. A., Straud, C. L., Finley, E. P., Tyler, H. C., Jacoby, V. M., Blount, T. H., Moring, J. C., Pruiksma, K. E., Blankenship, A. E., et al. (2020) · Community Mental Health Journal · doi:10.1007/s10597-020-00676-7 · Cited by 7
Predicting Infection in Very Preterm Infants
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A Large-Scale Observational Study on the Temporal Trends and Risk Factors of Opioid Overdose: Real-World Evidence for Better Opioids
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Moafa, I., Hoving, C., van den Borne, B. H. P., & Jafer, M. A. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18147481 · Cited by 7
“99) and strong evidence (OR > = 4) [17,18].”
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Minatoya, M., Araki, A., Miyashita, C., Itoh, S., Kobayashi, S., Yamazaki, K., Bamai, Y. A., Saijo, Y., Sato, Y., Ito, Y., et al. (2021) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph18137082 · Cited by 7
Exploring Socio-Demographic Factors Affecting Psychological Symptoms in Humidifier Disinfectant Survivors
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Bulimia nervosa
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“Effect sizes were calculated using odds ratios (function exp(); Hosmer, 2004) and interpreted as odds ratios of 1.5, 2.5 or 4.2 indicating a small, medium or large effect (Chen et al., 2010).”
MethodInfluential
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Self-citation
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“Along with gender differences, declining trends were the most prominent features of the results (small to moderate effect sizes; [64, 65].”
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History of chronic pain and opioid use is associated with cognitive decline and mild cognitive impairment
Bell, T. R., Elman, J. A., Gustavson, D. E., Lyons, M. J., Fennema‐Notestine, C., Williams, M. E., Panizzon, M. S., Pearce, R. C., Reynolds, C. A., Sanderson‐Cimino, M. E., et al. (2025) · Journal of the International Neuropsychological Society · doi:10.1017/s1355617725101057 · Cited by 6
“These can be interpreted in terms of effect sizes (small effect ∼ .80 or 1.20; moderate effect ∼ .67 or 1.50; large effect ∼ .50 or 2.00) (Chen et al., 2010).”
Influential
Agreement and Reliability Between Tele-Assessment and In-Person Assessment of the One-Minute Sit-to-Stand Test in Patients with Chronic Respiratory Diseases
Larrateguy, S., Otto‐Yáñez, M., Bogado, J., Larrateguy, L., Barros-Poblete, M., Mazzucco, G. A., Blanco, I., Gimeno‐Santos, E., & Torres‐Castro, R. (2025) · Journal of Clinical Medicine · doi:10.3390/jcm14145049 · Cited by 6
“The effect size was categorized as small, moderate, and large, with Cohen’s d values < 0.2, between 0.2 and 0.5, and >0.8, respectively [30].”
Influential
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“With 232 participants and a Bonferroni-corrected alpha-level of 0.05, we had 83.7% power to detect a small-to-medium effect size of OR = 2.575 42 for each predictor.”
Influential
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“Notably, S. anginosus had an OR of 3.39 with q < 0.05 (Table 3; Supporting Information Figure S8), approximately equivalent to Cohen ’ s d = 0.5 (i.e., a medium effect size) [49].”
Influential
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Handicraft art leisure activities and cognitive reserve
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“…research (Table 1) revealed that the present results pertaining to Block Design and Visual Puzzles had stronger effect sizes than those reported previously (odds ratio values and Pearson Correlation values were converted to Cohen’s d values using the calculation described by Chen et al. (2010).”
Method
Parental practices and their association with alcohol and cannabis use among adolescents in Chile
Libuy, N., Viviana Guajardo, T., Ibáñez, C. F., Araneda, A. M., Taibo, L. C., Donoso, P., Gaete, J., & Mundt, A. P. (2023) · Frontiers in Psychology · doi:10.3389/fpsyg.2023.1209584 · Cited by 6
“The odds ratios reported in this study had small to medium effect sizes (Chen et al., 2010).”
Background
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Inferring COVID-19 testing and vaccination behavior from New Jersey testing data
Freedman, A. S., Sheen, J. K., Tsai, S., Yao, J., Lifshitz, E. I., Adinaro, D., Levin, S. A., Grenfell, B. T., & Metcalf, C. J. E. (2024) · Proceedings of the National Academy of Sciences · doi:10.1073/pnas.2314357121 · Cited by 6

Authors: Chen, H., Cohen, P., & Chen, S.
Affiliations: Winthrop-University Hospital (US)
New York State Psychiatric Institute (US)
Health Canada (CA)
Corresponding author: Chen, Henian
ORCID: Chen, Henian
Chen, Sophie
Venue: Communications in Statistics - Simulation and Computation
Publisher: Informa UK Limited
Published: 2010-03-31
Volume: 39
Issue: 4
Pages: 860-864
ISSN: 0361-0918 (ISSN-L)
1532-4141
DOI: 10.1080/03610911003650383
OpenAlex: W2029059557
Cited by: 1,952
References: 20
Citations by year: 2026: 170 · 2025: 201 · 2024: 259 · 2023: 234 · 2022: 254 · 2021: 242 · 2020: 196 · 2019: 123 · 2018: 93 · 2017: 65 · 2016: 44 · 2015: 31 · 2014: 18 · 2013: 11 · 2012: 4
FWCI: 5.45
Type: journal article
Language: en
Open access: closed
Locations: Communications in Statistics - Simulation and Computation (publishedVersion)
Topics: Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Epidemiology
Social Sciences › Decision Sciences › Statistics, Probability and Uncertainty › Meta-analysis and systematic reviews
Physical Sciences › Mathematics › Statistics and Probability › Statistical Methods in Clinical Trials
Keywords: odds ratio, effect size interpretation, Cohen's d, standardized mean difference, disease incidence

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How Big is a Big Odds Ratio? Interpreting the Magnitudes of Odds Ratios in Epidemiological Studies

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