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How Big is a Big Odds Ratio? Interpreting the Magnitudes of Odds Ratios in Epidemiological Studies
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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“Although the effect sizes of Hedges g and OR can be difficult to compare, outcomes based on continuous data and reported as Hedges g, appeared to generate larger effect sizes compared with dichotomous scoring, reported as OR [91].”
From The psychological subtype of intimate partner violence and its effect on mental health: a systematic review with meta-analyses (2022) · cites this paper as [91]
In the citing paper
“The mentoring structures and outcomes of the students in our study differed based on their gender and race/ethnicity, although the sizes of these differences were small (Cohen, 1992; Chen et al., 2010).”
From Race and Gender Differences in Undergraduate Research Mentoring Structures and Research Outcomes (2017) · cites this paper as Chen et al., 2010
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“As Chen et al[66] have proposed, the size of RR can be transformed to a Cohen d equivalence by relating it to differences in a normal standard deviate.”
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“These findings represent small, but significant, effect sizes (Chen et al., 2010; Cohen, 1988), and agree with the finding of Faraone et al. (2021) that ADHD is most often caused by the combined effect of multiple risk factors, with each contributing a small risk.”
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“Cohen ’ s d= 0.2, 0.5 and 0.8 are defined cut-off values for small, medium and large effect sizes, respectively [12, 26].”
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“Interpretation of the magnitude of odds ratios was informed by Chen and colleagues’ guidelines (Chen et al., 2010).”
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“Each condition was significantly different from another, but the odds ratio was small (based on the effect size Impact of teachers’ SMK and KOSM criterion for odd ratios, which considers an odd ratio < 1.5 a small effect, suggested by Chen et al. , 2010).”
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“6In all studies reporting odds ratios as estimates of effect sizes (Studies 1–3b), classifications of small, medium, and large were interpreted from Chen et al. (2010).”
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“, FA10), the effect size was small (36,37).”
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“The difficulty of interpreting the OR has troubled many clinical researchers and epidemiologists for a long time (Chen et al. 2010).”
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“Effect sizes were labeled following the recommendations by Funder and Ozer (2019) and (Chen et al., 2010) for linear and generalized linear models, respectively.”
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“OR is considered as an effect size, although its interpretation may be challenging as the magnitude of an OR depends on the rate of the dependent variable (Chen et al., 2010).”
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Increased Risk of Parkinson's Disease in Patients With Schizophrenia Spectrum Disorders
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“001), implying a large effect size.(42) Because PD and SCD have overlapping phenotypical features and because iatrogenic parkinsonism in SCD and psychotic symptoms in PD are common, we focused only on PD risk and used stringent exclusion criteria for patients, including the use of time limits for diagnoses/ages and th…”
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“While OR is widely used as an indicator of risk for disease, it can vary strongly depending on sample size, case rates, and applied cut-off scores in data [48].”
BackgroundSuicidality among individuals with gambling problems: A meta-analytic literature review.
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What Helps–and What Doesn't–When Self-Esteem is Threatened?: Retrospective Reports of Esteem Support
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Use of social networking sites and alcohol consumption among adolescents
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“Additionally, given the large sample size, effect sizes were considered for binge drinking using the criteria for interpreting the size of the OR proposed by Chen et al.39: OR ¼ 1.7, 3.5, and 6.7 are equivalent to small (Cohen's d ¼ 0.2), medium (Cohen's d ¼ 0.5), and large (Cohen's d ¼ 0.8), respectively.”
MethodInfluentialChasm Crossed? Clicker Use in Postsecondary Chemistry Education
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“Notwithstanding, Chen et al. (2010) suggest that ORs of 1.46, 2.50, and 4.14 are indicative of weak, moderate, and large effects, respectively, when the outcome occurs in 10% of the nonexposed/comparison group.”
BackgroundMethodInfluentialLiterature Review of BARD1 as a Cancer Predisposing Gene with a Focus on Breast and Ovarian Cancers
Alenezi, W. M., Fierheller, C. T., Recio, N., & Tonin, P. N. (2020) · Genes · doi:10.3390/genes11080856 · Cited by 53
Defensive freezing and its relation to approach–avoidance decision-making under threat
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Metadata
- 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
- 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
- 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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