Relative and absolute risk

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Relative and absolute risk

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Anatomy clinical correlates: Pleura and lungs
Anatomy clinical correlates: Thoracic wall
Alveolar surface tension and surfactant
Anatomic and physiologic dead space
Breathing cycle and regulation
Diffusion-limited and perfusion-limited gas exchange
Gas exchange in the lungs, blood and tissues
Pulmonary shunts
Regulation of pulmonary blood flow
Respiratory system anatomy and physiology
Ventilation
Ventilation-perfusion ratios and V/Q mismatch
Zones of pulmonary blood flow
Cardiac afterload
Cardiac contractility
Cardiac cycle
Cardiac preload
Cardiac work
Frank-Starling relationship
Measuring cardiac output (Fick principle)
Pressure-volume loops
Stroke volume, ejection fraction, and cardiac output
Acid-base map and compensatory mechanisms
Buffering and Henderson-Hasselbalch equation
Physiologic pH and buffers
The role of the kidney in acid-base balance
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Deep vein thrombosis and pulmonary embolism: Pathology review
Heart failure: Pathology review
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Obstructive lung diseases: Pathology review
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Introduction to the cardiovascular system
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Anatomy of the abdominal viscera: Blood supply of the foregut, midgut and hindgut
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Anatomy of the abdominal viscera: Large intestine
Anatomy of the abdominal viscera: Small intestine
Anatomy of the gastrointestinal organs of the pelvis and perineum
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Gallbladder histology
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Bile secretion and enterohepatic circulation
Liver anatomy and physiology
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Jaundice: Pathology review
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Anatomy of the heart
Anatomy of the vagus nerve (CN X)
Aortic dissections and aneurysms: Pathology review
Cardiomyopathies: Pathology review
Coronary artery disease: Pathology review
Heart blocks: Pathology review
Supraventricular arrhythmias: Pathology review
Valvular heart disease: Pathology review
Ventricular arrhythmias: Pathology review
Hunger and satiety
Anxiety disorders, phobias and stress-related disorders: Pathology Review
Breast cancer: Pathology review
Colorectal polyps and cancer: Pathology review
Dementia: Pathology review
Diabetes mellitus: Pathology review
GERD, peptic ulcers, gastritis, and stomach cancer: Pathology review
Heart failure: Pathology review
HIV and AIDS: Pathology review
Hyperthyroidism: Pathology review
Inflammatory bowel disease: Pathology review
Jaundice: Pathology review
Lung cancer and mesothelioma: Pathology review
Malabsorption syndromes: Pathology review
Mood disorders: Pathology review
Tuberculosis: Pathology review

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Relative and absolute risk

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A researcher is studying a new vaccine for respiratory syncytial virus (RSV) in premature infants and is comparing it with the current standard of care treatment. 8% of infants who received the standard of care treatment developed symptomatic RSV, and 2% of infants who received the new vaccine developed symptomatic RSV. Which of the following is the relative risk reduction attributable to this new vaccine?  

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Risk is the probability of an event occurring - for example let’s say that we’re talking about the risk of being struck by lightning.

You might want to know - your chance of being struck by lightning - that would be the absolute risk. You might also want to know your chance of getting struck by lightning if you’re sipping hot chocolate under a blanket in your bed, versus your chance if you’re out flying a kite in a storm.

Now, let’s say that the kite-fliers are at higher risk then the chocolate-sippers of getting struck by lightning.

Well - you may want to know how many times higher is the risk - the risk ratio, or how much higher is the risk - the risk difference.

So let’s use some numbers to make this concrete. Say we have 400 people in the lightening study - imagine the incentives you’d need to get folks to sign up for that study.

So, let’s say that 200 of the people are sent out to fly a kite in a terrible storm, while the other 200 are sent indoors with a cup of hot chocolate and a blanket.

Now let’s say that 50 of the kite-fliers are struck by lighting.

Based on that data, the absolute risk of being struck by lightning if you’re out flying a kite is the number of lightning strikes, which is 50, divided by the number of people in the group, which is 200.

So, 50/200 or 0.25 is answer - a 25% risk.

Absolute risk = Number of events in a group / individuals in that group

While all that is happening, let’s say that 10 unfortunate chocolate-sipper also gets struck by lightning while sitting under a blanket.

Based on that data, the absolute risk of being struck by lightning if you’re sipping chocolate inside is the number of lightning strikes, which is 10, divided by the number of people in the group, which is 200.

So, 10/200 or 0.05 is answer - a 5% risk.

If you want to compare these two risks, you could say that the relative risk or risk ratio, is the risk in one group, let’s call that group A, divided by the risk in another group, let’s call that group B.

In this case that means 0.25 / 0.05 or a relative risk of 5.

Put differently, When you go outside to fly a kite, your risk of getting hit by lightning is 5 times the risk of getting hit by lightning if you just stayed in and drank that hot chocolate!

Risk ratio or relative risk = Risk in group A / Risk in group B

Now, you may want to know what the risk difference is in absolute terms, this is also called the absolute risk reduction.

Summary

Risk is the probability of an event occurring, for example, the risk of being struck by lightning. Absolute risk refers to the actual probability of an outcome occurring in a specific group regardless of any other factors. In this case, it would be the chance of being struck by lightning. Relative risk on the other hand, compares the risk of an outcome between exposed and unexposed groups. In this case, it would be the risk of being struck by lightning when flying a kite in a storm, versus when sitting still in a house.