Relative risk versus absolute risk: one cannot be interpreted without the other

Abstract

For the presentation of risk, both relative and absolute measures can be used. The relative risk is most often used, especially in studies showing the effects of a treatment. Relative risks have the appealing feature of summarizing two numbers (the risk in one group and the risk in the other) into one. However, this feature also represents their major weakness, that the underlying absolute risks are concealed and readers tend to overestimate the effect when it is presented in relative terms. In many situations, the absolute risk gives a better representation of the actual situation and also from the patient's point of view absolute risks often give more relevant information. In this article, we explain the concepts of both relative and absolute risk measures. Using examples from nephrology literature we illustrate that unless ratio measures are reported with the underlying absolute risks, readers cannot judge the clinical relevance of the effect. We therefore recommend to report both the relative risk and the absolute risk with their 95% confidence intervals, as together they provide a complete picture of the effect and its implications.

Keywords: absolute risk difference; epidemiology; number needed to treat; relative risk; risk reduction.