How to interpret an odds ratio of less than 1

In a recent paper (see page 122 ) I have read that an odds ratio OR of 0.7 means a 30% risk reduction which is wrong.

The OR is a measure of association not a risk ratio (which requires random sampling of the population and a slightly different formula).

Let’s have a look on the following table to see why this is all wrong

Disease+Disease-
Exposure+a=7b=10
Exposure-c=10d=10

The odds of an event is the number of those who experience the event divided by the number of those who do not.

Comparing the odds in an exposed and a not exposed group results in the simple odds ratio OR formula.

OR = (a/b) / (c/d)

But the odds is not the risk. The risk (incidence proportion) of an event is the number who experience it divided by everyone in that group – those who do and those who do not.

Risk for the exposed is 42.7%, for the unexposed 50%.


RR = ( a/(a+b) / c/c+b) )

Note the denominators: for the odds it was b and d (only the disease-free), for the risk it is the whole row (a+b and c+d). That single change is the whole difference between the two measures.

The risk ratio is then RR= 0.82 and the risk reduction 18%.

 

CC-BY-NC Science Surf , accessed 30.07.2026