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The Odd Ratios are Symmetrical but the Relative Risk Is Not

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Consider the data in the 2 × 2 contingency table of Table 3.7 where the relative risk of being alive in the exposed compared to the not exposed group is relative risk (alive) = 0.96 /0 99 = 0.97; the reciprocal is 1/relative risk (alive) = 1/ 0.97 = 1.03. The relative risk (dead) = 0.04/0.01 = 4. Thus, note that the relative risk (dead) is not equal to 1 / relative risk (alive).

Table 3.7 Example of a two by two contingency table with a binary outcome (alive or dead) and two groups of subjects (exposed or not exposed).

Outcome Test treatment exposed Control treatment not exposed
Alive 0.96 0.99
Dead 0.04 0.01
Total 1.00 1.00

The odds ratio (alive) = (0.96/0.04) / (0.99/0.01) = 0.24; the reciprocal is: 1/odds ratio (alive) = 1/ 0.24 = 4.13. The odds ratio (dead) = (0.04/0.96)/(0.01/0.99) = 4.13; and hence the odds ratio (dead) is equal to 1/odds ratio (alive).

Medical Statistics

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