The effect of category choice on the odds ratio and several measures of association in case-control studies

In many case-control studies the risk factors are categorized in order to clarify the analysis and presentation of the data. However, inconsistent categorization of continuous risk factors may make interpretation difficult. This paper attempts to evaluate the effect of the categorization procedure on the odds ratio and several measures of association. Often the risk factor is dichotomized and the data linking the risk factor and the disease is presented in a 2 x 2 table. We show that the odds ratio obtained from the 2x2 table is usually considerably larger than the comparable statistic that would have been obtained had a large number of outpoints been used. Also, if 2 x 2, 2 x 3, or 2 x 4 tables are obtained by using a few outpoints on the risk factor, the measures of association for these tables are usually greater than the measure that would have been obtained had a large number of cntpoints been used. We propose an odds ratio measure that more closely approximates the odds ratio between the continuous risk factor and disease. A corresponding measure of association is also proposed for 2 x 2, 2x3, and 2x4 tables.