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Effect modification in cohort studies can be recognized by examining the stratum-specific relative risks in a manner similar to that for case-control studies. Exhibit 11-2, which shows how to recognize confounding and effect modification in case-control studies, can also be used with cohort studies by simply substituting “RR” for “OR” and “relative risk” for “odds ratio” wherever they occur in the exhibit. For example, if the relative risk in one stratum does not equal the relative risk in another stratum, and the difference is unlikely due to random variation, then effect modification is probable. Example 12-1 provides an illustration of the analysis of a cohort study based on cumulative incidence rates. |
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