Letter to the editor: Beyond the odds ratios: Why risk ratios offer clearer clinical insight in comparative surgical meta-analyses

The odds ratio (OR) and the risk ratio (RR) are valid measures of association but differ substantially in interpretability and magnitude when outcomes are common. The RR compares event probabilities directly, whereas the OR compares odds, diverging from risks as event frequency increases. When events are rare, both measures approximate each other; however, with higher incidences, ORs increasingly overestimate RRs, potentially exaggerating the apparent effect size (Cochrane Handbook, Chapter 6.4.1.3) (“Problems may arise if the odds ratio is misinterpreted as a risk ratio.