Journal article
Moving beyond risk ratios in sibling analysis: estimating clinically useful measures from family-based analysis
European journal of epidemiology, Forthcoming
24 Jan 2026
PMID: 41579296
Abstract
Findings from family-based analyses, such as sibling comparisons, are often reported using only odds ratios or hazard ratios. We demonstrate how this can be improved upon by applying the marginalized between-within framework. We provide an overview of sibling comparison methods and the marginalized between-within framework, which enables estimation of absolute risks and clinically relevant metrics while accounting for shared familial confounding. We illustrate the approach using Swedish registry data to examine the association between maternal smoking and infant mortality, estimating absolute quantities (e.g., cumulative risks), average treatment effects, attributable fractions, and numbers needed to harm (or treat). The marginalized between-within model decomposes effects into within- and between-family components while applying a global baseline across all families. Although it typically yields similar relative estimates to conditional logistic or stratified Cox regression, the model's specification of a baseline enables the estimation of absolute measures. In the applied example, absolute measures provided more interpretable and policy-relevant insights than relative estimates alone. Code for implementation in Stata and R is provided. The marginalized between-within framework may strengthen the interpretability of family-based analysis by enabling absolute and policy-relevant estimates for both binary and time-to-event outcomes, moving beyond the limitations of solely relying on relative effect measures.
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Details
- Title
- Moving beyond risk ratios in sibling analysis: estimating clinically useful measures from family-based analysis
- Creators
- Viktor H Ahlqvist (Corresponding Author) - Karolinska InstitutetHugo Sjöqvist - Karolinska InstitutetArvid Sjölander - Karolinska InstitutetDaniel Berglind - Karolinska InstitutetPaul C Lambert - Norwegian Institute of Public HealthBrian K Lee - Drexel UniversityPaul Madley-Dowd - University of Bristol
- Publication Details
- European journal of epidemiology, Forthcoming
- Publisher
- Springer Nature
- Number of pages
- 7
- Grant note
- Karolinska Institute
Open access funding provided by Karolinska Institute.
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Epidemiology and Biostatistics
- Web of Science ID
- WOS:001668380500001
- Other Identifier
- 991022155318704721