Describing the appropriate use and interpretation of odds and risk ratios.

In sport medicine, epidemiology of sport-related injury provides the foundation for understanding what types of injuries and illnesses occur and who is at the highest risk. Thus, accurate and transparent reporting and interpretation of risk metrics is essential to sports epidemiology. Odds ratios (OR) and risk ratios (RR) are two statistics used to quantify the association between exposure and outcome and are frequently seen in sports medicine literature. While similarities exist, there are optimal ways to use and interpret OR and RR based on the study design and outcome incidence in the target population. In this short communication, we will present common study designs (e.g. prospective cohort, case-control, cross-sectional) along with recommendations for the use and interpretation of OR and RR. This will ultimately assist practitioners in choosing and interpreting these frequently confused measures of association and also help journal reviewers better understand the appropriate use of these measures when evaluating a manuscript.

Hypertension labelling was associated with poorer self-rated health in the Third US National Health and Nutrition Examination Survey.

Individuals labelled as having hypertension tend to report poor self-rated health (SRH), but it is unclear whether this association is independent of actual hypertension, socioeconomic status and adiposity, and extends across racial and ethnic groups. In a cross-sectional study we compared hypertensive and normotensive individuals (N = 19,057) who varied in whether they had ever been labelled hypertensive. Blood pressure was measured in participants' homes and mobile examination centres in the United States as part of the Third National Health and Nutrition Examination Survey, 1988-1994. The main outcome measure was global SRH. Hypertensive labelling was associated with poorer SRH and was independent of established SRH predictors, antihypertensive medication use, body mass index, and hypertension status (adjusted odds ratio (OR) = 1.79, 95% confidence interval (CI), 1.61-1.99). Hypertension was also associated with poorer SRH (OR = 1.26; 95% CI 1.09-1.46) but this association was eliminated by adjustment for hypertensive labelling (OR 1.06; 95% CI 0.92-1.22). These effects were consistent across non-Hispanic white, non-Hispanic black, and Hispanic subgroups. Individuals labelled hypertensive are more likely to have lower SRH and this labelling effect predominates over that of actual hypertension. Public health efforts to increase the number of individuals screened for high blood pressure may successfully detect the presence of hypertension but may also reduce health-related quality of life as measured by global SRH.

Effects of lovastatin on cognitive function and psychological well-being.

PURPOSE: Animal research and cross-sectional studies suggest that serum lipid concentrations may influence cognitive function, mood, and behavior, but few clinical trials have studied these effects. SUBJECTS AND METHODS: In this double-blind investigation, 209 generally healthy adults with a serum low-density-lipoprotein (LDL) cholesterol level of 160 mg/dL or higher were randomly assigned to 6-month treatment with lovastatin (20 mg) or placebo. Assessments of neuropsychological performance, depression, hostility, and quality of life were conducted at baseline and at the end of the treatment period. Summary effect sizes were estimated as z scores on a standard deviation (SD) scale. RESULTS: Placebo-treated subjects improved between baseline and posttreatment periods on neuropsychological tests in all five performance domains, consistent with the effects of practice on test performance (all P <0.04), whereas those treated with lovastatin improved only on tests of memory recall (P = 0.03). Comparisons of the changes in performance between placebo- and lovastatin-treated subjects revealed small, but statistically significant, differences for tests of attention (z score = 0.18; 95% confidence interval (CI), 0.06 to 0.31; P = 0.005) and psychomotor speed (z score = 0.17; 95% CI, 0.05 to 0.28; P = 0. 004) that were consistent with greater improvement in the placebo group. Psychological well-being, as measured several ways, was not affected by lovastatin. CONCLUSION: Treatment of hypercholesterolemia with lovastatin did not cause psychological distress or substantially alter cognitive function. Treatment did result in small performance decrements on neuropsychological tests of attention and psychomotor speed, the clinical importance of which is uncertain.

The effects of social context and defensiveness on the physiological responses of repressive copers.

In previous research (T.L. Newton & R.J. Contrada, 1992), social context was found to moderate exaggerated physiological reactivity among individuals identified as using a repressive coping style. In this experiment, 119 undergraduates were classified into low-anxious, high-anxious, repressor, and defensive high-anxious coping categories. All participants completed a stressful speech task under either a public or private social context condition. The experimental social context was related to physiological reactivity and self-reported affect but did not moderate reactivity among repressive copers. Additionally, reactivity among repressive copers was not attributable to high defensiveness alone. Consistent with a theory of emotional inhibition, nonspecific skin conductance responses, but not heart rate, discriminated between repressors and nonrepressors.

Disclosure of traumas and health among Holocaust survivors.

On the basis of a theory of inhibition and psychosomatics, it was predicted that the more individuals disclosed personally traumatic experiences, the better their long-term health following the disclosure. Thirty-three Holocaust survivors talked for 1-2 hours about their personal experiences during World War II while skin conductance level (SCL) and heart rate (HR) were continuously monitored. Each videotaped interview was rated by independent judges once every minute on the degree to which the survivor's experience was traumatic. For each subject, the trauma ratings were correlated with minute-by-minute SCL and HR readings. Based on previous research, negative trauma-SCL correlations are indicative of high personal disclosure, whereas positive trauma-SCL correlations suggest low disclosure, whereas positive trauma-SCL correlations suggest low disclosure. Approximately 14 months after the interview, self-reports of the subjects' health were collected. Controlling for pre-interview health problems, degree of disclosure during the interview was found to be positively correlated with long-term health after the interview. The possible health benefits of disclosure are discussed.