ABSTRACT
Florence Nightingale used a table of hospital mortality rates in a book, igniting a debate in 1864 between William Farr (the Registrar General) and several physicians. Some physicians denounced incidence rates as misleading and claimed that risks (incidence proportions) claimed were superior. The same debate reappeared in a 1996 article and subsequent letters. In 1995, an article in the British Medical Journal criticized the use of fracture rates. Many limitations of rates were noted. A response appeared from Harvard in 1996. A 2009 paper criticized incidence rates and argued that risk ratios, odds ratios, and hazard ratios should be preferred over rate ratios. These arguments are discussed.
