Cohort Studies Flashcards
Kinds of frequent epidemiological studies
Cross-sectional studies
Case-control studies
Prospective cohort study
Cohort definition
A group of people with something in common, usually an exposure or involvement in a defined population group within a defined period of time
Characteristics cohort study
All of them should be at risk of developing the disease
They shouldn’t have the disease at baseline
After 1 year you classify them into ‘new incident cases’ and those who didn’t develop the disease
The exposure usually occurs prior to the beginning of the study
Fixed cohort
When the cases being studied are selected at the beginning of the study - once the study starts, there is no more recruitment
Case-cohort design
All the cases are included - instead of including 100% of the cohort, you select a random sample
This is done in order to cut costs
Dynamic cohort
You don’t close period of recruitement (permanently open)
You can balance those who enter/and exit the study
Uses of cohort studies
We study frequent outcomes (no rare diseases)
We can also study rare exposures
Relatively short induction period (period between action of risk factors and occurrence of disease)
Advantages cohort studies
• Well suited to assess peculiar exposures
• You can collect multiple effects of the same exposure and also multiple exposures if planned
• The temporal sequence is adequate
• They can explain the natural history of disease
• Long latency periods
• Prevents misclassification bias
• We get direct and timely info on exposure and repeated measures
• Allows direct calculation of incidence (absolute risks)
Disadvantages cohort studies
• Useless for rare diseases
• Expensive
• You need patience (not immediate results)
• Ascertainment bias
• Changes in diagnostic criteria in the long term
Nationwide registries
They study the whole population of a place
Retrospective / Historical Cohort Study
You start the study after the exposure and after the disease
You need to trust your registries - have very good historical records