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Cohort Study Park Textbook

A cohort study is an analytical epidemiological study that follows a disease-free population over time, comparing exposed and unexposed groups to measure incidence, relative risk, and attributable risk. There are three types of cohort studies: prospective, retrospective, and ambidirectional, each with distinct methodologies. While cohort studies are advantageous for establishing temporal relationships and measuring multiple outcomes, they can be time-consuming and subject to biases.

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30 views10 pages

Cohort Study Park Textbook

A cohort study is an analytical epidemiological study that follows a disease-free population over time, comparing exposed and unexposed groups to measure incidence, relative risk, and attributable risk. There are three types of cohort studies: prospective, retrospective, and ambidirectional, each with distinct methodologies. While cohort studies are advantageous for establishing temporal relationships and measuring multiple outcomes, they can be time-consuming and subject to biases.

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gmch.rubul
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© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
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Cohort Study

Based on Park’s Textbook of


Preventive & Social Medicine
Prepared by: [Your Name]
Introduction & Definition
• • Analytical epidemiological study where a
disease-free population is followed over time.
• • Groups: Exposed vs Unexposed.
• • Measures: Incidence, Relative Risk (RR),
Attributable Risk (AR).
• • Establishes temporal relationship between
exposure and disease.
Types of Cohort Studies
• 1. Prospective (Concurrent) Cohort Study –
Exposure and outcome followed forward in
time.
• 2. Retrospective (Historical) Cohort Study –
Uses past records for exposure and outcome.
• 3. Ambidirectional – Combines both
prospective and retrospective features.
Steps in Conducting a Cohort Study
• 1. Define study population (disease-free at
start).
• 2. Classify participants based on exposure.
• 3. Follow up to observe disease development.
• 4. Compare incidence between exposed and
unexposed groups.
• 5. Calculate RR and AR.
2×2 Table and Measures of
Association
• Exposure vs Disease Table:

• | Exposure | Disease Yes | Disease No | Total


|
• |-----------|--------------|-------------|--------|
• | Exposed | a |b | a+b |
• | Unexposed | c |d | c+d |

• Relative Risk (RR) = [a/(a+b)] / [c/(c+d)]


Advantages & Disadvantages
• Advantages:
• • Temporal relationship clear.
• • Multiple outcomes from one exposure.
• • Incidence and risk directly measurable.

• Disadvantages:
• • Time-consuming and costly.
• • Loss to follow-up.
• • Inefficient for rare diseases.
Bias & Confounding in Cohort
Study
• • Selection bias (different follow-up rates).
• • Information bias (misclassification of
exposure).
• • Attrition bias (loss to follow-up).
• • Confounding (controlled by stratification or
regression).
Examples & Applications
• • Framingham Heart Study (Cardiovascular
risk factors).
• • Nurses’ Health Study (Lifestyle & chronic
diseases).
• • Example from Park: Boston neonatal
monitoring cohort.
Summary
• • Cohort study = Follows exposed &
unexposed over time.
• • Measures risk, RR, AR directly.
• • Useful for establishing causality.
• • Despite limitations, it's vital in public health
research.
References
• 1. Park K. Textbook of Preventive and Social
Medicine.
• 2. Hennekens CH, Buring JE. Epidemiology in
Medicine.
• 3. Rothman KJ, Greenland S. Modern
Epidemiology.

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