Professional Documents
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Dr. A. K. AVASARALA
MBBS, M.D.
PROFESSOR & HEAD
DEPT OF COMMUNITY
MEDICINE & EPIDEMIOLOGY
PRATHIMA INSTITUTE OF
MEDICAL SCIENCES,
KARIMNAGAR, A.P.
INDIA: +91505417
avasarala@yahoo.com
LEARNING OBJECTIVES
LEARNER SHOULD BE ABLE TO KNOW AT
THE END OF THIS LECTURE
• ANALYTICAL OBSERVATIONAL
STUDIES
• ALMOST SIMILAR TO THE
EXPERIMENTAL STUDIES
WHAT IS A COHORT?
ABSENT c d c+d
a+c b +d a+b+c+d
ANALYSIS
1. IN A SIMILAR MANNER BOTH FOR
THE STUDY COHORT AND
COMPARISON COHORT
2. DUE CONSIDERATION TO
• THE LOSS ON FOLLOW-UP
• THE SECONDARY INFORMATION
OBTAINED FROM OTHER SOURCES
(FAMILY MEMBERS AND
NEIGHBORS) WITH REGARD TO
ATTRITION
COMPARISON COHORT
• INTERNALLY,
• EXTERNALLY OR
• WITH GENERAL POPULATION
RATES.
INCIDENCE RATES
• INCIDENCE AMONG THE EXPOSED (NEW
CASES AMONG THE SMOKERS) = (A/ A+B)
COMPARISON COHORT
STUDY COHORT (NOT EXPOSED)
(EXPOSED GROUP) INTERNAL OR EXTERNAL
COMPARISON OR WITH THE GENERAL
POPULATION RATES
FORWARD
SUSPECTED EFFECT/
CAUSE DISEASE
FOLLOW UP STUDY
3. RETROSPECTIVE – PROSPECTIVE
COHORT (COMMENCED IN THE PAST
AND EXTENDED INTO THE FUTURE)
STEPS IN CONDUCTING
COHORT STUDY
• DISEASED PERSONS
• EXPOSED PERSONS
EXPOSURE CONSIDERATIONS
• HOMOGENEOUS COHORT
• HETEROGENEOUS COHORT
SOURCES OF STUDY COHORT
1. GENERAL POPULATION
DIFFERENT SUBGROUPS OF
SAME HETEROGENEOUS
COHORT ARE COMPARED
EXTERNAL COMPARISON
• SPECIAL GROUPS,
• EXPOSURE GROUPS,
• HOSPITAL REGISTERS,
• MEDICAL RECORDS, AND
•DEATH CERTIFICATES, ETC.
COHORT SELECTION
TECHNIQUES
• DOSE-RESPONSE RELATIONSHIP
DATA COLLECTION
TECHNIQUES-2
• DURATION OF FOLLOW UP
FOLLOW-UP TECHNIQUES
1. PERIODICAL MEDICAL EXAMINATIONS AND MAILED
QUESTIONNAIRES
• FOLLOW UP
• ATTRITION
• ETHICAL PROBLEMS
SUMMARY
THOUGH COHORT STUDY IS
• TIME CONSUMING
• EXPENSIVE
• LESS BIASED