Preventive Medicine

 


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A.  Study Design and Terminology

  1. Cohort study: refers to the group of subjects who are followed forward in time to see which ones develop the outcome.
Prospective cohort study:  follows subjects from presentfuture
Retrospective cohort study:  follows subjects from pastpresent
Nested cohort study:  Retrospective + Prospective study
Cohort studies provide incidence--rate of development of a disease over a period of time.
May give predictive factors of a condition.
Expensive and impractical for rare diseases.
Sensitive to confounding variables.
  1. Case-Control (retrospective) study: a group of people who have a disease (cases) are compared with people whom they closely resemble except for the presence of the disease under study controls.
Follows subjects from presentpast
Provides odds ratio:  strength of association among predictors in the cases and in the controls.
Sample sizes can be very small
Applicable for finding exposures of disease and studies of rare diseases.
  1. Cross-Sectional studies: exposure and outcome are measured at the same point in time.
Provides prevalence and relative prevalence
Cannot provide casual relationship:  only associations
Design is time and cost efficient
  1. Clinical trials: prospective studies in which an intervention is applied.
  2. Meta-analysis: retrospective analysis of studies regard to the same topic.
  3. P-value:  likelihood of the results by chance (needs to be <= 0.05 to be considered significant).

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