Study types Cohort and case-control studies:研究类型的队列研究和病例对照研究[精品].ppt

Study types Cohort and case-control studies:研究类型的队列研究和病例对照研究[精品].ppt

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Study types Cohort and case-control studies:研究类型的队列研究和病例对照研究[精品]

* * Strengths of Cohort Studies Efficient for rare exposures, diseases with long induction and latent period Can evaluate multiple effects of an exposure If prospective, good information on exposures, less vulnerable to bias, and clear temporal relationship between exposure and disease * Weaknesses of Cohort Studies Inefficient for rare outcomes If retrospective, poor information on exposure and other key variables, more vulnerable to bias If prospective, expensive and time consuming, inefficient for diseases with long induction and latent period Keep these strengths and weaknesses in mind for comparison with case-control studies * Cohort study Example of cohort studies ? The association between statin use and prostate cancer risk ? All men 45+ years enrolled in GHC for at least 2 years during 1990-2004 ? Exposure is statin use, which may change over 14 years ? Follow 14 years until develop prostate cancer, die, or disenroll from GHC ? Each subject will contribute person-time to follow-up ? Survival analysis to account for time varying exposure, adjust for other risk factors, account for censoring Prostate cancer No cancer Statin user Nonuser 14 years Prostate cancer No cancer * Prospective vs. retrospective Cohort Studies Prospective Cohort Studies Time consuming, expensive More valid information on exposure Measurements on potential confounders Retrospective Cohort Studies Quick, cheap Appropriate to examine outcome with long latency periods Admission to exposure data Difficult to obtain information of exposure Risk of confounding * Analysis in Cohort study ? Exposed and non-exposed individuals are followed over time to determine whether they experience the outcome of interest ? Examples of exposure: Environmental factor, condition, procedure ? Examples of outcome: Disease, death, costs * * but before I go into details about the cohort and case-control studies I would like to place these kind of studies in relation to other types of epidemiolo

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