true or false:
- The term “natural history” refers to how a disease evolves over time and to the factors that shape its evolution
- What the physician sees in his clinic is just an episode of the natural history
true
cohort study investigates — of the disease and the 3 components of this study is:
2 main types of cohort studies:
1- —-: Follow up of population groups to document incidence of diseases or disorders and their risk factors
- these tells us how the disease —- in —- people
2- —- : Follow up of patient groups to document natural history and prognosis of a disease or disorder
- these tell us about the —- and the — of the disease
population cohort studies:
- provide info on the — of health problems
- General population studies (rare) often take the population of a defined —-
examples:
-Birth cohort studies recruit all children born in a defined period
-Studies may recruit participants in an age range of interest (e.g. persons over 65)
-Occupational cohorts (workers in specific industries are followed up to look for occupational hazards)
incidince
geographical regions
how are the population cohort conducted :
1- identify population group of —- :
-Defined as not already having the —- or — of interest
Can be —- found (e.g. medical charts)
2- measure charactericts at —-:
- classifying into — depending on — status of risk factors ( these risk factors can be genetic environmental or behavioural )
3- —- over time to assess defined endpoint to determine —-
healthy individuals
disease or disorder
retrospectively
at baseline
groups
exposure
follow up
incidence rates
endpoint of interest
rolling basis
survival time
variable follow up
event ( outcome )
how long
zero
outcomes
1
outcomes
( check slide 17-23 important for example plsss)
risk factor and outcome
is causal
before
statistical measure
-clinical cohort studies study — and —
- the cohort is a —- which defined — or —
- they are followed from a — in the natural history of the disease or condition for example: from time of diagnosis, or date of discharge
- The study records incidence of —- and— which affect the incidence for example: —-
natural history and prognosis
group of participants
diagnosis or condition
defined point
clinical endpoint
factors
examples: . mortality and morbidity, readmission, disease progression
( check slide 26-32pls)
strengths of cohort studies:
- cohort often study —– which is impritsnt to justify the — of follow up
- they record — which is important info for health care service —
- —- is the the rate of occurrence of new cases per unit time per unit population
- it indicates the – of contracting a disease ( communicable or non )
- useful for population —- as : . emerging or resurging disease
- indicator of the scope for —
multiple different endpoints
high cost
record incidence
planning
incidence ( example: Incidence of cancer is 800 new cases per 100,000 per year in Ireland or, equivalently, 0.8% chance per year for any person)
risk
population surveillance
prevention
strengths of cohort studies ( continued )
- Less biased information on risk factors because the risk factor is measured — the disease occurs
- Unlike case-control studies and “Retrospective” cohort studies, which ascertain exposure retrospectively
- Time-order with regard to risk factor is —: less susceptible to biases associated with cross-sectional or case-control studies
- The results are — to —- to the population aka —-
before
clear
easier
generalise
external validity
weakness of cohort studies:
- collecting data requires —
- —- of study ( specific time-frame of the study )
- Even for common diseases, a lot of —- needed to detect a worthwhile number of cases
- may require —-
- —- ,—– , —– are issues
- —- to conduct
- Impractical for diseases with a —- and —
follow ups
long duration
follow ups
large sample size
Non-response, migration, loss-to-follow-up and selection biases are issues
expensive
long pre-clinical phase (latency period) which is the phase before the first clinical manifestation and impractical for rare disease
summary :
1- cohort studies :
- followed a — of participants
- over a —-
- record — of events of interest
2- —- studies study incidence of disease to look for risk factors
3- —– studies examine the natural history and prognosis of a disease, looking for factors that affect —- and possible —- by which they work
defined group
period of time
incidence
population cohort
clinical cohort
prognosis
mechanisms
summary :
all cohort studies :
- measure —- then —- and record —- of events
- they measure the effect of risk factors by comparing —- which is the relative risk
- When looking for causes of diseases, they do not provide as —– as —-
risk factors
follow up
incidence
incidence
strong evidence as intervention studies ( In many cases intervention studies are not possible, so they provide the strongest actual evidence)