Cohort Study
Usually undertaken to obtain additional evidence to refute or
support the existence of an association between suspected
cause and disease
Also known as :
i) Prospective study
ii) Longitudinal study
iii) Incidence study
iv) Forward looking study
Concept
• Cohort is defined as a group of people who share
a common characteristic or experience within a
defined time period.
• Examples:
• Birth cohort
• People exposed to same drug/ infection
(exposure cohort)
• Marriage cohort
Indications for Cohort
Study
• When there is good evidence of association
between exposure and disease
• When exposure is rare, but Incidence is high
among exposed
• When attrition of study population can be
minimised
• When adequate funds are available
General considerations
taken to account in a
Cohort
• The cohorts must be free from disease under
study
• Both the study and control groups must be equally
suspecitble to the disease
• Both the groups should be comparable in respect
of all possible variables
• The diagnostic and eligibility criteria of the disease
must be defined before hand
Types of Cohort Study
1) Prospective Cohort studies
It is the one in which the disease has not occurred at
the start of investigation.
They begin in the present and continue to the future.
Examples :
i) US public health Service's Framingham heart study.
ii) Doll and Hill prospective study on smoking and
lung cancer
2) Retrospective Cohort
Study
• It is the one in which the outcomes have occured
before the start of the investigation.
• Investigator usually goes back in time to select
study groups from existing records of past
employment,medical or other records.
• Example :
• Occupational exposures like study of role of arsenic
in human carcinogenesis
• Study of mortality in physicians in relation to
radiation exposure
3) Combination of Retrospective
and Prospective Cohort studies
• In this study both the retrospective and prospective
types are combined. The Cohort is identified from
the past records and assessed till present .
• Same cohort is followed into future for further
assessment.
Example :
• Done by Court-Brown and Doll in 1934-1954 to
study the effects of radiation
