Cohort Study Design Discussion
Cohort Study Design Discussion
Cohort Study Design Discussion
Week 3 discussion Discussion Part One Risk and Cohort Study Design As an Advanced Practice Nurse, you will care for patients who are at risk for specific diseases. Please pick one chronic or infectious disease specific to a population in your geographic area and provide evidence of risk, relative risk, and odds ratio in relation to that disease, and specific risks in the population you identified. Discussion Part Two Now that you have identified the disease and risk, what is one evidence-based action that you could take within your local community or patient population to prevent this risk? Discussion Part Three Please provide a summary of the case or information you have discussed this week.
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Cohort Study
Meta-
Analysis
Systematic
Review
Practice
Guideline
Randomized
Controlled Trial
Cohort Study
Case Control Study
Case Reports
Definition
A study design where one or more samples (called cohorts) are followed prospectively and subsequent status evaluations with respect to a disease or outcome are conducted to determine which initial participants exposure characteristics (risk factors) are associated with it. As the study is conducted, outcome from participants in each cohort is measured and relationships with specific characteristics determined
Advantages
Subjects in cohorts can be matched, which limits the influence of confounding variables
Standardization of criteria/outcome is possible
Easier and cheaper than a randomized controlled trial (RCT)
Disadvantages
Cohorts can be difficult to identify due to confounding variables
No randomization, which means that imbalances in patient characteristics could exist
Blinding/masking is difficult
Outcome of interest could take time to occur
Design pitfalls to look out for
The cohorts need to be chosen from separate, but similar, populations.
How many differences are there between the control cohort and the experiment cohort? Will those differences cloud the study outcomes?
Fictitious Example
A cohort study was designed to assess the impact of sun exposure on skin damage in beach volleyball players. During a weekend tournament, players from one team wore waterproof, SPF 35 sunscreen, while players from the other team did not wear any sunscreen. At the end of the volleyball tournament players’ skin from both teams was analyzed for texture, sun damage, and burns. Comparisons of skin damage were then made based on the use of sunscreen. The analysis showed a significant difference between the cohorts in terms of the skin damage.
Real-life Examples
Hoepner, L., Whyatt, R., Widen, E., Hassoun, A., Oberfield, S., Mueller, N., … Rundle, A. (2016). Bisphenol A and Adiposity in an Inner-City Birth Cohort. Environmental Health Perspectives, 124(10), 1644-1650. https://doi.org/10.1289/EHP205
This longitudinal cohort study looked at whether exposure to bisphenol A (BPA) early in life affects obesity levels in children later in life. Positive associations were found between prenatal BPA concentrations in urine and increased fat mass index, percent body fat, and waist circumference at age seven.
Lao, X., Liu, X., Deng, H., Chan, T., Ho, K., Wang, F., … Yeoh, E. (2018). Sleep Quality, Sleep Duration, and the Risk of Coronary Heart Disease: A Prospective Cohort Study With 60,586 Adults. Journal Of Clinical Sleep Medicine, 14(1), 109-117. https://doi.org/10.5664/jcsm.6894
This prospective cohort study explored “the joint effects of sleep quality and sleep duration on the development of coronary heart disease.” The study included 60,586 participants and an association was shown between increased risk of coronary heart disease and individuals who experienced short sleep duration and poor sleep quality. Long sleep duration did not demonstrate a significant association.
