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Epidemiology · Public Health

Epidemiology: Study Designs

Cohort, case-control, cross-sectional, and randomized controlled trial study designs with their key strengths and limitations.

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What is the defining feature of a cohort study's direction of investigation?
It follows exposed and unexposed groups forward in time to see who develops the outcome.
In a cohort study, is exposure or outcome status known at the start?
Exposure status is known at the start; outcome is observed over time.
What is the key difference between a prospective and a retrospective cohort study?
Prospective follows subjects forward from now; retrospective uses existing records to look back from a past exposure to an outcome that already occurred.
What measure of disease frequency can cohort studies calculate directly?
Incidence (the rate of new cases).
What association measure is typically calculated from a cohort study?
Relative risk (risk ratio).
What is one strength of cohort studies regarding outcomes?
They can examine multiple outcomes from a single exposure.
Why are cohort studies well suited to studying rare exposures?
Subjects are selected based on exposure status, ensuring enough exposed people are included.
What is a major limitation of prospective cohort studies related to cost and time?
They are often expensive and take a long time, especially for diseases with a long latency period.
Why are cohort studies poorly suited to studying rare diseases?
A very large sample size and long follow-up would be needed to observe enough cases.
What bias can result when many cohort study participants drop out before the outcome is assessed?
Loss to follow-up bias (attrition bias).
What is the defining feature of a case-control study's direction of investigation?
It starts with people who already have the outcome (cases) and those who do not (controls), then looks backward for exposure.
What association measure is calculated from a case-control study?
The odds ratio.
Why are case-control studies well suited to studying rare diseases?
Subjects are selected based on disease status, ensuring enough cases are included even if the disease is rare.
What is one strength of case-control studies regarding exposures?
They can examine multiple exposures for a single outcome.
Why are case-control studies generally faster and cheaper than cohort studies?
They do not require long-term follow-up since the outcome has already occurred.

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