Health research designs: a short play Jamie Fox Juan M. Lozano
• Compare and contrast common study designs RCT Prospective cohort Retrospective cohort Case control • Demonstrate interactive teaching strategies and tools
But once upon at time….
Our PICO question P In healthy men with lots of hair, I (E) does shampooing daily, C as compared with shampooing once or twice weekly, O increase the risk of baldness (alopecia)? T Type of question: harm T Type of study: open…..
Please take a few minutes (3) to think how you would conduct the following studies to answer the question: • RCT • Prospective cohort • Retrospective cohort • Case control
“Prospective” (concurrent) cohort study Case-control study No disease Exposed Exposed to factor Disease Sample of to factor individuals No disease Unexposed Unexposed without disease to factor to factor Disease Exposed to factor Sample of individuals with Unexposed disease to factor “Retrospective” (historical) cohort study No disease Available in your Exposed Sample of to factor Disease workshop folder: individuals without No disease tab 5 – last page Unexposed disease to factor Disease Trace Follow Future time Past time Present time
Randomized controlled trial (RCT) Hairy Shampoo daily Sample of Bald individuals with hair Hairy Shampoo weekly Bald Follow Future time Past time Present time
“Prospective” (concurrent) cohort study Hairy Shampoo daily Sample of Bald individuals with hair Hairy Shampoo weekly Bald Follow Future time Past time Present time
“Retrospective” (historical) cohort study Hairy Shampoo daily Sample of Bald individuals with hair Hairy Shampoo weekly Bald Track Future time Past time Present time
Case-control study Shampoo daily Sample of bald individuals Shampoo weekly Shampoo daily Sample of hairy individuals Shampoo weekly Trace Future time Past time Present time
In a study of risk factors for the development of asthma, investigators enrolled consecutive children during their first newborn well child check. The child ’ s caretakers were asked whether or not a dog lived in the house. The children were followed for 5 years and the frequency of asthma in children with and without dogs in their house was assessed. What type of study was this? a. Randomized controlled trial (RCT) b. Prospective cohort c. Retrospective cohort d. Case control
In a study of risk factors for the development of asthma, investigators accessed records from a primary care clinic’ s electronic database. They identified all children with a diagnosis of asthma. They also identified children of similar age and sex who did not have asthma. The investigators then looked to see how many children in each group had dogs in their home before they were diagnosed with asthma. What type of study was this? a. Randomized controlled trial (RCT) b. Prospective cohort c. Retrospective cohort d. Case control
In a study of risk factors for the development of asthma, last month investigators accessed records from a primary care clinic’s electronic database from 2000-2008. The investigators determined which children had a dog in their house at the time of their birth. They then looked to see which children developed asthma by their 5 th birthday. What type of study was this? a. Randomized controlled trial (RCT) b. Prospective cohort c. Retrospective cohort d. Case control
In a study of risk factors for the development of asthma, investigators enrolled families for a study during their newborn visit. After enrollment, the investigators used a computer to determine which families would raise a dog or a goldfish in their home. They followed families for 5 years to see which children developed asthma by their 5 th birthday. What type of study was this? a. Randomized controlled trial (RCT) b. Prospective cohort c. Retrospective cohort d. Case control
Feature Controlled Prospective Retrospective Case - trial cohort cohort control Who Researcher Other Other Other assigns (randomly, exposure ideally) Direction Exposure to Exposure to Exposure to Outcome to outcome outcome outcome exposure When Now and Now and Past Past future future
Health research designs: a short play Jamie Fox Juan M. Lozano
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