06-CohortStudies

06-CohortStudies - Principles of Epidemiology for Public...

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2/15/2011 Cohort studies 1 Study designs: Cohort studies Principles of Epidemiology for Public Health (EPID600) Victor J. Schoenbach, PhD home page Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill www.unc.edu/epid600/
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“Bottled at the source” Italy? France? Germany? Switzerland?
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Not quite – “Bottled at the CG Roxane Source a the Mountains of Tennessee” Welcome to the American Alps!?
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10/8/2001 4 Students examination answers From Ann Landers "Science answers are hilarious but scary” (taken from a Popular Science article citing [real] test answers given by students in science classes)
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2/11/2003 5 “To collect fumes of sulfur, hold a deacon over a flame in a test tube.” “Water is composed of two gins, oxygin and hydrogin. Oxygin is pure gin. Hydrogin is gin and water.” “Nitrogen is not found in Ireland because it is not found in a free state.” More exam answers
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10/8/2001 6 “When you smell an odorless gas, it is probably carbon monoxide.” “The pistol of a flower is its only protection against insects.” “Germinate: to become a naturalized German.” “To prevent contraception, wear a condominium.” More exam answers
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2/15/2011 Cohort studies 7 Study designs: Cohort studies Principles of Epidemiology for Public Health (EPID600) Victor J. Schoenbach, PhD home page Department of Epidemiology Gillings School of Global Public Health University of North Carolina at Chapel Hill www.unc.edu/epid600/
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10/1/2001 Cohort studies 8 Cohort studies Intuitive approach to studying disease incidence and risk factors: 1. Start with a population at risk 2. Measure characteristics at baseline 3. Follow-up the population over time with a) surveillance or b) re-examination 4. Compare event rates in people with and without characteristics of interest
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7/1/2009 Cohort studies 9 Cohort studies Can be large or small Can be long or short Can be simple or elaborate Can be local or multinational For rare outcomes need many people and/or lengthy follow-up May have to decide what characteristics to measure long in advance
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10/1/2001 Cohort studies 10 Case example – Atherosclerosis Risk in Communities (ARIC) Study Prospective study in four U.S. communities to investigate: 1. etiology and natural history of atherosclerosis 2. etiology of clinical atherosclerotic diseases 3. variation in CVD risk factors, medical care and disease by race, sex, place, and time.
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10/4/2005 Cohort studies 11 Background to ARIC Study – the CVD epidemic of the 20th century Heart disease became the leading cause of death in men and women Major CVD cohort studies, e.g.: Framingham, MA British Civil Servants Tecumseh, MI Paris Evans County, GA Honolulu, HI
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2/15/2011 Cohort studies 12 Background to ARIC Study – the CVD epidemic of the 20th century CVD (heart disease, stroke, hypertension, etc.) rose from the 4 th leading cause of death in 1900 to the leading cause by 1910 CVD death rates peaked in 1963 and proceeded to fall by over one-half (56%) Death rates from coronary heart disease (CHD) and stroke fell most
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10/1/2001 Cohort studies 13 CHD Non-CVD Stroke
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10/1/2001 Cohort studies 14 CHD Non-CVD Stroke
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10/1/2001 Cohort studies 15 White male Black male Black female White female
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