Evolution of the cohort study.
Evolution of the cohort study.
复制标题
队列研究的演变。
DOI：
10.1093/oxfordjournals.epirev.a017964
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发表时间：
1998
影响因子：
5.5
通讯作者：
Muñoz,A
中科院分区：
文献类型：
--
作者：
Samet,JM;Muñoz,A
随着时间的推移事件的发生统一了流行病学研究。无论研究假设和设计如何，暴露和修正因素的致病作用都被制定为结果发生的先决条件。所有研究设计都固有地承认时间，并代表了对人群进行采样的替代方法，因为暴露和非暴露人员会随着时间的推移而患病。队列设计明确纳入了时间的推移。在队列研究中，受试者在研究开始和结束时定义的时间间隔内接受随访，并对感兴趣的结局指标进行观察：死亡，疾病发生率，生物学指标的变化或健康状况。该研究的目的可能集中在测试特定（或一般）假设上，收集数据用于描述性目的或促进对有关疾病的多种假设的测试。在队列研究参与者的随访经验中，决定参与者健康的因素可能会随着参与者年龄的增长和环境因子暴露的开始、停止、增加或减少而不断变化（图1）。许多风险因素的动态性质及其与疾病发生时间的关系只能在队列设计中获得;这种时间相互作用本质上不存在于横断面数据中，并且通常仅难以使用病例对照设计进行研究（1）。流行病学家可能会在调查多种风险因素之间的关系时遇到挑战，其中一些风险因素随时间变化，以及疾病发生，如图1所示。在队列随访期间，受试者的年龄、时间趋势可能会影响受试者，以及暴露于主要风险因素的风险。
The occurrence of events over time unifies epidemiologic research. Regardless of the study hypothesis and design, the disease-causing actions of exposures and modifying factors are formulated as antecedent to the occurrence of the outcome. All study designs inherently acknowledge time and represent alternative approaches for sampling populations as exposed and nonexposed persons develop disease over time. The cohort design explicitly incorporates the passage of time. In cohort studies, participants are followed over an interval defined by the study's beginning and end, and observations are made on outcome measures of interest: death, incidence of disease, change in a biologic measure, or health status. The study's purpose may be focused—to test a specific (or general) hypothesis—to gather data for descriptive purposes or to facilitate the testing of multiple hypotheses concerning disease. During the follow-up experience of participants in a cohort study, the factors determining the health of the participants may be continually changing as the participants age and exposures to environmental agents start, stop, increase, or decrease (figure 1). The dynamic nature of many risk factors and their relations in time to disease occurrence can only be captured in the cohort design; this temporal interplay is inherently absent from crosssectional data and often investigated only with difficulty using the case-control design (1). Epidemiologists may be challenged in investigating the relation between multiple risk factors, some changing in time, and disease occurrence, as displayed schematically in figure 1. During the follow-up of a cohort, participants age, temporal trends may affect the participants, and exposures to risk factors of primary