Nuances of Cohort Studies and Risk Ratio

Abstract

Post-graduate students and faculty usually conduct case-control studies. However, sometimes they conduct cohort studies that are short-duration. Most investigators enroll the participants in two groups according to the exposure. Then, follow the participants for some duration. At the end of the study, relative risk is calculated, and the work is published in some journal. The exposure may be one time, which may or may not be quantified. The follow-up duration may not be participant-specific, and differential follow-up does not exist. The author has given three examples: the first example of consanguineous marriages and congenital disabilities, the second example of the ABO blood group system and childhood asthma, and the third example of insecticide spraying and stillbirth. In the given examples, cumulative or density incidence cannot be calculated in a true sense and, therefore, risk ratio. Even estimating the incidence of outcome variables in some studies is not appropriate. Risk ratio calculation in such scenarios is questionable because exposure quantification, follow-up period, and combination are the limiting factors. In case-control studies, the prevalence ratio is calculated, which is analogous to relative risk. The author suggests that, in such circumstances, prevalence ratio calculation will be more appropriate.

Keywords

• cumulative incidence
• density incidence
• differential follow-up
• exposure quantification
• prevalence ratio
• relative risk