Cohort Study: Definition, Designs & Examples

A cohort study is a type of longitudinal study where a group of individuals (cohort), often sharing a common characteristic or experience, is followed over an extended period of time to study and track outcomes, typically related to specific exposures or interventions.

In cohort studies, the participants must share a common factor or characteristic such as age, demographic, or occupation. A “cohort” is a group of subjects who share a defining characteristic.

Cohort studies are observational, so researchers will follow the subjects without manipulating any variables or interfering with their environment.

This type of study is beneficial for medical researchers, specifically in epidemiology, as scientists can use data from cohort studies to understand potential risk factors or causes of a disease.

Before any appearance of the disease is investigated, medical professionals will identify a cohort, observe the target participants over time, and collect data at regular intervals.

Weeks, months, or years later, depending on the duration of the study design, the researchers will examine any factors that differed between the individuals who developed the condition and those who did not.

They can then determine if an association exists between an exposure and an outcome and even identify disease progression and relative risk.

Advantages

Determine cause-and-effect relationships

Because researchers study groups of people before they develop an illness, they can discover potential cause-and-effect relationships between certain behaviors and the development of a disease.

Provide extensive data

Cohort studies enable researchers to study the causes of disease and identify multiple risk factors associated with a single exposure. These studies can also reveal links between diseases and risk factors.

Enable studies of rare exposures

Cohort studies can be very useful for evaluating the effects and risks of rare diseases or unusual exposures, such as toxic chemicals or adverse effects of drugs.

Can measure a continuously changing relationship between exposure and outcome

Because cohort studies are longitudinal, researchers can study changes in levels of exposure over time and any changes in outcome, providing a deeper understanding of the dynamic relationship between exposure and outcome.

Limitations

Time consuming and expensive

Cohort studies usually require multiple months or years before researchers are able to identify the causes of a disease or discover significant results. Because of this, they are often more expensive than other types of studies. Retrospective studies, though, tend to be cheaper and quicker than prospective studies as the data already exists.

Require large sample sizes

Cohort studies require large sample sizes in order for any relationships or patterns to be meaningful. Researchers are unable to generate results if there is not enough data.

Prone to bias

Because of the longitudinal nature of these studies, it is common for participants to drop out and not complete the study. The loss of follow-up in cohort studies means researchers are more likely to estimate the effects of an exposure on an outcome incorrectly.

Unable to discover why or how a certain factor is associated with a disease

Cohort studies are used to study cause-and-effect relationships between a disease and an outcome. However, they do not explain why the factors that affect these relationships exist. Experimental studies are required to determine why a certain factor is associated with a particular outcome.

Examples

The Framingham Heart Study

Studied the effects of diet, exercise, and medications on the development of hypertensive or arteriosclerotic cardiovascular disease, in a longitudinal population-based cohort.

The Whitehall Study

The initial prospective cohort study examined the association between employment grades and mortality rates of 17139 male civil servants over a period of ten years, beginning in 1967. When the Whitehall Study was conducted, there
was no requirement to obtain ethical approval for scientific studies of this kind.

The Nurses’ Health Study

Researched long-term effects of nurses” nutrition, hormones, environment, and work-life on health and disease development.

The British Doctors Study

This was a prospective cohort study that ran from 1951 to 2001, investigating the association between smoking and the incidence of lung cancer.

The Black Women’s Health Study

Gathered information about the causes of health problems that affect Black women.

Millennium Cohort Study

Found evidence to show how various circumstances in the first stages of life can influence later health and development. The study began with an original sample of 18,818 cohort members.

The Danish Cohort Study of Psoriasis and Depression

Studied the association between psoriasis and the onset of depression.

The 1970 British Cohort Study

Followed the lives of around 17,000 people born in England, Scotland, and Wales in a single week of 1970.

Frequently Asked Questions