jacket队列研究优缺点

2021年1月28日发(作者：bosma)

However,

it

has

been

demonstrated

that

long-termoutcomes

of

anti-VEGF

treatment

are

disappointing

atapproximately

7

years

after

ranibizumab

therapy

in

theANCHOR

and

MARINA

trials in which one- third of patientsdemonstrated good visual outcomes, whereas another third

had

poor

outcomes.

Compared

with

baseline,

almost

half

ofeyes

were

stable,

whereas

one-third

declined

by

15

letters

ormore.

Even

at

this

late

stage

in

the

therapeutic

course,

patientswith neovascular AMD remain at risk for substantial visualdecline.

Advantages of cohort studies

Cohort

studies

have

many

appealing

features.

They

arethe

best

way

to

ascertain

both

the

incidence and naturalhistory of a disorder. The temporal sequence betweenputative cause and

outcome is usually clear: the exposedand unexposed can often be seen to be free of theoutcome

at

the

outset.

By

contrast,

this

chicken-eggquestion

often

frustrates

cross-sectional

and

case-controlstudies. For example, in a case-control study, patientswith chronic widespread pain

were more likely to havemental illness than controls. Do mood and anxietydisorders increase this

risk,

or

do

patients

with

chronicpain

develop

mood

and

anxiety

disorders

as

a

result

oftheir

disorder?

队列研究有许多吸引人的特性。

他们是确定发病率和自然历史的障碍的最好的方法。

假定的

原因和结果之间的时间序列通常是明确的

:

公开和未 曝光

,

经常可以看到在一开始是免费的结

果。相比之下

,

这个先问题往往使横断面和病例对照研究。例 如

,

在病例对照研究中

,

慢性广泛

疼痛患者更有可能比控制精神疾病。做的心境和焦虑障碍增加这种风 险

,

还是慢性疼痛患者

心境和焦虑障碍 的发展障碍

?

Cohort

studies

are

useful

in

investigation

of

multipleoutcomes

that

might

arise

after

a

single

exposure.

Aprototype

would

be

cigarette

smoking

(the

exposure)

andstroke,

emphysema,

oral

cancer, and heart disease (theoutcomes). Although assessment of many outcomes isoften cited

as

a

positive

attribute

of

cohort

studies,

thisfeature

can

be

abused.

For

example,

testing

theassociations between exposure and many outcomes, butonly reporting the significant ones,

represents

misleadingscience.

Investigators

should

preferably

have

plannedprimary

and

secondary

associations

to

examine(sometimes

called

hypothesis

confirmation).

Althoughinvestigators can look at other outcomes (hypothesisgeneration), they should report the

findings

of

allexaminations, not

just

significant

ones,

so

that

readers

cancorrectly

interpret

the

results.

队列研究 是有用的在调查多个单一曝光后可能产生的结果。

原型将吸烟

(

暴露

)

和中风

,

肺气肿

,

口腔癌症和心脏病

(

结果

)

。

< p>
虽然许多成果的评估通常被视为一个积极的属性群组研究

,

该特性

可以被滥用。例如

,

测 试风险之间的关联和很多结果

,

但只有报告重要的

,

代表误导科学。调查

人员应该更好地计划中小学协 会检查

(

有时称为假设确认

)

。尽管调查人员可以查看其他结果

(

假设一代< /p>

),

他们应该报告所有考试的结果

,

不仅是重要的

,

以便读者可以正确地解释结 果。

The

cohort

design

is

also

useful

in

the

study

of

rareexposures:

a

researcher

can

often

recruit

people

withuncommon

exposures

—

eg,

to

ionising

radiation

orchemicals

—

in

the

workplace.

A

hospital

or

factory

mightprovide

a

large

number

of

individuals

with

the

exposure

ofinterest,

which would be rare in the general the investigator does not assign exposure,

no ethicalconcerns arise.

队列研究设计也很有用的罕见曝光

:

< p>
研究员通常可以招募患者少见

exposures- eg,

电离辐射或