Prospective Study: Definition, Examples

Design of Experiments > Prospective study

What is a Prospective Study?

prospective Study
Prospective Cohort Study. Image: SUNY Downstate


A prospective study (sometimes called a prospective cohort study) is a type of cohort study, or group study, where participants are enrolled into the study before they develop the disease or outcome in question. The opposite is a retrospective study, where researchers enroll people who already have the disease/condition. Prospective studies typically last a few years, with some (like the Framingham Heart Study) lasting for decades.

Study participants typically have to meet certain criteria to be involved in the study. For example, they may have to be of a certain age, profession, or race. Once the participants are enrolled, they are followed for a period of time to see who gets the outcome in question (and who doesn’t). Usually, the research is conducted with a goal in mind and participants are periodically checked for progress, using the same data collection methods and questions for each person in the study. Follow ups might include:

  • Email questionnaires,
  • Phone, internet, or in-person interviews,
  • Physical exams,
  • Imaging or laboratory tests.

Outcomes

Participants are followed for years and data is collected on the factors of interest, which might include:

  • When the subject develops the condition,
  • When they drop out of the study or become “lost,”
  • When their exposure status changes,
  • When they die.

Advantages and Disadvantages

Advantages

  1. Disease outcomes and prevalence are east to calculate.
  2. Multiple disease and conditions can be studied at the same time.
  3. Researchers don’t have to deal with ethical issues like who receives which treatment (or none at all).

Disadvantages

  1. All cohort studies can be expensive and time consuming.
  2. Confounding variables can be a larger problem with this type of study.
  3. Sample sizes are typically very large.
  4. Selection bias may be an issue.

Famous Prospective Study Examples

  • Sir Richard Doll began a prospective cohort study in 1951, following 35,000 male physicians. Doll published his initial findings three years later, in 1954.

    “I personally thought it was tarring of the roads. We knew that there were carcinogens in tar. It wasn’t long before it became clear that cigarette smoking may be to blame. I gave up smoking two-thirds of the way through that study” — Sir Richard Doll.

    Follow ups lasted 50 years, and in 2004 Doll published “Mortality in relation to smoking: 50 years’ observations on male British doctors” in the British Medical Journal.

  • The Framingham Heart Study is one example of a prospective cohort study; The researchers have, to date, studied three generations of Framingham residents in order to understand the causes of heart disease and stroke.
  • The Nurses Health Studies, established in 1976, investigates risk factors for chronic diseases in women. The study has followed 280,000 male and female nurses to date.
  • The Black Women’s Health Study seeks to understand why black women have higher rates of many illnesses like breast cancer and diabetes. The study has been following participants for more than 20 years.

Other Examples:

References:
American Journal of Epedemiology. Sir Richard Doll, 1912-2005. Retrieved July 22, 2016 from: http://aje.oxfordjournals.org/content/164/1/95.full.
Doll, R. et. al. Mortality in relation to smoking: 50 years’ observations on male British doctors. 2004. BMJ 2004;328:1519


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