Retrospective cohort study
Encyclopedia
A retrospective cohort study, also called a historic cohort study, (from Latin retr, "look back") generally means to take a look back at events that already have taken place. For example, the term is used in medicine, describing a look back at a patient's medical history or lifestyle.
It is a medical research study in which the medical records of groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke and those who do not smoke) are compared for a particular outcome
(such as lung cancer
). In retrospective cohort studies, a risk ratio or odds ratio
gives an assessment of relative risk
.
Retrospective cohort studies have existed for approximately as long as prospective cohort studies. In the case of a retrospective cohort study, the investigator collects data from past records and does not follow patients up as is the case with a prospective study. However, the starting point of this study is the same as for all Cohort studies. The first objective is still to establish two groups - Exposed versus Nonexposed; and these groups are followed up in the ensuing time period.
Retrospective studies have various advantages and disadvantages vis-a-vis prospective studies. Among the disadvantages are that some key statistics cannot be measured, and significant biases may affect the selection of controls. Additionally, major biases with retrospective cohort studies can impact the recall of former exposure to risk variables. Among the biases which can negatively impact the veracity of this type of study are selection bias
and misclassification or information bias
as a result of the retrospective aspect. With retrospective studies, the temporal relationship is frequently difficult to assess. Further, those conducting retrospective studies can't control exposure or outcome assessment, but instead need to rely on others for accurate record-keeping. This is particularly problematic because it can be very difficult to make accurate comparisons between the exposed and non-exposed. Retrospective studies also can need very large sample sizes for rare outcomes.
Retrospective cohort studies, though, do have distinct advantages as well when compared with prospective cohort studies, including the smaller scale which retrospective studies often entail. Another key benefit of retrospective cohort studies is that they typically require less time to complete. Another chief advantage is that retrospective studies are better for analyzing multiple outcomes. And one of the biggest benefits to a retrospective study in a medical context is its ability to address rare diseases, which would necessitate extremely large cohorts in prospective studies. In such a study, diseased people have already been identified, so retrospective studies are especially helpful in addressing diseases of low incidence. The fact that retrospective studies are generally less expensive than prospective studies also can be a key benefit. These studies tend to be less expensive in part because outcome and exposure have already occurred, and the resources are mainly directed at collection of data only. Additionally, it has essentially all the benefits of a Cohort Study (Statistics)
In a nutshell, in Retrospective Cohort Study, all the events - exposure, latent period, and subsequent outcome (ex. development of disease) have already occurred in the past. We merely collect the data now, and establish the risk of developing a disease if exposed to a particular risk factor. On the other hand, Prospective Cohort Study is conducted by starting with two groups at the current point, and following up in future for occurrence of disease, if any.
It is important to understand that the methodology of prospective and retrospective cohort studies is fundamentally the same, but the retrospective study is performed posthoc, as the cohort is followed retrospectively. The time to complete a retrospective study is only as long as it takes to collect and interpret the data. Retrospective studies examine possible risk and protection variables in relation to a result that is already established at the start of the study.
Caution needs to be exercised in particular with retrospective cohort studies because errors due to confounding and bias are more common in retrospective studies than in prospective studies.
It is a medical research study in which the medical records of groups of individuals who are alike in many ways but differ by a certain characteristic (for example, female nurses who smoke and those who do not smoke) are compared for a particular outcome
Outcome
Outcome may refer to:* Outcome , a concept in game theory* The Outcome, a Swedish punk rock band* outcome measure in a clinical trial...
(such as lung cancer
Lung cancer
Lung cancer is a disease characterized by uncontrolled cell growth in tissues of the lung. If left untreated, this growth can spread beyond the lung in a process called metastasis into nearby tissue and, eventually, into other parts of the body. Most cancers that start in lung, known as primary...
). In retrospective cohort studies, a risk ratio or odds ratio
Odds ratio
The odds ratio is a measure of effect size, describing the strength of association or non-independence between two binary data values. It is used as a descriptive statistic, and plays an important role in logistic regression...
gives an assessment of relative risk
Relative risk
In statistics and mathematical epidemiology, relative risk is the risk of an event relative to exposure. Relative risk is a ratio of the probability of the event occurring in the exposed group versus a non-exposed group....
.
Retrospective cohort studies have existed for approximately as long as prospective cohort studies. In the case of a retrospective cohort study, the investigator collects data from past records and does not follow patients up as is the case with a prospective study. However, the starting point of this study is the same as for all Cohort studies. The first objective is still to establish two groups - Exposed versus Nonexposed; and these groups are followed up in the ensuing time period.
Retrospective studies have various advantages and disadvantages vis-a-vis prospective studies. Among the disadvantages are that some key statistics cannot be measured, and significant biases may affect the selection of controls. Additionally, major biases with retrospective cohort studies can impact the recall of former exposure to risk variables. Among the biases which can negatively impact the veracity of this type of study are selection bias
Selection bias
Selection bias is a statistical bias in which there is an error in choosing the individuals or groups to take part in a scientific study. It is sometimes referred to as the selection effect. The term "selection bias" most often refers to the distortion of a statistical analysis, resulting from the...
and misclassification or information bias
Information bias
Information bias is a type of cognitive bias, and involves e.g. distorted evaluation of information. Information bias occurs due to people's curiosity and confusion of goals when trying to choose a course of action.-Over-evaluation of information:...
as a result of the retrospective aspect. With retrospective studies, the temporal relationship is frequently difficult to assess. Further, those conducting retrospective studies can't control exposure or outcome assessment, but instead need to rely on others for accurate record-keeping. This is particularly problematic because it can be very difficult to make accurate comparisons between the exposed and non-exposed. Retrospective studies also can need very large sample sizes for rare outcomes.
Retrospective cohort studies, though, do have distinct advantages as well when compared with prospective cohort studies, including the smaller scale which retrospective studies often entail. Another key benefit of retrospective cohort studies is that they typically require less time to complete. Another chief advantage is that retrospective studies are better for analyzing multiple outcomes. And one of the biggest benefits to a retrospective study in a medical context is its ability to address rare diseases, which would necessitate extremely large cohorts in prospective studies. In such a study, diseased people have already been identified, so retrospective studies are especially helpful in addressing diseases of low incidence. The fact that retrospective studies are generally less expensive than prospective studies also can be a key benefit. These studies tend to be less expensive in part because outcome and exposure have already occurred, and the resources are mainly directed at collection of data only. Additionally, it has essentially all the benefits of a Cohort Study (Statistics)
In a nutshell, in Retrospective Cohort Study, all the events - exposure, latent period, and subsequent outcome (ex. development of disease) have already occurred in the past. We merely collect the data now, and establish the risk of developing a disease if exposed to a particular risk factor. On the other hand, Prospective Cohort Study is conducted by starting with two groups at the current point, and following up in future for occurrence of disease, if any.
It is important to understand that the methodology of prospective and retrospective cohort studies is fundamentally the same, but the retrospective study is performed posthoc, as the cohort is followed retrospectively. The time to complete a retrospective study is only as long as it takes to collect and interpret the data. Retrospective studies examine possible risk and protection variables in relation to a result that is already established at the start of the study.
Caution needs to be exercised in particular with retrospective cohort studies because errors due to confounding and bias are more common in retrospective studies than in prospective studies.