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Cohort Worksheet

This document provides a worksheet to critically appraise a cohort study. It lists questions to consider regarding selection of exposed and non-exposed cohorts, ascertainment of exposures and outcomes, follow-up duration, accounting for confounders, and strengths and limitations of the study.

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Ryan Cole
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20 views

Cohort Worksheet

This document provides a worksheet to critically appraise a cohort study. It lists questions to consider regarding selection of exposed and non-exposed cohorts, ascertainment of exposures and outcomes, follow-up duration, accounting for confounders, and strengths and limitations of the study.

Uploaded by

Ryan Cole
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as DOCX, PDF, TXT or read online on Scribd
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CRITICAL APPRAISAL OF A COHORT STUDY

COHORT WORKSHEET

Citation:

Are the results valid?


1. Was there a clearly defined, focused
research question? What was the study
question?

2. How was the exposed cohort selected?


Was there a well defined selection
procedure for inclusion into the cohort?
What proportion of eligible subjects was
actually included?

3. How was the non exposed cohort


selected? Was this cohort drawn from the
same source population as the exposed
cohort? Was there a well defined selection
procedure for inclusion into the cohort?
What proportion of eligible subjects was
actually included?

4. How were the main exposures


ascertained? Were the exposures clear,
specific and measurable? Any likelihood of
exposure misclassification?

5. Was the cohort free of the disease


(outcome) at the start of follow-up? Were
only people at risk of the outcome included?

6. Was duration of follow-up adequate (i.e.


long enough for main outcomes to occur)?

Source: Adapted from 1) Newcastle Ottawa Scale [http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm); 2) 1


Reader’s Guide to Critical Appraisal of Cohort Studies. BMJ 2005 (3 article series); 3) Grimes et al. Lancet
2002;359:341-45; and 4) Guyatt & Rennie. Users’ Guides to the Medical Literature, AMA Press, 2002.
Compiled by Madhu Pai [[email protected]]
CRITICAL APPRAISAL OF A COHORT STUDY
COHORT WORKSHEET

7. Was follow-up complete? Were efforts


made to limit the loss to follow-up? What
was the rate of attrition and was loss to
follow-up similar in the exposed and non
exposed cohorts?

8. What were the primary and secondary


outcomes of the study? How well were the
outcomes measured? Was the outcome
clear, specific and measurable? Were
surrogate outcomes used?

9. Were outcomes measures similarly in


exposed and non exposed cohorts? Was
outcome ascertainment influenced by
knowledge of the exposure status (i.e. lack
of blinding)?

10. How comparable were the exposed and


non-exposed cohorts? Have the authors
identified all potentially important
confounders? Is there information on how
the potential confounders are distributed
between the comparison groups? What
confounders were adjusted for and was the
adjustment adequate? Is residual
confounding a concern?

Any other potential biases in this study?

Potential for selection bias?

Source: Adapted from 1) Newcastle Ottawa Scale [http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm); 2) 2


Reader’s Guide to Critical Appraisal of Cohort Studies. BMJ 2005 (3 article series); 3) Grimes et al. Lancet
2002;359:341-45; and 4) Guyatt & Rennie. Users’ Guides to the Medical Literature, AMA Press, 2002.
Compiled by Madhu Pai [[email protected]]
CRITICAL APPRAISAL OF A COHORT STUDY
COHORT WORKSHEET

Potential for information bias?

Potential for confounding?

Was there a clear rationale for the sample


size estimation?

Are the analytic strategies clearly described?


Were the data analytic methods appropriate
for the research question and study design?

What are the results?

What are the study results?

1. How strong was the association


between exposure and outcome (e.g. rate
ratio or hazard ratio or odds ratio)?

2. How precise was the estimate of the


association (i.e. confidence intervals
around the point estimates or p-values)?

Source: Adapted from 1) Newcastle Ottawa Scale [http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm); 2) 3


Reader’s Guide to Critical Appraisal of Cohort Studies. BMJ 2005 (3 article series); 3) Grimes et al. Lancet
2002;359:341-45; and 4) Guyatt & Rennie. Users’ Guides to the Medical Literature, AMA Press, 2002.
Compiled by Madhu Pai [[email protected]]
CRITICAL APPRAISAL OF A COHORT STUDY
COHORT WORKSHEET

In summary:
What are the major strengths of this study?

What are the major limitations of this study?

Are there any major ethical concerns with this study?

Source: Adapted from 1) Newcastle Ottawa Scale [http://www.ohri.ca/programs/clinical_epidemiology/oxford.htm); 2) 4


Reader’s Guide to Critical Appraisal of Cohort Studies. BMJ 2005 (3 article series); 3) Grimes et al. Lancet
2002;359:341-45; and 4) Guyatt & Rennie. Users’ Guides to the Medical Literature, AMA Press, 2002.
Compiled by Madhu Pai [[email protected]]

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