Cohort studies — MCQs

Question 31: A recent study attempted to analyze whether increased "patient satisfaction" driven healthcare resulted in increased hospitalization. In this hospital, several of the wards adopted new aspects of "patient satisfaction" driven healthcare, whereas the remainder of the hospital continued to use existing protocols. Baseline population characteristics and demographics were collected at the start of the study. At the end of the following year, hospital use was assessed and compared between the two groups. Which of the following best describes this type of study?

• A. Prospective cohort (Correct Answer)
• B. Cross-sectional study
• C. Retrospective case-control
• D. Prospective case-control
• E. Retrospective cohort

Explanation: ***Prospective cohort*** - This study design involves following a group of **exposed individuals (patient satisfaction-driven healthcare)** and a group of **unexposed individuals (existing protocols)** forward in time to observe the development of an outcome (**hospitalization**). - The exposure status is determined at the **start of the study (baseline)**, and outcomes are measured prospectively over a period, which aligns with observing hospital use over the following year. *Cross-sectional study* - A **cross-sectional study** assesses both exposure and outcome simultaneously at a single point in time, providing a snapshot. - This study design involves follow-up over a year, making it unsuitable for a cross-sectional classification. *Retrospective case-control* - A **retrospective case-control study** begins with identifying individuals based on their outcome status (cases with the outcome and controls without the outcome) and then looks back in time to determine past exposures. - This study starts by defining exposure groups and then follows them to observe future outcomes, which is the opposite of a case-control design. *Prospective case-control* - A **prospective case-control study** is a less common and often refers to a nested case-control study within a cohort, where cases and controls are selected from a larger cohort that has been followed prospectively. - The described study directly follows entire exposed and unexposed groups without specifically selecting cases and controls from a pre-defined cohort. *Retrospective cohort* - A **retrospective cohort study** defines cohorts based on past exposures using existing data and then looks back in time to determine outcomes that have already occurred. - The study explicitly states that hospital use was assessed at the "end of the following year," indicating a forward-looking collection of outcome data, not a retrospective assessment of already recorded outcomes.