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Diseño de estudios
● Estudios observacionales– Descriptivos
● Reporte de caso● Serie de casos● De prevalencia
– Analíticos● Casos y controles● Cohorte
– Prospectiva– retrospectiva
● Estudios experimentales
● In vitro● Animales● Clínicos
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Estudios de cohorte
Población definida que se sigue para distingur características sub-grupales
Pueden o no estar expuestas
Year introduced: 1989 MeSH
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Usos en Odontología
● Identificar factores de riesgo● Evaluar sobrevida o duración● Complicaciones● Otros outcomes
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Estudio de cohortesEnfermos Sanos
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Riesgo de losexpuestos
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Riesgo de losno expuestos
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Estudio de cohortesEnfermos Sanos
aa bb
ddcc
Riesgo de losexpuestos
a-----a+b
Riesgo de losno expuestos
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RIESGORIESGORELATIVORELATIVO
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● Results Meta-analysis of the five prospective cohort studiesprospective cohort studies (86 092 patients) found people with PD had a 1.14-fold higher risk of developing coronary heart disease (CHD) than controls [RR, 1.14; 95% confidence interval (CI), 1.07–1.21; P<0.001][RR, 1.14; 95% confidence interval (CI), 1.07–1.21; P<0.001]. Case–control studiesCase–control studies (1423 patients) showed an even greater risk of developing CHD (OR, 2.22; 95% CI, 1.59–3.117; (OR, 2.22; 95% CI, 1.59–3.117; P<0.001)P<0.001). The prevalence of CHD in the cross-sectional cross-sectional studiesstudies (17 724 patients) was significantly greater in individuals with PD than in those with no PD (OR, 1.59; 95% CI, 1.33–(OR, 1.59; 95% CI, 1.33–1.91; P<0.001)1.91; P<0.001). Analysing the relationship between number of teeth and incidence of CHD found a 1.24-fold increased risk (95% CI, 1.14–1.36; P<0.0001) of development of CHD in people who had <10 teeth.
Bahekar et al. Am Heart J 2007; 154:830–837.
The prevalence and incidence of coronary heart disease is significantly increased in periodontitis: a meta-analysis
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● Thomson WM et alCigarette smoking and periodontal disease among 32-year-olds: a prospective study of a representative birth cohort. J Clin Periodontol. 2007 Oct;34(10):828-34.
● Broadbent JM et alProgression of dental caries and tooth loss between the third and fourth decades of life: a birth cohort study. Caries Res. 2006;40(6):459-65.
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● Simecek JW et al.Dental sealant longevity in a cohort of young U.S. naval personnel.J Am Dent Assoc. 2005 Feb;136(2):171-8.
● Kirstilä VLongitudinal analysis of the association of human salivary antimicrobial agents with caries increment and cariogenic micro-organisms: a two-year cohort study.J Dent Res. 1998 Jan;77(1):73-80.
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Ventajas
● relación temporal verificable● calcula incidencia● outcomes múltiples o desconocidos● < sesgo de selección que casos y controles● calcula riesgo
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EstudioCasos y controles Transversales Cohortes
Población enfermos todos sanosIncidencia no no si
Prevalencia no si noAsociación OR RR, OR RR, OR
Tasa de incidencia