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Revista Brasileira de Epidemiologia

Print version ISSN 1415-790XOn-line version ISSN 1980-5497

Rev. bras. epidemiol. vol.8 no.3 São Paulo Sept. 2005 



Cohort study methods



ABRASCO's epidemiology committee organized, in the beginning of August, a conference to discuss significant challenges for cohort studies in the contemporary scenario, in order to assess prospects and propose strategies aimed to foster the expansion of this type of investigation in Brazil.

In spite of the increasing number of studies using this design, we are still a long way from what is necessary to access the incidence of diseases in Brazil, many of which are the consequences of the marked demographical and cultural changes that occurred in the country over past decades. Moreover, in the Brazilian scenario, the execution of cohort studies should take into account the wide range of conditions and chronic funding difficulties, by pursuing creative solutions that also allow following the methodological advances in the area. The conference aimed, therefore, to gather epidemiologists with specific interest in the methodological aspects of this type of study.

The event focused on the discussion of six cohort studies, with two to three guest debaters. In this fashion, it was possible to learn from experience, based on sharing with the epidemiological community not only the successes and positive results, as is the case of scientific publications, but, especially, experiences, problems and strategies.

The six studies were chosen trying to encompass the broadest range possible: observational and intervention studies, focusing the elderly, children, adults and specific populations. We debated the Pelotas cohort, the longest lasting Brazilian study and with the largest accumulated experience; the ARIC (Atherosclerosis Risk in Communities Study) a multicenter study whose main site is in the US, and began collecting data in 1987; the Bambuí project, a population-based cohort study on the health of the elderly, and which has already visited the study population seven times; the Pro-Saúde study, with emphasis on the effects of social status and behaviors of the population of workers of the State University of Rio de Janeiro; the REVAC study, a randomized large-scale trial to assess the effectiveness of the second dose of BCG; and the multi-center study with homo and bisexual male HIV negative cohorts, whose recruiting strategy (snow-ball) was widely discussed.

Many major studies were not, unfortunately, included among these six, due to the option for a small event, without simultaneous activities, and with enough time to debate each of them.

The state of the art was presented in three conferences that focused on study designs, feasibility strategies and statistic modeling of longitudinal data. The conference ended with a debate on "Challenges and Future Directions of Longitudinal Studies in Brazil", focusing on the role of these studies in the definition of healthcare and funding policies.

The conference exceeded expectations, both in relation to the interest aroused 179 participants and as to the degree of maturity and depth of debates. During the three intense days, the prevailing feeling was of satisfaction and that the conference itself already represented an advance, suggesting new possibilities and partnerships. From strictly academic issues to the discussion of public policies, there was, undoubtedly, a strong link between the epidemiologists community and managers, in tune with the interest to foster new cohort studies in the country.

Motivated by the success of this first Methodological Conference, ABRASCO's Epidemiology Committee intends to organize other events of the same kind, on various subjects, for example, surveys and studies to assess health intervention, among others. We intend to publish, in forthcoming numbers of Revista Brasileira de Epidemiologia the debates of the conference, in order to share with RBE readers the rich scientific exchange enabled by the event.

Marilia Sá Carvalho and Claudia Lopes


ABRASCO's Epidemiology Committee

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