Case-Cohort Studies

Ruth Pfeiffer

The case-cohort design was proposed by Ross Prentice as an alternative design in epidemiologic follow-up studies that is less expensive than a full-scale cohort study. The case-cohort design involves collecting covariate data only for cases, that is, subjects who experience the event of interest in a cohort, and for members of a relatively small randomly selected subcohort. The subcohort may serve as a comparison group for several different types of disease outcomes. The case-cohort design can substantially reduce cost and effort of exposure assessment by limiting exposure to a small fraction of the cohort with only a small loss of efficiency compared with a full cohort design. The case-cohort design is most beneficial when the most expensive part of the study is not in ascertaining subjects but in measuring their exposures. If the main cost is in ascertainment, a full cohort analysis might be a more sensible approach to analysis. ...

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