I picked up the folders for the two courses required of every student at the school. Statistics and epidemiology. Epi—what?

In the first lecture, we ‘reviewed’ all the major study types. For example, in the case-control study you find a group of people with a disease, and then look for people who are much the same but without the disease. You compare the two groups to see if they have different risks. It’s a relatively cheap method, but it doesn’t tell you much about the order in which things happen. I can’t remember all the examples used in the lecture, but let’s say you want to look at causes of depression in women. You start with 600 depressed women, find another 600 who match them in age, ethnicity and educational status, and then ask them all about their lives. Let’s say you find out that women who are depressed are six times more likely not to have had sex in the last year as women who are cheerful. That means if you’re not having sex you get depressed, right? But hang on, couldn’t it be that women who are moping around looking miserable don’t get laid much?

Perhaps you’d be better off with a cohort study. You start off with several thousand women who are perfectly happy. Then you follow them over time, recording their behaviours, and see which of them get depressed. If you find that women who have sex are less likely to become depressed than women who aren’t getting any, it suggests it is the lack of sex that causes the depression, not the depression which stops you getting laid. You can throw out the ‘misery guts’ theory and recommend more good sex as an intervention to promote mental health.

-- Elizabeth Pisani, The Wisdom of Whores, p. 16