A researcher wants to study whether low birth weight is associated with adult-onset type 2 diabetes. The MOST efficient and ethical study design is:

• A Prospective cohort study from birth
• B Randomised controlled trial
• C Cross-sectional study
• D Nested case-control study within a birth cohort ✓

Explanation

A nested case-control study within an existing birth cohort (such as a hospital birth registry) allows efficient examination of early-life exposures (birth weight recorded at birth) and adult outcomes (diabetes). It is more feasible than a 40-year prospective cohort (very long follow-up, expensive) and avoids the ethical impossibility of randomising birth weight. Cross-sectional studies cannot establish temporal sequence as both exposure and outcome are measured simultaneously in adulthood.

Reference: Park's Textbook of Preventive and Social Medicine, 27th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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