Bruinsma et al. BMC Public Health 2011, 11(Suppl 5):S7 http://www.biomedcentral.com/1471-2458/11/S5/S7 R E S E A R C H Open Access Looking back in time: conducting a cohort study of the long-term effects of treatment of adolescent tall girls with synthetic hormones Fiona J Bruinsma1*, Jo-Anne Rayner1, Alison J Venn2, Priscilla Pyett3, George Werther4 Abstract Objective: Public health research is an endeavour that often involves multiple relationships, far-reaching collaborations, divergent expectations and various outcomes. Using the Tall Girls Study as a case study, this paper will present and discuss a number of methodological, ethical and legal challenges that have implications for other public health research. Approach: The Tall Girls Study was the first study to examine the long-term health and psychosocial effects of oestrogen treatment for tall stature. Results: In undertaking this study the research team overcame many hurdles: in maintaining collaboration with treating clinicians and with the women they had treated as girls - groups with opposing points of view and different expectations; using private practice medical records to trace women who had been patients up to forty years earlier; and exploring potential legal issues arising from the collection of data related to treatment. Conclusion: While faced with complex challenges, the Tall Girls Study demonstrated that forward planning, ongoing dialogue between all stakeholders, transparency of processes, and the strict adherence to group- developed protocols were keys to maintaining rigour while undertaking pragmatic research. Implications: Public health research often occurs within political and social contexts that need to be considered in the planning and conduct of studies. The quality and acceptability of research findings is enhanced when stakeholders are engaged in all aspects of the research process. Introduction Public health research often involves investigation of topics that are broad and complex and generates find- ings with social as well as health implications. This paper tells the story of the Tall Girls Study and uses it as a case study to consider issues that may arise in other public health research. The paper begins with the background to the Tall Girls Study. It then discusses aspects of study design, particularly in regard to acces- sing an appropriate cohort, tracing study participants and practicalities of data collection. Ethical issues and consumer participation are also discussed. * Correspondence: f.bruinsma@latrobe.edu.edu 1Mother and Child Health Research, La Trobe University, 215 Franklin St, Melbourne, Victoria 3000, Australia Full list of author information is available at the end of the article The first long-term follow-up of girls treated with oes- trogens, the Tall Girls Study, was undertaken in Austra- lia between 2000 and 2003 [1]. The study examined a broad range of health and psychosocial outcomes in women treated with high dose oestrogens as adolescents in an attempt to reduce their adult height and compared them with women who were assessed but not treated for tall stature. While the short-term side-effects of this treatment, including weight gain, menstrual irregulari- ties, nausea, night cramps and limb pains, benign breast disease, excessive vaginal discharge, thrombosis and ovarian cysts were well documented [2-5], nothing was known about the long-term health and psychosocial out- comes of this treatment. The study contributed to a broader understanding of the associations of high levels of oestrogen in adolescence on reproductive [1] and other outcomes [6-9]. © 2011 Bruinsma et al; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.