current international priorities in health research opportunities for epidemiology
DESCRIPTION
Current International Priorities in Health Research Opportunities for Epidemiology. Henry Völzke. The Risk Transition. WHO 2009. The Obesity Map, 2008. www.hsph.harvard.edu. Finucane et al.; Lancet 2011. WHO 2009. WHO 2009. Known Risk Factors for MI. Yusuf et al., Lancet 2007. - PowerPoint PPT PresentationTRANSCRIPT
Society Science
Epidemiology
• Disparities • Health care allocation• Preventive programs• Prognosis
• Risk factors• Predictors• Interactions• Subgroups
SHIP SNiP
Interventions
Epidemiology Clinical Chemistry
Dermatology
PsychiatryMicrobiology
NeurologyGastroenterolog
y
Endocrinology
RESEARCH NETWORK COMMUNITY MEDICINE
Cardiology
Pneumology
Radiology Molecular Medicine
Dentistry
Community Medicine
Economics
Objectives
1. Prevalence and incidence of common risk factors and diseases
2. Associations and interactions among common risk factors, subclinical disorders and diseases
N= 430820-79 years
Rügen
Use-dom
Stralsund
Greifswald
Nordvorpommern
OstvorpommernSchleswig-
Holstein
Hamburg
BerlinNiedersachsen
Sachsen-Anhalt
Mecklenburg-Vorpommern
Brandenburg
1997-2001
SHIP-0
Baseline
SHIP-1
5y Follow-up
SHIP-2
10y Follow-up
SHIP-TREND
Baseline
2002-2006 2008-2012
n= 2333(63.5%)
n= 4422(50.3%)
n= 4308 (68.8%)
n= 3300 (84.5%)
Publications1-2 publications/ week, mean impact factor ~7
• Cardiovascular Disease (JAMA, Lancet, Nat Genetics, Circulation, JACC, Eur Heart J, ATVB, Hypertension, Nat Rev Cardiol)
• Metabolic Syndrome (Nature, Science, Nat Genetics, Diabetes, Diab Care, JCEM)
• Gastroenterology (Nat Genetics, Gastroenterology, Gut, Hepatology, Am J Gastroenterol)
• Thyroidology (JAMA, Arch Intern Med, Am J Hum Genetics, JCEM, Thyroid)
• Psychiatry (JAMA, Nat Genetics, Am J Psychiatry, Biol Psychiatry, Mol Psychiatry)
• Dentistry (Diab Care, Dent Res, J Clin Periodontol, Thromb Haemost, J Hypertens)
• Haematology & Oncology (Nat Genetics, Blood, Am J Hum Genetics)
• Neurology (Lancet, Nat Genetics, Arch Intern Med, Stroke)
• Pneumology (Nat Genetics, Eur Respiratory J, Chest)
• Nephrology (Nat Genetics, J Am Soc Nephrol, Kidney Int)
• Epidemiology (Science, Am J Epidemiol, Int J Epidemiol, J Clin Epidemiol, Eur J Epidemiol)
Publications1-2 publications/ week, mean impact factor 7
• Cardiovascular Disease (JAMA, Lancet, Nat Genetics, Circulation, JACC, Eur Heart J, ATVB, Hypertension, Nat Rev Cardiol)
• Metabolic Syndrome (Nature, Science, Nat Genetics, Diabetes, Diab Care, JCEM)
• Gastroenterology (JAMA, Nat Genetics, Gastroenterology, Gut, Hepatology, Am J Gastroenterol)
• Thyroidology (JAMA, Arch Intern Med, Am J Hum Genetics, JCEM, Thyroid)
• Psychiatry (JAMA, Nat Genetics, Am J Psychiatry, Biol Psychiatry, Mol Psychiatry)
• Dentistry (Diab Care, Dent Res, J Clin Periodontol, Thromb Haemost, J Hypertens)
• Haematology & Oncology (Nat Genetics, Am J Hum Genetics)
• Neurology (Lancet, Arch Intern Med, Stroke)
• Pneumology (Nat Genetics, Eur Respiratory J, Chest)
• Nephrology (Nat Genetics, J Am Soc Nephrol, Kidney Int)
• Epidemiology (Int J Epidemiol, Am J Epidemiol, J Clin Epidemiol, Eur J Epidemiol)
Methods of Quality Management
• Standard Operating Procedures for each examination method
• Training of potential observers in hospitals and the SHIP examination center
• Reader certification (2 x 25 images)
– Intra- and Inter-Reader-Variability
• Observer certification (2 x 12 volunteers before and 2 x 6 volunteers semiannually during the study)
– Intra- and Inter-Observer-Variability
• Calibration and re-certification
• Paper-free data documentation
• Semiannual quality reports to the Data Safety & Monitoring Committee
Proband Management
Data Collection
Data Dictionary
Training Certification
Quality Monitoring
Data Clean-up
Data Transfer Infr
ast
ruct
ure
(D
evi
ces,
Co
mp
ute
rs, F
aci
litie
s)
Communication Structures
BASELINE
Comprehensive,standardized phenotyping
Subclinical and overt parameters
Biobanking
OMICs
FOLLOW-UP
Subclinical and overt
phenotypes
Morbidity
Mortality
CardiovascularHeart failure(systolic & diastolic)
RenalRenal insufficiency
CerebrovascularStroke / TIA
MetabolismMetabolic syndrome & co-morbidities
Comparison to SHIP cohorts
Comparison to SHIP cohorts
…
Recruitment of patient cohorts(in accordance with methods and quality standards of SHIP)
InternationalThe Vision
To build up an international consortium to collect multi-national population data
Collaborative use of SHIP instruments for standardization and quality assurance
To achieve best possible comparability of phenotypic data
Potential Bias in Global Epi Research
Measure Methodological Differences
Obesity Self-reported? Measured? With or without clothes?
Abdominal Obesity Correct position? Horizontal measurement? Observer certification?
Diabetes Self-reported? Physician‘s diagnosis? Validated?
Glucose & Lipids Fasting or not? Pre-analytic handling? Storage? Lab method?
Goiter Ultrasound device and probe? Observer certification?
Brain atrophy MR/CT device? Fasting or not? Reader certification?
Even high-quality epidemiological studies usually take less care on external validity!