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Nordic Population based cohorts from a GP perspective ?. Carsten Obel. Things that characterise a GP’s work. Evaluates health in a life long perspective Follows people over a long period of time Deals with factors relevant for health that goes beyond disease. - PowerPoint PPT Presentation
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Nordic Population based cohorts from a GP perspective?
Carsten Obel
Things that characterise a GP’s work
• Evaluates health in a life long perspective• Follows people over a long period of time• Deals with factors relevant for health that
goes beyond disease
Things that characterize a GP’s work
• Evaluates health in a life long perspective• Follow people over a long period of time• Deals with factors relevant for health that
goes beyond disease
• Same that characterise a population based cohort
The cohort idea and life perspective
The Framingham study
• In 1948 about 5000, aged 30-62 from the town of Framingham, Massachusetts
• Third generation enrolled 2005• The basis of our counceling in preventing CVD– Cholesterol, blodpressure, smoking
Nordic cohorts established in adulthood
• The Glostrup cohort (1964-)• Umeå, Stockholm, Tromsø, Oslo, Bergen,
Copenhagen, Aarhus and probably more
• The Danish Diet, cancer, health prolect– 57,000 participants– Focus on diet
The Northern Finland Birthcohort
• Established 1966 by professor Rantakillio• About 12,000 pregnant women enrolled week 24 of
pregnancy• Offspring follow until the age of 31• Similar cohort of children born 1985-6
Examples of Nordic birth cohorts
• The Northern Finnish birthcohorts (born 1966 & 1985-86)
• The Aarhus Birth cohort (born 1990-2009)• The national birth cohorts– Norway (born 1999-2008)– Denmark (born 1996-2003)
Aarhus Birth cohort 1990-2007%
Danish National Birth Cohort
• Established in collaboration with GP’s
• More than 100,000 children
• Telephone interviews• Biobank (3 full blood
samples)• Follow up to 7 years• 11 y follow up next
Example from DNBC
• Does infertility treatment cause offspring with problems?
• Zhu et al.– Malformations– Intrauterine growth retardation– Psychomotor development– Cerebral palsy, behavioural problems
• Subfecundity more than treatment matters
The Nordic Perspective
• Can we combine cohorts to gain further scientific value?
• Yes, if data are comparable– Retesting hypotheses– Study rare endpoints– Develop clinical tools
Example- A clinical tool to identify children in risk of overweight
• Overweight is a major public health problem• The preschool age is the most promising point of
attack• We need a tool to identify children at risk for
overweight
• The algoritm for risk assesment of CVD is extensively used in gereral practice
• Aim: To develop an algoritm to predict overweight in pre-school age
Framingham for kids?
• Cohorts– Aarhus Birth Cohort (90-92)– Northern Finnish Birth Cohort (85-86)
• Some of the potential predictive variables– Both parents BMI– Maternal smoking– Breastfeeding– Childs growth
Growth-pattern of Finnish children
Data from Northern Finnish Birth Cohorts. Marjo Riita Järvellin et al.
Conclusion
• We have large and well established cohorts in the Nordic countries
• In combination with the national registers the Nordic cohorts are unique
• Results from cohort studies could often be relevant for the GP’s work
• There is an added value of Nordic collaboration • Science would gain from more GP’s taking active
part in cohort studies