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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.

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Current international priorities in health research opportunities for epidemiology

Current International Priorities in Health ResearchOpportunities for Epidemiology

Henry Völzke



The obesity map 2008
The Obesity Map, 2008

www.hsph.harvard.edu





Known risk factors for mi
Known Risk Factors for MI

Yusuf et al., Lancet 2007



Risk factors for peptic ulcer
Risk Factors for Peptic Ulcer

  • Stress

  • Alcohol

  • Smoking

  • Diet

  • Family History

wikipedia.org


Society

Science

Epidemiology

  • Disparities

  • Health care allocation

  • Preventive programs

  • Prognosis

  • Risk factors

  • Predictors

  • Interactions

  • Subgroups



RESEARCH NETWORK COMMUNITY MEDICINE

Community Medicine

Epidemiology

Clinical Chemistry

Radiology

Molecular Medicine

SHIP

SNiP

Interventions

Microbiology

Psychiatry

Cardiology

Pneumology

Dentistry

Dermatology

Economics

Neurology

Gastroenterology

Endocrinology


Objectives
Objectives

Prevalence and incidence of common risk factors and diseases

Associations and interactions among common risk factors, subclinical disorders and diseases


Rügen

Stralsund

Nordvorpommern

Greifswald

Use-

Ostvorpommern

dom

Schleswig-

Holstein

Mecklenburg

-

Vorpommern

Hamburg

Brandenburg

Niedersachsen

Berlin

Sachsen-

Anhalt

N= 4308

20-79 years


SHIP-0

Baseline

SHIP-1

5y Follow-up

SHIP-2

10y Follow-up

n= 4308 (68.8%)

n= 3300 (84.5%)

n= 2333

(63.5%)

SHIP-TREND

Baseline

n= 4422

(50.3%)

1997-2001

2002-2006

2008-2012





GWA Uric Acid

Metabolomics

Doering, et al. Nat Genetics 2008



Missing teeth and mortality
Missing Teeth and Mortality

Polzer et al., Int J Cardiol 2012


Publications
Publications

1-2 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
Publications

1-2 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


Tasks

Data Dictionary

Proband Management

Training Certification

Data Collection

Infrastructure (Devices, Computers, Facilities)

Communication Structures

Quality Monitoring

Data Clean-up

Data Transfer




Recruitment of patient cohorts

(in accordance with methods and quality standards of SHIP)

Comparison to

SHIP cohorts

Comparison to

SHIP cohorts

Cardiovascular

Heart failure

(systolic & diastolic)

FOLLOW-UP

Subclinical

and overt phenotypes

Morbidity

Mortality

BASELINE

Comprehensive,

standardized phenotyping

Subclinical and overt parameters

Biobanking

OMICs

Metabolism

Metabolic syndrome

& co-morbidities

Renal

Renal insufficiency

Cerebrovascular

Stroke / TIA


The Vision

International

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

Even high-quality epidemiological studies usually take less care on external validity!


International

Santiago de Chile

Pomerode



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