Current International Priorities in Health Research Opportunities for Epidemiology

1. Current International Priorities in Health ResearchOpportunities for Epidemiology Henry Völzke

2. The Risk Transition WHO 2009

3. The Obesity Map, 2008 www.hsph.harvard.edu

4. Finucane et al.; Lancet 2011

5. WHO 2009

6. WHO 2009

7. Known Risk Factors for MI Yusuf et al., Lancet 2007

8. Keller et al., Nat Comm 2012

9. Risk Factors for Peptic Ulcer • Stress • Alcohol • Smoking • Diet • Family History wikipedia.org

10. Society Science Epidemiology • Disparities • Health care allocation • Preventive programs • Prognosis • Risk factors • Predictors • Interactions • Subgroups

11. Quelle: Nationalatlas Bundesrepublik Deutschland Life Expectancy

13. 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

14. Objectives Prevalence and incidence of common risk factors and diseases Associations and interactions among common risk factors, subclinical disorders and diseases

15. Rügen Stralsund Nordvorpommern Greifswald Use- Ostvorpommern dom Schleswig- Holstein Mecklenburg - Vorpommern Hamburg Brandenburg Niedersachsen Berlin Sachsen- Anhalt N= 4308 20-79 years

16. 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

17. Völzke et al.; Int J Epidemiol 2011

18. Hegenscheid et al.; Röfo 2009

19. Gloger et al.; Magn Resonance Tomography 2010

20. GWA Uric Acid Metabolomics Doering, et al. Nat Genetics 2008

21. 10-year Trend BMI and Obesity

22. Missing Teeth and Mortality Polzer et al., Int J Cardiol 2012

23. 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)

24. 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)

27. 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

28. Tasks Data Dictionary Proband Management Training Certification Data Collection Infrastructure (Devices, Computers, Facilities) Communication Structures Quality Monitoring Data Clean-up Data Transfer

29. Web-based Certification System

30. Data Monitoring System

31. 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 …

32. 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

33. Bassett & Winter-Nelson 2010

35. Bassett & Winter-Nelson 2010

36. Potential Bias in Global Epi Research Even high-quality epidemiological studies usually take less care on external validity!

37. International Santiago de Chile Pomerode

38. voelzke@uni-greifswald.de