Nordic Population based cohorts from a GP perspective ?

1. Nordic Population basedcohorts from a GP perspective? Carsten Obel

2. Thingsthatcharacterise a GP’swork • 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

3. Thingsthatcharacterize a GP’swork • 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

4. The cohortidea and lifeperspective

5. 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

6. Nordic cohortsestablished 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

7. 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

8. 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)

9. Aarhus Birth cohort 1990-2007 %

10. 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

11. 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

12. 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

13. 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 • Weneed a tool to identifychildren at risk for overweight • The algoritm for riskassesment of CVD is extensivelyused in gereralpractice • Aim: To develop an algoritm to predictoverweight in pre-school age

14. 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

15. Growth-pattern of Finnish children Data from Northern Finnish Birth Cohorts. Marjo Riita Järvellin et al.

16. Conclusion • We have large and wellestablishedcohorts in the Nordic countries • In combinationwith the national registers the Nordic cohortsareunique • Results from cohort studies couldoftenbe relevant for the GP’swork • There is an addedvalue of Nordic collaboration • Science wouldgain from more GP’stakingactive part in cohort studies