Nordic Population based cohorts from a GP perspective

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Nordic Population based cohorts from a GP
perspective?

• Carsten Obel

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Things that characterise a GPs 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

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Things that characterize a GPs 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

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The cohort idea and life perspective
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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

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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

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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

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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)

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Aarhus Birth cohort 1990-2007

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Danish National Birth Cohort

• Established in collaboration with GPs
• More than 100,000 children
• Telephone interviews
• Biobank (3 full blood samples)
• Follow up to 7 years
• 11 y follow up next

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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

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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

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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

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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

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Growth-pattern of Finnish children
Data from Northern Finnish Birth Cohorts. Marjo
Riita Järvellin et al.
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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 GPs work
• There is an added value of Nordic collaboration
• Science would gain from more GPs taking active
  part in cohort studies