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