1. Nordic Population based cohorts from a GP perspective?
Carsten Obel

2. 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

3. 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

4. The cohort idea and life perspective

5. The Framingham study
In 1948 about 5000, aged from the town of Framingham, Massachusetts
Third generation enrolled 2005
The basis of our counceling in preventing CVD
Cholesterol, blodpressure, smoking

6. 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

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

8. Examples of Nordic birth cohorts
The Northern Finnish birthcohorts (born 1966 & )
The Aarhus Birth cohort (born )
The national birth cohorts
Norway (born )
Denmark (born )

9. Aarhus Birth cohort %

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
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

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 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