1 Epidemiology in Groningen What is epidemiology Our department Projects in our department Special Oncology.

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Epidemiology in Groningen

• What is epidemiology

• Our department

• Projects in our department

• Special Oncology

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Definition of epidemiology

• “The study of the distribution and determinants of health-related states or events in specified populations, and the application of this study to control of health problems”

• The study of the occurrence of a disease in a population, in relation to its determinants.

http://bmj.bmjjournals.com/collections/epidem

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Epidemiology is occurrence research

• Object of research: occurrence relation

Outcome = ƒ(determinants)

– Determinants are all factors that influence the frequency of a disease (causal or not-causal)

– Outcome may include (other) risk factors, disorders, disease progression/cure, burden of disease, costs

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Department of Epidemiology at UMCGFacts• Established February 2005

• Union of epidemiology, data management and MTA groups from Medical School and Academic Hospital

• Focus on own research in collaboration with strong clinical research groups

• Clinical Research desk (CRD) for consultancy

• Teaching in several Bachelors and Master programs, including new MSc Epidemiology program

• About 65 people– 8 associate/full professors– ~25 scientific staff

www.EpidemiologyGroningen.nl

www.EpidemiologyGroningen.nl

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Scientific output 2005

• 81 PubMed publications

– 27 first, second, last author

• 2 PhD-theses completed (co-promotor)

• 24 grant applications

– ≥ 5 granted

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Organization

• Two sections

– Research & Education R&E (O&O)• Diabetes/obesity• Cardio-renal disorders• Lung diseases• Oncology• Psychiatry• Medical statistics• Genetic epidemiology• MTA

– Research support (RCC)

• Management team

– Secretary, supporting staff

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Department of Epidemiology

Ongoing projects offering excellent

research opportunities

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Chronic diseases are the greatest threat to quality of life and have one thing in common: ageing is the number 1 risk factor

75%

100%

125%

150%

175%

200%

225%

2005 2015 2030

Source: WHO, Global Burden of Disease Estimates

1) Disability Adjusted Life Year

• Diabetes

• Alzheimer’s

• Cancer

• Parkinson’s

• All diseases combined

• Communicable, hereditary and nutrition related diseases

Age-related (chronic) diseases

Burden through age-related diseases [worldwide loss in DALY’s1), 2005 =100%]

Index 2005

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LIFELINES

• Focus on modification of universal risk factors for

multifactorial diseases

Population-based study

165.000 participants from the northern provinces of the

Netherlands

Three-generation study design

Multiple UMCG departments involved

www.lifelines.nl

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Purpose of LifeLines

Central question

• Why do some people get old in a healthy manner, and why

have others already severe impairments or diseases early

in their life?

Focus on

• Multifactorial diseases (gene + environment)

• Factors which cause more than one disease

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Main focus of LifeLinesFrequently occuring diseases with high impact

Cardio-renal disease

Ag

ein

g

Lung disease

Metabolic disease

Psychiatric disease

Note: many diseases are defined by an arbitrary cut-off in a continuous disease marker or endophenotype.

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LifeLines cohort dimensionsThe study will cover 30,000 index persons (probands or propositi) with an age between 25 and 50 years in

a defined geographical area, and subsequently assess and follow their family members

propositus

partner

father

mother

partner’sfather

partner’smother

child 1

child 2

Aselect:30.000

Partner assumption:20.000

Family assumption:2 children

Children involved assumption:40.000

Parents alive assumption:75.000

Total number ofparticipants:

165.000

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Mental disease- TRAILS

• Aims at understanding the origins of mental disease

• Provides a multitude of repeatedly measured psychosocial

and biological data

• Included a cohort of more than 2000 adolescents from the

general population

• Principally carried out by the department of Psychiatry

• www.trails.nl

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Cardiovascular disease - PREVEND

• Directed at the assessment of the impact of

microalbuminuria

• Focus is on renal and cardiovascular disease

• Cohort study with 8592 persons from the general

population

• Carried out in close collaboration with the department of

Internal Medicine

• www.prevend.org

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Adiposity - GECKO

• Focus on development of body weight during the first year of life

• Measures of metabolism, genetics, parental life style

• Includes a cohort of all children born in Drenthe during one year

(N=5500)

• Carried out in close collaboration with the department of

Pediatrics

• www.rug.nl/umcg/faculteit/disciplinegroepen/kindergeneeskunde/

gecko

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COPD - VLAGTWEDDE/VLAARDINGEN

• Sample of the general population of the Netherlands

followed up for 25 years

• Measurements of FEV1, single nucleotide polymorphisms,

life style factors (smoking)

• In collaboration with the department of Pulmonary Diseases

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Oncology – CANCER REGISTRY

• Early detection of breast and ovarian cancer in families with

BRCA mutations

• Follow-up after breast cancer

• Incidence and determinants of irradical tumor resection