SHEEP - Stockholm Heart Epidemiology Program SHEEP - Stockholm Heart Epidemiology Program ext0039-1-1 Swedish National Data Service Svensk nationell datatjänst SHEEP - Stockholm Heart Epidemiology Program SHEEP - Stockholm Heart Epidemiology Program ext0039-1-1 Hallqvist, Johan Hallqvist, Johan Leander, Karin Leander, Karin Swedish National Data Service Svensk nationell datatjänst Swedish Cohort Consortium (Cohorts.se) The Swedish Cohort Consortium (Cohorts.se) is a project aimed at improving management and increasing the use of Swedish population-based cohorts (research databases with sensitive person data) for world-leading research. Coordination of all Swedish prospective population-based cohorts in a common infrastructure will enable more precise research findings and facilitate research on rare diseases and exposures, leading to better utilization of study participants’ data, better return of funders’ investments, and higher benefit to patients and populations. Cohorts.se will support some aspects of single cohort operations and all aspects of collaborations between cohorts. Important components of the infrastructure involve data curation and management, cataloguing of variables, presentation of and access to data, harmonization of variables for research projects, linkage of cohorts and official registries, and statistical analysis including a novel method for distributed data analysis eliminating the need to share data. The project aims to increase collaboration between Swedish universities and with international cohort consortia, and to be a node for researchers who want to collaborate, perhaps extra important for young researchers without a large contact network. SND collaborates with Cohorts.se. Partly through training of data managers and statisticians in the Maelstrom system (maelstrom-research.org), which is tailored for cohort collaboration and will be used in this infrastructure; partly through collaboration around logistics by forwarding researchers seeking access to person data from cohorts to Cohorts.se and the Maelstrom repository. Contact for Cohorts.se: Johan Sundström, Professor at UCR-Uppsala Clinical Research center johan.sundstrom@ucr.uu.se The Swedish Cohort Consortium (Cohorts.se) är ett projekt som syftar till att förbättra förvaltningen och öka utnyttjandet av svenska populationsbaserade kohorter (forskningsdatabaser med känsliga individdata) för världsledande forskning. Genom samutnyttjande av många kohorter kan vi skapa säkrare forskningsresultat till bättre nytta för patienter och allmänhet. Infrastrukturen kommer att omfatta kohorter med känsliga individdata och metadata, mjukvara, och servicetjänster. Infrastrukturen kommer att kurera data, katalogisera kohorter, förvalta kohorter, administrera datauttag och -insättningar och länkningar till andra register, harmonisera variabler vid sammanläggningsprojekt, genomföra statistisk analys, och genomföra utbildningsinsatser. Långsiktig professionell kohortförvaltning som inte är personberoende ger ökad säkerhet och kvalitet. Uniform katalogisering och dokumentation och uniforma uttagsprocesser ger ökad tillgänglighet. Infrastrukturen ger ökat utnyttjande av redan insamlade kohorter, och därmed ökat värde för skattebetalarnas grundinvesteringar i kohorterna. Infrastrukturen kan öka samarbeten mellan svenska lärosäten och med internationella kohortkonsortier, och den kan vara en nod för forskare som vill samarbeta, kanske extra viktigt för unga forskare utan stort kontaktnät. SND samarbetar med Cohorts.se. Dels genom utbildning av data managers och statistiker i den för ändamålet designade mjukvara som framförallt används i infrastrukturen, Maelstrom (maelstrom-research.org). Dels genom att forskare som vill ha tillgång till individdata från kohorter lotsas vidare från SND till Cohorts.se och Maelstrom-katalogen. Kontaktperson Cohorts.se: Johan Sundström, Professor vid Institutionen för medicinska vetenskaper, Uppsala universitet johan.sundstrom@ucr.uu.se Sexual Behavior Sexuellt beteende Physical Examination Hälsokontroll Exercise Träning Population Surveillance Populationsövervakning Socioeconomic Factors Socioekonomiska faktorer Risk Factors Riskfaktorer Myocardial Infarction Hjärtinfarkt Alcohol Drinking Alkoholkonsumtion Job Satisfaction Arbetstillfredsställelse Case-Control Studies Fall-kontrollstudier Genetics Genetik Insulin Insulin Coffee Kaffe Dietary Supplements Kosttillskott Coronary Disease Kranskärlssjukdom Body Height Kroppslängd Body Weight Kroppsvikt Tobacco Smoke Pollution Tobaksröksförorening Smoking Rökning Stress, Psychological Psykologisk stress Occupational Exposure Yrkesmässig exponering Heredity Ärftlighet Cross-Over Studies Överkorsningsstudier HEALTH HÄLSA SHEEP (the Stockholm Heart Epidemiology Program) is a population based case-referent study of risk factors for first episode of acute myocardial infarction in women and men in the ages 45-70 years living in the Stockholm County. Exposure information was collected by a questionnaire and a health examination including blood sampling. A large number of potential risk factors were included in the questionnaire items and comprised occupational, social, as well as life style or individual factors. A total of 5452 subjects were included in SHEEP: 2246 cases and 3206 referents. The response rate was higher among men than among women. Exposure information based on both the questionnaire and biological data from the health examination was available for 78% of the male and 67% of the female non-fatal cases; the corresponding figures for their referents were 68% and 64%. Purpose: To simultaneously test several hypotheses concerning potential risk factors for acute myocardial infarction, first event. To compare the effect of different risk factors/exposures between women and men. To identify and evaluate potential effect modification between different risk factors. SHEEP (Stockholm Heart Epidemiology Program) är en befolkningsbaserad fall-kontrollstudie av riskfaktorer för förstagångs hjärtinfarkt hos män och kvinnor i åldern 45-70 år boende i Stockholms län. Information om exponering för olika riskfaktorer samlades in genom enkäter och telefonintervjuer. För avlidna fall besvarades enkäten av en nära anhörig. Totalt 5452 individer inkluderades: 2246 fall och 3206 kontroller. Det gjordes också hälsokontroller. De kvinnliga fallen besvarade också en enkät om hormonell exponering. Svarsfrekvensen bland fallen var 80 % och bland kontrollerna 73 %. Svarsfrekvensen var högre bland kvinnor än bland män. Data baserat på både enkäter och hälsoundersökning finns tillgängligt från de överlevande fallen för 78% av männen och 67% av kvinnorna; motsvarande siffror för kontrollerna är 68% respektive 64%. SHEEP har använts för att studera riskfaktorer för hjärtinfarkt i en mängd olika projekt, avslutade och pågående. Syfte: Att testa hypoteser gällande potentiella riskfaktorer för förstagångsfall av akut hjärtinfarkt. Att jämföra effekterna av riskfaktorer/exponering mellan kvinnor och män. Att identifiera och utvärdera möjliga effektmodifieringar mellan olika riskfaktorer. 1992 1994 1992 1994 Sweden Sverige IndividualIndividual IndividIndivid The Sheep study base comprised all Swedish citizens resident in the Stockholm county 1992-1994 who were 45-70 years of age and were free of previous clinically diagnosed myocardial infarction. Male cases were identified during a two-year period (1992-1993 Fall och kontroller identifierades under 1992-94 bland alla som bodde i Stockholms län, var svenska medborgare i åldrarna 45-70 år och som inte tidigare hade haft hjärtinfarkt, sammanlagt 2246 fall - 1485 manliga och 761 kvinnliga. Av fallen hade 1643 öve Numeric Exposure information was collected by a questionnaire and a health examination including blood sampling. A large number of potential risk factors were included in the questionnaire items and comprised occupational, social, as well as life style or individual factors.Exposure information was collected by a questionnaire and a health examination including blood sampling. A large number of potential risk factors were included in the questionnaire items and comprised occupational, social, as well as life style or individual factors. Fallen rekryterades via länets akutsjukhus, via slutenvårdsregistret och via dödsbevis från Statistiska centralbyrån. Kontrollerna valdes ur befolkningsregistret vid Stockholms läns landsting.Fallen rekryterades via länets akutsjukhus, via slutenvårdsregistret och via dödsbevis från Statistiska centralbyrån. Kontrollerna valdes ur befolkningsregistret vid Stockholms läns landsting. Self-administered questionnaire: PaperSelf-administered questionnaire: Paper Självadministrerat frågeformulär: papperSjälvadministrerat frågeformulär: papper Physical measurements and testsPhysical measurements and tests Fysiska mätningar och testerFysiska mätningar och tester Access to data through an external actor. Access to data is restricted. Åtkomst till data via extern aktör. Tillgång till data är begränsad. restrictedAccess Gustavsson P, Plato N, Lewné M, Schéele P, Hallqvist J, Hogstedt C, Reuterwall C and the SHEEP study group. Myocardial infarction and occupational exposure to combustion products - a case-referent study in Sweden. Epidemiology 2001 Mar;12:222-8. Gustavsson P, Plato N, Lewné M, Schéele P, Hallqvist J, Hogstedt C, Reuterwall C and the SHEEP study group. Myocardial infarction and occupational exposure to combustion products - a case-referent study in Sweden. Epidemiology 2001 Mar;12:222-8. Romelsjö A, Branting M, Hallqvist J, Alfredsson L, Hammar N, Leifman A, Ahlbom A. Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions- the SHEEP case-control study. Addiction 2003;98:1453-62. Romelsjö A, Branting M, Hallqvist J, Alfredsson L, Hammar N, Leifman A, Ahlbom A. Abstention, alcohol use and risk of myocardial infarction in men and women taking account of social support and working conditions- the SHEEP case-control study. Addiction 2003;98:1453-62. Leander K, Wiman B, Hallqvist J, Sten-Linder M, de Faire U. PAI-1 level and the PAI-1 4G/5G polymorphism in relation to risk of myocardial infarction. Results from the Stockholm Heart Epidemiology Program (SHEEP). Thromb Haemost 2003;89:1064-71. Leander K, Wiman B, Hallqvist J, Sten-Linder M, de Faire U. PAI-1 level and the PAI-1 4G/5G polymorphism in relation to risk of myocardial infarction. Results from the Stockholm Heart Epidemiology Program (SHEEP). Thromb Haemost 2003;89:1064-71. Bennet AM, Prince JA, Fei G-Z, Lyrenäs L, Huang Y, Wiman B, Frostegård J, de Faire U. Interleukin-6 serum levels and genotypes; relations to serum-insulin, myocardial infarction and interactions with other cardiovascular risk factors. Atherosclerosis Volume 171, Issue 2, December 2003, Pages 359-367 Bennet AM, Prince JA, Fei G-Z, Lyrenäs L, Huang Y, Wiman B, Frostegård J, de Faire U. Interleukin-6 serum levels and genotypes; relations to serum-insulin, myocardial infarction and interactions with other cardiovascular risk factors. Atherosclerosis Volume 171, Issue 2, December 2003, Pages 359-367 Hallqvist J, Lundberg M, Diderichsen F, Ahlbom A. Socioeconomic differences in risk of myocardial infarction 1971-1994 among men and women in Sweden. Time trends in incidence, relative risks and population attributable risks. Int J Epidemiol 1998;27:410-5. 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A case-crossover analysis nested in a population based case-referent study (SHEEP). Am J Epidemiol 2000;151:459-67. Hallqvist J, Lynch J, Bartley M, Lang T, Blane D. Accumulation of Exposure to Low Socioeconomic Positions During the Life Course and Risk of Myocardial Infarction. Can the Effect be Disentangled from Effects of Critical Periods and Social Mobility? Stockholm Heart Epidemiology Program (SHEEP). Soc Sci Med. 2004 Apr;58(8):1555-62. Hallqvist J, Lynch J, Bartley M, Lang T, Blane D. Accumulation of Exposure to Low Socioeconomic Positions During the Life Course and Risk of Myocardial Infarction. Can the Effect be Disentangled from Effects of Critical Periods and Social Mobility? Stockholm Heart Epidemiology Program (SHEEP). Soc Sci Med. 2004 Apr;58(8):1555-62. Rosenlund M, Berglind N, Gustavsson A, Reuterwall C, Hallqvist J, Nyberg F, Pershagen G & the SHEEP study group. 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