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Epidemiology in General Practice – the Nordic paradise. Mogens Vestergaard GP, Associate professor, PhD. Data collection. Storm P. Modern science (1910). The Nordic paradise. Several important papers. Programme. Nationwide registries - Mogens Vestergaard
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Epidemiology in General Practice– the Nordic paradise A A R H U S U N I V E R S I T Y INSTITUTE OF PUBLIC HEALTH Department of General Practice Mogens Vestergaard GP, Associate professor, PhD
Data collection Storm P. Modern science (1910).
Programme • Nationwide registries • - Mogens Vestergaard • The Danish General Practice Database • Henrik Schroll • Drugs and registers • - Morten Andersen • Population-based cohorts • - Carsten Obel
Nationwide registries Civil Registration System
Nationwide registries National Presciption Registry Danish General Practice Database National Health Service PKU register Civil Registration System Cause of death register National Hospital Register Psykiatric Central Register Statistic Denmark Medical Birth Register
MRR-vaccine was introduced MMR and Autism WakefieldLancet 1998 Timing of symptoms
Vaccination cohort • Registries • Civil Registration system, Central psychiatric Register, National Hospital Register, Medical Birth Register, National Health Service • Cohort • Danish children born 1991-1998 (N= 537,000) • MMR vaccinated (N=439,251) • Outcome • Autism (N= 316), Autism spectrum disorder (N= 422) • Febrile seizures (N=17,986)
Age at MMR vaccination MRR vaccination
Stress and childhood cancer • Maternal bereavement • Child • Partner • Sibling • Parent Childhood cancer Prenatal Postnatal
Scandinavian registries Finland Denmark Stress and cancer Sweden
Registerbased research - strenght • Size matters
Registerbased research - strenght Sizematters Noselection bias
Registerbased research - strenght • Sizematters • Noselection bias • Data is collectedprospectively
Registerbased research - strenght • Sizematters • Noselection bias • Data is collectedprospectively • The researcher do not influence data collection
Registerbased research - strenght • Sizematters • Noselection bias • Data is collectedprospectively • The researcher do not influence data collection • Data alreadyexists
Registerbased research - weaknesses Data quality
Registerbased research - weaknesses Data quality
Registerbased research - weaknesses Data quality Heavy computer skillsareneeded
Registerbased research - weaknesses Data quality Heavy computer skillsareneeded Statisticalsignificantresultsneed not bebiological relevant
Registerbased research - weaknesses Data quality Heavy computer skillsareneeded Statisticalsignificantresultsneed not bebiological relevant Lack of important variables
Registerbased research Use it but look out for the pitfalls