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Strengths & Limitations of existing data sources Julia Critchley Simon Capewell

Strengths & Limitations of existing data sources Julia Critchley Simon Capewell. MONICA Project. Advantages: Comparable and reliable data Hot-cold pursuit to identify suspected events in all countries All events validated during registration period Limits:

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Strengths & Limitations of existing data sources Julia Critchley Simon Capewell

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  1. Strengths & Limitations of existing data sourcesJulia CritchleySimon Capewell

  2. MONICA Project Advantages: • Comparable and reliable data • Hot-cold pursuit to identify suspected events in all countries • All events validated during registration period Limits: • Coverage (only some areas of country) • Age range (35-64) • Cost • Dated [1985-1996]

  3. HFA DB

  4. HFA DB

  5. CHD rates & Life expectancy

  6. HFA DB(European Health For All Database) Advantages: • Covers all countries • User friendly web access • Nice graphics for Powerpoint Limits: • Data not standardised • Dated (most recent 2001- 2005)

  7. LIMITATIONS Reliable indicators for monitoring CVD and for which data are available on a comparable basis across EU countries are currently limited Even mortality is scarcely comparable since the diagnostic criteria for coding death certificates are not standardized at international level and diagnostic information is not based on uniform criteria

  8. CVD international sources include: • WHO-mortality • WHO-MONICA • EUROCISS inventory of population-based registers

  9. LIMITATIONS Reliable indicators for monitoring CVD and for which data are available on a comparable basis across EU countries are currently limited Even mortality is scarcely comparable since the diagnostic criteria for coding death certificates are not standardized at international level and diagnostic information is not based on uniform criteria

  10. CVD international sources include: • WHO-mortality • WHO-MONICA • EUROCISS inventory of population-based registers

  11. Mortality data available WHO HFA, EUROSTAT Age: 0-64, 65+, 25-64, 0-14, 15-29, 30-44, 45-59, 60-74, 75+; from WHO-HFA 0-84 by 5-year age groups, 85+, 0-64 from EUROSTAT for CHD and STROKE

  12. K. Steinbach BELGIUM M AUSTRIA M. Kornitzer DENMARK M. Madsen FINLAND V. Salomaa france S. Paterniti GERMANY A. Doring ITALY S. Giampaoli, L. Palmieri, S. Panico, F. Seccareccia, D. Vanuzzo ICELAND V. Gudnason GREECE A. Trichopoulou M. Verschuren NORWAY POLAND A. Pajak PORTUGAL E. Rocha SPAIN S. Sans SWEDEN N. Hammar UK P. Primatesta EUROPEAN HEART NETWORK Participating countries the NETHERLANDS S. Graff-Iversen P. Primatesta

  13. The map….

  14. Main objectives • To prioritise cardiovascular disease of major interest in EU countries • To provide a list of specific indicators and sources of information for monitoring CVD • To prepare the Manual of Operations for the implementation of population-based registers of acute myocardial infarction/acute coronary syndrome, stroke and of CVD surveys

  15. EUROCISS Recommendations for mortality indicators AMI: ICD10 codes I20-I21 (ICD9: 410) IHD: ICD10 codes I20-I25 (ICD9: 410-414) CVA : ICD10 codes I60-I69 (ICD9: 430-438) Ischaemic STROKE : ICD10 code I64 (ICD9: 434) Haemorragic STROKE : (Intracerebral) ICD10 codes I61, I62 (ICD9: 431, 432) (Subarachnoid) ICD10 code I60 (ICD9: 430) Age:35-44, 45-54, 55-64, 65-74 and 75-84 Indicators should be standardised by age and gender using the European standard population

  16. Population-based specific AMI Registers:population characteristics

  17. Population-based specific AMI Registers:case definition (*) all codes are presented in the ICD-9 revision to facilitate the comparison

  18. International sources of data

  19. WHO Global Infobase • a data warehouse that collects, stores and displays information on chronic diseases and their risk factors for all WHO member states http://www.who.int/infobase/report.aspx

  20. Risk factors included in InfoBase • Alcohol • Blood Pressure • Cholesterol • Diet - Low fruit and vegetable • Overweight & Obesity • Physical Activity • Tobacco

  21. Asia-Pacific Studies Collaboration

  22. Asia Pacific Studies Collaboration - APCSC • Individual patient data meta-analysis from existing longitudinal studies with information on cardiovascular disease in the Asia Pacific. • The project's main research themes are: • risk factors for cardiovascular disease • interactions between risk factors for cardiovascular disease • prevalence and attributable risk for five major cardiovascular disease risk factors • the relationship of cancer incidence to cardiovascular disease risk factors • over 650,000 participants, 44 separate cohort studies in mainland China, Hong Kong, Taiwan, Japan, South Korea, Singapore, Thailand, New Zealand and Australia. • 35 papers from the project have been published or are in press in international peer reviewed journals. http://www.apcsc.info/

  23. International - Global Burdens of Disease Project (GBD) • WHO Project, commenced 1992 • World Bank, Harvard School of Public Health • Comprehensive and consistent set of estimates of mortality and morbidity by age, sex, region for world for first time for 1990 • New measure – DALY (Disability Adjusted Life Year) – includes premature deaths and disability, weighted by severity of disability

  24. GBD • Only 1/3 estimated 56 million deaths occurring annual are recorded in vital registration systems • Uses estimates from these plus disease registers, population surveys, epidemiological studies to “fill in the gaps”

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