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Bo Christensen, Professor Praktiserende læge, Ph.d.
A A R H U S U N I V E R S I T Y
INSTITUTE OF PUBLIC HEALTHDepartment of General Practice
Mogens VestergaardGP, Associate professor, PhD
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Storm P. Modern science (1910).
Data collection
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The Nordic paradise
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Several important papers
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Nationwide registries - Mogens Vestergaard
The Danish General Practice
Database - Henrik Schroll
Drugs and registers- Morten Andersen
Population-based cohorts- Carsten Obel
Programme
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Civil Registration
System
Nationwide registries
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National Health Service
National Hospital Register
Statistic Denmark
Medical Birth Register
Cause of death register
National Presciption Registry
PKU register
Danish General Practice Database
Psykiatric Central Register
Civil Registration
System
Nationwide registries
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Childhood vaccinations – an example
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Wakefield Lancet 1998
Timing of symptoms
MMR and Autism
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Vaccination cohort
RegistriesCivil Registration system, Central psychiatric Register, National Hospital Register, Medical Birth Register, National Health Service
CohortDanish children born 1991-1998 (N= 537,000)
MMR vaccinated (N=439,251)
OutcomeAutism (N= 316), Autism spectrum disorder (N= 422)
Febrile seizures (N=17,986)
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MMR vaccination
AutismAutism spectrum
disorder
No
Yes
1.00 (reference)
0.92 (0.68-1.24)
1.00 (reference)
0.83 (0.65-1.07)
MMR and Autism
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0,00
1,00
2,00
3,00
4,00
5,00
6,00
7,00
3 8 13 18 23 28 33 38 43 48 53 58
Pro
po
rtio
n (
%)
Age of the child (months)
Boys Girls
MMR and febrile seizures
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0,00
1,00
2,00
3,00
4,00
5,00
6,00
7,00
3 8 13 18 23 28 33 38 43 48 53 58
Pro
po
rtio
n (
%)
Age of the child (months)
Boys Girls
Age at MMR vaccination
MRR vaccination
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01
23
45
67
8 - 2626 - 52
52 - 104104- 156
156 -
Time since vaccination (weeks)
RR
0
1
2
3
4
MMR and Febrile seizures – relative risk
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Number of febrile seizures within 14 days of a MMR vaccination per 1000 children aged 15-
17 months
Not vaccinated
Vaccinated Risk difference
All children
Siblings to children with febrile
Children with a history of febrile seizures
0,9
2,6
11,5
2,5
6,6
31
1,6 (1,4-1,7)
4.0 (2,9-5,4)
19,5 (16,1-23,6)
MMR and Febrile seizures – absolute risk
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Stress and childhood cancer - an example
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Maternal bereavement• Child• Partner• Sibling• Parent
Childhood cancer
Prenatal Postnatal
Stress and childhood cancer
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Sweden
Finland Denmark
Stress and cancer
Scandinavian registries
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Registerbased research - strenght
Size matters
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Size matters
No selection bias
Registerbased research - strenght
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Size matters
No selection bias
Data is collected prospectively
Registerbased research - strenght
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Size matters
No selection bias
Data is collected prospectively
The researcher do not influence data collection
Registerbased research - strenght
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Size matters
No selection bias
Data is collected prospectively
The researcher do not influence data collection
Data already exists
Registerbased research - strenght
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Data quality
Registerbased research - weaknesses
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Data quality
Registerbased research - weaknesses
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Data quality
Heavy computer skills are needed
Registerbased research - weaknesses
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Data quality
Heavy computer skills are needed
Statistical significant results need not be biological relevant
Registerbased research - weaknesses
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Data quality
Heavy computer skills are needed
Statistical significant results need not be biological relevant
Lack of important variables
Registerbased research - weaknesses
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Use it but look out for the pitfalls
Registerbased research
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