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Family studies in the age of big data. Proc Natl Acad Sci U S A 2022; 119:e2200472119. [PMID: 35344402 PMCID: PMC9169710 DOI: 10.1073/pnas.2200472119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
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Hamm NC, Hamad AF, Wall-Wieler E, Roos LL, Plana-Ripoll O, Lix LM. Multigenerational health research using population-based linked databases: an international review. Int J Popul Data Sci 2021; 6:1686. [PMID: 34734126 PMCID: PMC8530190 DOI: 10.23889/ijpds.v6i1.1686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Family health history is a well-established risk factor for many health conditions but the systematic collection of health histories, particularly for multiple generations and multiple family members, can be challenging. Routinely-collected electronic databases in a select number of sites worldwide offer a powerful tool to conduct multigenerational health research for entire populations. At these sites, administrative and healthcare records are used to construct familial relationships and objectively-measured health histories. We review and synthesize published literature to compare the attributes of routinely-collected, linked databases for three European sites (Denmark, Norway, Sweden) and three non-European sites (Canadian province of Manitoba, Taiwan, Australian state of Western Australia) with the capability to conduct population-based multigenerational health research. Our review found that European sites primarily identified family structures using population registries, whereas non-European sites used health insurance registries (Manitoba and Taiwan) or linked data from multiple sources (Western Australia). Information on familial status was reported to be available as early as 1947 (Sweden); Taiwan had the fewest years of data available (1995 onwards). All centres reported near complete coverage of familial relationships for their population catchment regions. Challenges in working with these data include differentiating biological and legal relationships, establishing accurate familial linkages over time, and accurately identifying health conditions. This review provides important insights about the benefits and challenges of using routinely-collected, population-based linked databases for conducting population-based multigenerational health research, and identifies opportunities for future research within and across the data-intensive environments at these six sites.
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Affiliation(s)
- Naomi C Hamm
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3
| | - Amani F Hamad
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3
| | - Elizabeth Wall-Wieler
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, CANADA, R3E 3P5
| | - Leslie L Roos
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3.,Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, MB, CANADA, R3E 3P5
| | - Oleguer Plana-Ripoll
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, DENMARK, 8210
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, MB, CANADA, R3E 0W3
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Hamad AF, Walld R, Lix LM, Urquia ML, Roos LL, Wall-Wieler E. Data Resource Profile: The Manitoba Multigenerational Cohort. Int J Epidemiol 2021; 51:e65-e72. [PMID: 34519337 DOI: 10.1093/ije/dyab195] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Accepted: 08/24/2021] [Indexed: 11/13/2022] Open
Affiliation(s)
- Amani F Hamad
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Randy Walld
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lisa M Lix
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Marcelo L Urquia
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada.,Dalla Lana School of Public Health, Centre for Global Health, University of Toronto, Toronto, Ontario, Canada
| | - Leslie L Roos
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Elizabeth Wall-Wieler
- Department of Community Health Sciences, Rady Faculty of Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
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Bouvard B, Briot K, Legrand E, Blain H, Breuil V, Chapurlat R, Duquenne M, Guggenbuhl P, Lespessailles E, Thomas T, Cortet B. Recommandations françaises de la prise en charge et du traitement de l’ostéoporose masculine. ACTA ACUST UNITED AC 2021. [DOI: 10.1016/j.rhum.2021.02.024] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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Hamad AF, Yang S, Yan L, Leslie WD, Morin SN, Walld R, Roos LL, Lix LM. The association of objectively ascertained sibling fracture history with major osteoporotic fractures: a population-based cohort study. Osteoporos Int 2021; 32:681-688. [PMID: 32935168 DOI: 10.1007/s00198-020-05635-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Accepted: 09/08/2020] [Indexed: 11/25/2022]
Abstract
UNLABELLED We investigated the association of objectively ascertained sibling fracture history with major osteoporotic fracture (hip, forearm, humerus, or clinical spine) risk in a population-based cohort using administrative databases. Sibling fracture history is associated with increased major osteoporotic fracture risk, which has implications for fracture risk prediction. INTRODUCTION We aimed to determine whether objectively ascertained sibling fracture history is associated with major osteoporotic fracture (MOF; hip, forearm, humerus, or clinical spine) risk. METHODS This retrospective cohort study used administrative databases from the province of Manitoba, Canada, which has a universal healthcare system. The cohort included men and women 40+ years between 1997 and 2015 with linkage to at least one sibling. The exposure was sibling MOF diagnosis occurring after age 40 years and prior to the outcome. The outcome was incident MOF identified in hospital and physician records using established case definitions. A multivariable Cox proportional hazards regression model was used to estimate the risk of MOF after adjustment for known fracture risk factors. RESULTS The cohort included 217,527 individuals; 91.9% were linked to full siblings (siblings having the same father and mother) and 49.0% were females. By the end of the study period, 6255 (2.9%) of the siblings had a MOF. During a median follow-up of 11 years (IQR 5-15), 5235 (2.4%) incident MOF were identified in the study cohort, including 234 hip fractures. Sibling MOF history was associated with an increased risk of MOF (hazard ratio [HR] 1.67, 95% confidence interval [CI] 1.44-1.92). The risk was elevated in both men (HR 1.57, 95% CI 1.24-1.98) and women (HR 1.74, 95% CI 1.45-2.08). The highest risk was associated with a sibling diagnosis of forearm fracture (HR 1.81, 95% CI 1.53-2.15). CONCLUSION Sibling fracture history is associated with increased MOF risk and should be considered as a candidate risk factor for improving fracture risk prediction.
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Affiliation(s)
- A F Hamad
- Department of Community Health Sciences, University of Manitoba, 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada.
| | - S Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China
| | - L Yan
- Department of Community Health Sciences, University of Manitoba, 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada
| | - W D Leslie
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
| | - S N Morin
- Department of Medicine, McGill University, Montreal, Quebec, Canada
| | - R Walld
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - L L Roos
- Department of Community Health Sciences, University of Manitoba, 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada
- Manitoba Centre for Health Policy, University of Manitoba, Winnipeg, Manitoba, Canada
| | - L M Lix
- Department of Community Health Sciences, University of Manitoba, 753 McDermot Avenue, Winnipeg, MB, R3E 0T6, Canada
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Yang S, Lix LM, Yan L, Walld R, Roos LL, Goguen S, Leslie WD. Parental cardiorespiratory conditions and offspring fracture: A population-based familial linkage study. Bone 2020; 139:115557. [PMID: 32730928 DOI: 10.1016/j.bone.2020.115557] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 06/26/2020] [Accepted: 07/05/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND The role of parental cardiorespiratory conditions on fracture risk is unclear. We examined the associations between parental cardiorespiratory conditions and offspring fracture risk. METHODS In this population-based retrospective cohort study, we identified 279,085 offspring aged≥40 years between April 1, 1997 and December 31, 2015 with successful linkage to 273,852 mothers and 254,622 fathers. Parental cardiorespiratory conditions, including cerebral vascular disease, congestive heart failure, hypertension, ischemic heart disease, myocardial infarction, chronic obstructive pulmonary disease (COPD) and peripheral vascular disease, were ascertained using physician and hospital records dating back to 1979. The outcome was offspring incident major osteoporotic fracture (MOF). RESULTS During an average of 11.8 years of offspring follow-up, we identified 8762 (3.1%) incident MOF. Either parent congestive heart failure (adjusted hazard ratio [HR]: 1.13; 95% confidence interval [CI] 1.07-1.19) and COPD (adjusted HR: 1.12; 95% CI 1.07-1.17) were independently associated with increased offspring MOF risk; all their false discovery rates were <0.001. Similar risk estimates were observed when analyses were performed for fathers only, mothers only or both parents, in multivariable models with and without adjustment for offspring cardiorespiratory conditions, and stratified by offspring sex and offspring incident fracture site. Parental cerebrovascular disease, hypertension, ischemic heart disease and myocardial infarction were not associated with offspring MOF. CONCLUSIONS Parental congestive heart failure and parental COPD are independent risk factors for offspring MOF.
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Affiliation(s)
- Shuman Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, Jilin, China.
| | - Lisa M Lix
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Lin Yan
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Randy Walld
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Leslie L Roos
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Stephanie Goguen
- Department of Community Health Sciences, University of Manitoba, Winnipeg, Manitoba, Canada
| | - William D Leslie
- Department of Internal Medicine, University of Manitoba, Winnipeg, Manitoba, Canada
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Abstract
PURPOSE OF REVIEW Identifying individuals at high fracture risk can be used to target those likely to derive the greatest benefit from treatment. This narrative review examines recent developments in using specific risk factors used to assess fracture risk, with a focus on publications in the last 3 years. RECENT FINDINGS There is expanding evidence for the recognition of individual clinical risk factors and clinical use of composite scores in the general population. Unfortunately, enthusiasm is dampened by three pragmatic randomized trials that raise questions about the effectiveness of widespread population screening using clinical fracture prediction tools given suboptimal participation and adherence. There have been refinements in risk assessment in special populations: men, patients with diabetes, and secondary causes of osteoporosis. New evidence supports the value of vertebral fracture assessment (VFA), high resolution peripheral quantitative CT (HR-pQCT), opportunistic screening using CT, skeletal strength assessment with finite element analysis (FEA), and trabecular bone score (TBS). The last 3 years have seen important developments in the area of fracture risk assessment, both in the research setting and translation to clinical practice. The next challenge will be incorporating these advances into routine work flows that can improve the identification of high risk individuals at the population level and meaningfully impact the ongoing crisis in osteoporosis management.
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Affiliation(s)
- William D Leslie
- Departments of Medicine and Radiology, University of Manitoba, 409 Tache Avenue, Winnipeg, Manitoba, R2H 2A6, Canada.
| | - Suzanne N Morin
- Department of Medicine, McGill University- McGill University Health Center, Montreal, Quebec, Canada
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