Establishing a follow-up of the Swiss MONICA participants (1984-1993) record linkage with census and mortality data.docVIP

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Establishing a follow-up of the Swiss MONICA participants (1984-1993) record linkage with census and mortality data.doc

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Establishing a follow-up of the Swiss MONICA participants (1984-1993) record linkage with census and mortality data

Boppetal.BMCPublicHealth2010,10:562 /1471-2458/10/562 RESEARCH ARTICLE OpenAccess Establishingafollow-upoftheSwissMONICA participants(1984-1993):recordlinkagewith censusandmortalitydata MatthiasBopp*,JuliaBraun,DavidFaeh,FelixGutzwiller,SwissNationalCohortStudyGroup Abstract Background:Toassessthefeasibilityandqualityofananonymouslinkageof1)MONICA(MONItoringoftrends anddeterminantsinCArdiovsculardisease,threewavesbetween1984and1993)datawith2)censusandmortality recordsoftheSwissNationalCohortinordertoestablishamortalityfollow-upuntil2008.Manycountriesfeature thedefectoflackinggeneralpopulationcohortsbecausetheyhavemissedtoprovideforfollow-upinformationof healthsurveys. Methods:Recordlinkageprocedureswereusedinamulti-stepapproach.Kaplan-Meiercurvesfromourdatawere contrastedwiththesurvivalprobabilitiesexpectedfromlifetablesforthegeneralpopulation,age-standardized mortalityratesfromourdatawiththosederivedfromofficialcross-sectionalmortalitydata.Coxregressionmodels werefittoinvestigatetheinfluenceofcovariatesonsurvival. Results:97.8%oftheeligible10,160participants(25-74yatbaseline)couldbelinkedtoacensus(1990:9,737; 2000:8,749),mortality(1,526,1984-2008)and/oremigrationrecord(320,1990-2008).Linkagesuccessdidnotdiffer byanykeystudycharacteristic.Resultsofsurvivalanalyseswererobusttolinkagesteporcertaintyofacorrectlink. Losstofollow-upbetween1990and2000amountedto4.7%.MONICAparticipantshadlowermortalitythanthe generalpopulation,butsimilarmortalitypatterns,(e.g.variationbyeducationallevel,maritalstatusorregion). Conclusions:Usinganonymizedcensusanddeathrecordsallowedanalmostcompletemortalityfollow-upof MONICAstudyparticipantsofupto25years.Lowermortalitycomparedtothegeneralpopulationwasinlinewith apresumable?healthyparticipant’selectionintheoriginalMONICAstudy.Apartfromthat,thederiveddataset reproducedknownmortalitypatternsandshowedonlynegligiblepotentialforselectionbiasintroducedbythe linkageprocess.Anonymousrecordlinkagewasfeasibleandprovidedrobustresults.Itcanthusprovide