Cohort Profile: the Million Women Study

Banks, Emily; Carpenter, Lucy; Dezateux, Carol; Patnick, Julietta; Pető, Richárd; Abbiss, Hayley; Abbott, Simon; Alison, Rupert; Baker, Krys; Balkwill, Angela; Barnes, Isobel; Beral, Valerie; Black, Judith L.; Blanks, R G; Bradbury, Kathryn E.; Brown, Anna; Cairns, Benjamin J.; Chadwick, Andrew; Ewart, Dave; Ewart, Sarah; Floud, Sarah; Gathani, Toral; Gerrard, Laura; Goodill, Adrian; Green, Jane; Guiver, Lynden; Heath, Alicia K.; Hermon, C; Hogg, Darren; Lingard, Isobel; Kan, Sau Wan; Key, Tim; Langston, Nicky; Moser, Kath; Pirie, Kirstin; Price, Alison; Reeves, Gillian; Shaw, K. M.; Sherman, E. L. C.; Simpson, R. W.; Strange, Helena; Sweetland, S; Tipper, Sarah; Travis, Ruth C.; Trickett, Lyndsey; Webster, A. J. F.; Wotton, Clare J; Wright, F L; Yang, TienYu Owen; Young, Heather

doi:10.1093/ije/dyy065

Cited by 51 publications

(56 citation statements)

References 20 publications

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“…These databases include information on inpatient stays and day‐case admissions (women admitted and discharged on the same day), but not on outpatient visits. Follow‐up is virtually complete for this study population, with loss to follow‐up of only 1% …”

Section: Methodsmentioning

confidence: 96%

“…Full details of the design and study methods have been described elsewhere. (20) The Oxford and Anglia Multi-Centre Research Ethics Committee provided ethics approval for this study.…”

Section: Participants and Datamentioning

confidence: 99%

“…Follow-up is virtually complete for this study population, with loss to follow-up of only 1%. (20) Information on admission and discharge dates, and details of the diagnoses and procedures associated with each hospital admission, were provided, coded to the World Health Organization's International Classification of Diseases, 10th revision (ICD-10). (23) Incident cases were defined as the first hospital record (day-case or overnight admission) of fracture (either primary or secondary diagnosis) of the humerus (S42.2-S42.4), forearm (S52.0-S52.4, S52.7), wrist (S52.5-S52.6, S62.0-S62.1, S62.8), hip (S72.0-S72.1), femur (not neck) (S72.2-S72.4), lower leg (not ankle) (S82.1-S82.2, S82.4), or ankle (S82.3, S82.5-S82.6, S82.8), occurring after analysis baseline.…”

Section: Participants and Datamentioning

confidence: 99%

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The Associations Between Seven Different Types of Physical Activity and the Incidence of Fracture at Seven Sites in Healthy Postmenopausal UK Women

Armstrong

Lacombe

Wotton

et al. 2019

Journal of Bone and Mineral Research

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There is a paucity of information on associations between specific types of physical activity and fracture risk at different sites in otherwise healthy postmenopausal women. Therefore, we examined risk of fracture at seven different sites associated with seven different types of physical activity in the population-based prospective UK Million Women Study. A total of 371,279 postmenopausal women (mean age 59.8 years), rating their health as good or excellent and reporting participation in walking, cycling, gardening, doing housework, yoga, dance, and sports club activities, were followed for site-specific incident fracture through record linkage to national databases on day-case and overnight hospital admissions. Cox regression yielded adjusted relative risks (RRs) and, because of the large number of statistical tests done, 99% confidence intervals (CIs) for fracture at seven different sites in relation to seven different physical activities. During an average follow-up of 12 years, numbers with a first site-specific fracture were as follows: humerus (2341), forearm (1238), wrist (7358), hip (4354), femur (not neck) (617), lower leg (1184), and ankle (3629). For upper limb fractures there was significant heterogeneity across the seven activity types (test for heterogeneity p = 0.004), with gardening more than 1 hour/week associated with a lower risk (RR = 0.91; 99% CI, 0.86 to 0.96; p < 0.0001), whereas cycling more than 1 hour/ week was associated with an increased risk (RR = 1.11; 99% CI, 1.00 to 1.23; p = 0.008). For fractures of the lower limb (including hip) there was no significant heterogeneity by type of activity, with significant approximately 5% to 15% reductions in risk associated with most activities, except cycling. For hip fractures, there was no significant heterogeneity by type of activity, but with significant 15% to 20% reductions in risk associated with walking for 1 hour/day and participating in yoga and sporting activities. Physical activity is a modifiable risk factor for fracture, but the effects differ between different types of activities and different fracture sites.All analyses were conducted using Stata, version 14.1 (StataCorporation, Inc., College Station, TX, USA). (32) We calculated person-years from the date that women completed the baseline questionnaire. Follow-up was censored at whichever came first of: date of any fracture (see above in Participants and data section), date of death, date of emigration, or the end of follow-up, with the last date of follow-up being March 31, 2015. In cases where more than one fracture was recorded during the same Journal of Bone and Mineral Research n 278 ARMSTRONG ET AL. BMI = Body mass index; g = grams; HRT = hormone replacement therapy. Women with missing values were excluded when calculating the means or percentages for that given variable. An average of 12 years follow-up per woman. Restricted to women reporting that they were in good or excellent health.Journal of Bone and Mineral Research n 282 ARMSTRONG ET AL.eMET-hours = excess MET-hour...

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Section: Methodsmentioning

confidence: 96%

“…Full details of the design and study methods have been described elsewhere. (20) The Oxford and Anglia Multi-Centre Research Ethics Committee provided ethics approval for this study.…”

Section: Participants and Datamentioning

confidence: 99%

Section: Participants and Datamentioning

confidence: 99%

See 1 more Smart Citation

The Associations Between Seven Different Types of Physical Activity and the Incidence of Fracture at Seven Sites in Healthy Postmenopausal UK Women

Armstrong

Lacombe

Wotton

et al. 2019

Journal of Bone and Mineral Research

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View full text Add to dashboard Cite

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“…At recruitment, participants provided written informed consent and completed questionnaires regarding their lifestyle and medical history (http://www.millionwomenstudy.org). Detailed information on the study design and methods has been described previously, and information on data access is available through the study website.…”

Section: Participants and Methodsmentioning

confidence: 99%

“…millionwomenstudy.org). Detailed information on the study design and methods has been described previously, 23 and information on data access is available through the study website.…”

Section: Study Populationmentioning

confidence: 99%

Alcohol Intake and Parkinson's Disease Risk in the Million Women Study

et al. 2019

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BACKGROUND Alcohol intake may be associated with a lower risk of Parkinson's disease (PD), but findings from previous studies have been inconclusive. OBJECTIVE To determine the association between alcohol intake and PD risk in the Million Women Study, a large, prospective study of women in the UK. METHODS Between 1996 and 2001, approximately 1.3 million women in the UK, mean age 56 (standard deviation, 5) years, were recruited into the Million Women Study. Information on alcohol intake, lifestyle factors, and medical history was collected at recruitment by questionnaire. Information on incident cases of PD was ascertained by record linkage to national hospital admission records and death registrations. We estimated multivariable‐adjusted relative risks and corresponding 95% confidence intervals using Cox proportional hazards models according to categories of alcohol intake. RESULTS During an average of 17.9 years of follow‐up, 11,009 women had a new record of PD among 1,309,267 women. In drinkers, the multivariable‐adjusted relative risk comparing women who drank more than 14 drinks of alcohol per week with women who drank 1 to 2 drinks of alcohol per week was 0.99 (95% confidence interval: 0.90, 1.10). Results did not materially change after excluding the first 10 years of follow‐up (relative riskadjusted = 1.01; 95% confidence interval: 0.90, 1.13). There were no significant trends in alcohol‐related PD risk among never smokers. Additionally, examining this association by type of alcohol intake also yielded null findings. CONCLUSION These results do not support an association between alcohol intake and PD risk in women. © 2019 The Authors. Movement Disorders published by Wiley Periodicals, Inc. on behalf of International Parkinson and Movement Disorder Society.

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Comparison of the Accuracy and Completeness of Records of Serious Vascular Events in Routinely Collected Data vs Clinical Trial–Adjudicated Direct Follow-up Data in the UK

et al. 2021

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IMPORTANCE Routinely collected data could substantially decrease the cost of conducting trials. OBJECTIVE To assess the accuracy and completeness of UK routine data for ascertaining serious vascular events (SVEs) compared with adjudicated follow-up data. DESIGN, SETTING, AND PARTICIPANTSThis was a secondary analysis of a randomized clinical trial.From June 24, 2005, to July 28, 2011, the ASCEND (A Study of Cardiovascular Events in Diabetes) primary prevention trial used mail-based methods to randomize people with diabetes without evidence of atherosclerotic vascular disease using a 2 × 2 factorial design to aspirin and/or ω-fatty acids vs matching placebo in the UK. Direct participant mail-based follow-up was the main source of outcome data, with more than 90% of the primary outcome events undergoing adjudication.Follow-up was completed on July 31, 2017. In parallel, more than 99% of participants were linked to routinely collected hospital admission and death registry data (ie, routine data), enabling post hoc randomized comparisons of different sources of outcome data (conducted from September 1, 2018, to October 1, 2021).INTERVENTIONS Random allocation to 100 mg of aspirin once daily vs matching placebo and separately to 1 g of ω-3 fatty acids once daily vs placebo. MAIN OUTCOMES AND MEASURESThe primary outcome consisted of SVEs (a composite of nonfatal myocardial infarction, ischemic stroke, transient ischemic attack [TIA], or vascular death, excluding hemorrhagic stroke). RESULTSA total of 15 480 participants were randomized (mean [SD] age, 63 [9] years; 9684 [62.6%] men) and followed up for a mean (SD) of 7.4 (1.8) years. For SVEs, agreement between adjudicated direct follow-up and routine data sources was strong (1401 vs 1127 events; κ = 0.78 [95% CI, 0.76-0.80]; sensitivity, 72.0% [95% CI, 69.7%-74.4%]; specificity, 99.2% [95% CI, 99.0%-99.3%]), and sensitivity improved for SVEs excluding transient ischemic attack (1129 vs 1026 events; sensitivity, 80.6% [95% CI, 78.3%-82.9%]). Rate ratios for the aspirin-randomized comparison for adjudicated direct follow-up vs follow-up solely through routine data alone were 0.88 (95% CI, 0.79-0.97) vs 0.91 (95% CI, 0.81-1.02) for the primary outcome and 0.92 (95% CI, 0.82-1.03) vs 0.91 (95% CI, 0.80-1.02) for SVEs excluding TIA. Results were similar for the ω-3 fatty acid comparison, and adjudication did not seem to markedly change rate ratios. (continued) Key Points Question Are routinely collected data sufficiently accurate and complete to be a trial's sole follow-up method for serious vascular events (SVEs)? Findings In post hoc analyses of ASCEND (A Study of Cardiovascular Events in Diabetes), a trial including 15 480 UK residents with diabetes, routine data showed strong agreement for SVEs compared with adjudicated follow-up. On rerun randomized analyses, follow-up using routine data provided similar estimates of effect sizes on SVEs to adjudicated follow-up for both aspirin vs placebo and ω-3 fatty acids vs placebo comparisons. Meaning These routinely collected UK...

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Cohort Profile: the Million Women Study

Cited by 51 publications

References 20 publications

The Associations Between Seven Different Types of Physical Activity and the Incidence of Fracture at Seven Sites in Healthy Postmenopausal UK Women

The Associations Between Seven Different Types of Physical Activity and the Incidence of Fracture at Seven Sites in Healthy Postmenopausal UK Women

Alcohol Intake and Parkinson's Disease Risk in the Million Women Study

Comparison of the Accuracy and Completeness of Records of Serious Vascular Events in Routinely Collected Data vs Clinical Trial–Adjudicated Direct Follow-up Data in the UK

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