The CONSTANCES cohort: an open epidemiological laboratory

Abstract

BackgroundProspective cohorts represent an essential design for epidemiological studies and allow for the study of the combined effects of lifestyle, environment, genetic predisposition, and other risk factors on a large variety of disease endpoints. The CONSTANCES cohort is intended to provide public health information and to serve as an "open epidemiologic laboratory" accessible to the epidemiologic research community. Although designed as a "general-purpose" cohort with very broad coverage, it will particularly focus on occupational and social determinants of health, and on aging.Methods/DesignThe CONSTANCES cohort is designed as a randomly selected representative sample of French adults aged 18-69 years at inception; 200,000 subjects will be included over a five-year period. At inclusion, the selected subjects will be invited to fill a questionnaire and to attend a Health Screening Center (HSC) for a comprehensive health examination: weight, height, blood pressure, electrocardiogram, vision, auditory, spirometry, and biological parameters; for those aged 45 years and older, a specific work-up of functional, physical, and cognitive capacities will be performed. A biobank will be set up. The follow-up includes a yearly self-administered questionnaire, and a periodic visit to an HSC. Social and work-related events and health data will be collected from the French national retirement, health and death databases. The data that will be collected include social and demographic characteristics, socioeconomic status, life events, behaviors, and occupational factors. The health data will cover a wide spectrum: self-reported health scales, reported prevalent and incident diseases, long-term chronic diseases and hospitalizations, sick-leaves, handicaps, limitations, disabilities and injuries, healthcare utilization and services provided, and causes of death.To take into account non-participation at inclusion and attrition throughout the longitudinal follow-up, a cohort of non-participants will be set up and followed through the same national databases as participants.A field-pilot was performed in 2010 in seven HSCs, which included about 3,500 subjects; it showed a satisfactory structure of the sample and a good validity of the collected data.DiscussionThe constitution of the full eligible sample is planned during the last trimester of 2010, and the cohort will be launched at the beginning of 2011.

What can the life course approach contribute to an understanding of longevity risk?

“…Most research has concentrated on specific measures such as coronary heart disease risk, although measures of positive health more generally have been proposed, such as the concept of allostatic load (McEwen & Seeman, 1999) and its current development (Kelly--Irving et al, 2014). New initiatives in the area of positive health would be timely because of the wealth of biomedical data becoming available in large, representative social surveys, such as the Constances cohort (Zins et al, 2010) and the UK Household Longitudinal Study (Benzeval, Devillas, Kumari & Lynn, 2014).…”

Concerted Uranium Research in Europe (CURE): toward a collaborative project integrating dosimetry, epidemiology and radiobiology to study the effects of occupational uranium exposure

“…Modern biobanking methods allow for the long term conservation of biological material in suitable conditions for later analyses, years to decades after biospecimen collection (Palmer 2007, Zins et al 2010. The SOPs produced will ensure that the quality of the collected and stored material will facilitate future research, including analyses of potential new biomarkers as they are identified through experimental and molecular epidemiological research.…”

“…Regular medical check-ups conducted routinely as part of occupational medical surveillance over the workers' careers constitute an unique potential framework for the prospective and repeated collection of biological samples (Laurier et al 2012). A state-of-the-art-biobank centralizing such samples from a fixed cohort of individuals over many years would be a valuable resource for a detailed assessment of the long-term effects of protracted exposure to uranium, as is the case for other types of occupational or environmental exposures (Palmer 2007, Zins et al 2010.…”

“…One way to do this would be to conduct molecular epidemiological studies, by integrating the use of biomarkers in epidemiological studies (Palmer 2007, Zins et al 2010, Kreuzer et al 2015a. Various types of biomarkers could be used in epidemiological studies as a means to improve the risk assessment process, as discussed in (Pernot et al 2012).…”

Discovering predictors of mental health service utilization with k-support regularized logistic regression

“…Modern epidemiological research is often based on a large data sets such as the National Epidemiologic Survey for Alcohol and Related Conditions (NESARC) [9,10,11], the National Health and Nutritional Examination Survey (NHANES) [12]; the CONSTANCES cohort [13], and the Whitehall cohort study [14,15], etc. Problems that scientists face when dealing with such data sets include: multicolinearity (when variables are correlated to each other), confounding factors (when a risk factor is correlated with both exposure and outcome variable), interactions (when the direction or magnitude of an association between two variables differs due to the effect of a third variable), the sample size (the study can be too large with meaningful associations being declared or too small to detect important associations), and the number of factors being studied (the higher the number of factors the higher is the probability to find interactions due to chance alone) [16].…”