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Meta-analysis to establish the age and sex specific relationships of risk factors with common causes of death

Objectif

Objectives:
To conduct a meta-analysis of data obtained from prospective observational studies in which blood pressure and blood cholesterol were both recorded at baseline:
- to assess the age- and sex-specific relevance of cholesterol and of blood pressure to cause-specific vascular and non-vascular mortality.
- to help collaborators to investigate the effects of, and correction for, the under-estimation of risk associations due to the regression dilution bias, and to investigate the different degrees of under-estimation in different populations. (An advance over previous analyses in which adjustments for regression dilution have been made will be to correct in an appropriately time-dependent way and to consider the impact of error in confounders.)

The principal aim of this Concerted Action proposal is to conduct a collaborative meta-analysis of individual-person data obtained from prospective observational studies in which blood cholesterol and blood pressure were recorded at baseline, and in particular:
1. To assess the age-specific relationships of cholesterol (and where available, its fractions) and blood pressure with cause-specific mortality and with all-cause mortality, after adjusting for obesity, alcohol and smoking;
2. To assess the age-specific relevance of obesity, alcohol and smoking with cause-specific mortality and with all-cause mortality;
3. To assess the role of these variables in the presence and absence of other confounders and effect modifiers, namely, ethnicity and history of coronary heart disease, stroke and diabetes;
4. To investigate and adjust for the under-estimation of associations with risk obtained when no adjustment for "regression dilution bias" has been made, and to investigate the different degrees of under-estimation in different populations, e.g. different age, sex and ethnic groups.

This unique world wide collaboration will allow the characterisation, much more precisely than has previously been possible, of the age-specific relevance of these variables to common important causes of death. Data from Europe and from around the world will enable us to study a wider range of values of many of the risk factors. For rarer causes of death, individual studies do not have sufficient events to characterise relationships with potential risk factors but by obtaining data from the major prospective observational studies we will also be able to investigate these relationships in detail. This project will, therefore, aid the development of clinical guidelines and public health measures for the control of many diseases. The project will help to achieve harmonisation of public health policy across Europe, leading to the wider use of common clinical guidelines and public health measures for the control of these diseases. It will also transfer technology and expertise, partly through collaboration with workers in Europe on the large database and through help in improving the design of prospective observational studies by providing the means to adjust for the regression dilution bias in the individual studies in Europe as well as for the collaboration.

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THE CHANCELLOR, MASTERS AND SCHOLARS OF THE UNIVERSITY OF OXFORD
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Adresse
Radcliffe Infirmary
OX2 6HE OXFORD
Royaume-Uni

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