The LCE research program seeks to promote Life Course Epidemiology research at the UMCG through the development, improvement and dissemination of relevant advanced methodologies, as well as their applications to the available cohorts at the UMCG. With this focus, the LCE activities are attributable to “prevention” research, which is next to “mechanisms of diseases” and “innovative treatments” one of the research pillars of the overarching UMCG theme “Healthy Aging”.
We define Life Course Epidemiology as human health research using longitudinal studies with the aim to causally link exposures to long-term outcomes. Social and medical context (e.g. comorbidities) are taken into account. This definition connects also to definitions coined by Ben-Shlomo (2002) and George Davey Smith (2005).
Whereas prevention is the cornerstone of LCE, the program extended its original theme of the investigation of dynamic risk factors and exposures associated with disease occurrence (etiology) with the study of issues that are relevant to patient care, i.e. applied clinical research. Thereby it encompasses studies based on the disciplines of both public health epidemiology and clinical epidemiology. Whereas in public health epidemiology the ultimate aim is to unravel the complex origins of disease with a clear view to primary prevention, the aim in clinical epidemiology is to enhance the quality of care for patients through investigating mechanisms in the course of the disease, thus contributing to secondary and tertiary prevention.
LCE research is concerned with some specific methodological challenges, which require special attention when it comes to the statistical analysis. Examples are
- the cluster structure of the data through repeated measurements,
- prognostic tools considering the variability of predictors over time,
- evaluating (preventive) interventions/ exposures with lacking randomization, requiring specific methods for causal inference,
- computational problems due to missing data,
- high dimensionality of problems, occurring from the improvement of data collection opportunities in recent years (big data),
- analyses of ecological momentary assessments,
To achieve the aim of our program we strive for methodological improvement with respect to those challenges, through gathering methodological experts from various disciplines, sharing knowledge, experiences and project ideas. The development, improvement and dissemination of advanced methodology is the aim of this program. Consequently, a further goal is to apply these methods in future research projects to data from our large (population based) cohorts. Examples include LifeLines, Vlaardingen – Vlagtwedde, PREVEND, Pregnancy Anxiety and Depression study, TRAILS, GECKO.
Our ambition herein is to become a center of excellence for Life Course Epidemiology methods, applications and research findings.
Christine zu Eulenburg & Huibert Burger