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Comparison of risk factor associations in UK Biobank against representative, general population based studies with conventional response rates: prospective cohort study and individual participant meta-analysis

Comparison of risk factor associations in UK Biobank against representative, general population based studies with conventional response rates: prospective cohort study and individual participant meta-analysis
Comparison of risk factor associations in UK Biobank against representative, general population based studies with conventional response rates: prospective cohort study and individual participant meta-analysis

Objective To compare established associations between risk factors and mortality in UK Biobank, a study with an exceptionally low rate of response to its baseline survey, against those from representative studies that have conventional response rates. Design Prospective cohort study alongside individual participant meta-analysis of other cohort studies. Setting United Kingdom. Participants Analytical sample of 499 701 people (response rate 5.5%) in analyses in UK Biobank; pooled data from the Health Surveys for England (HSE) and the Scottish Health Surveys (SHS), including 18 studies and 89 895 people (mean response rate 68%). Both study populations were linked to the same nationwide mortality registries, and the baseline age range was aligned at 40-69 years. Main outcome measure Death from cardiovascular disease, selected malignancies, and suicide. To quantify the difference between hazard ratios in the two studies, a ratio of the hazard ratios was used with HSE-SHS as the referent. Results Risk factor levels and mortality rates were typically more favourable in UK Biobank participants relative to the HSE-SHS consortium. For the associations between risk factors and mortality endpoints, however, close agreement was seen between studies. Based on 14 288 deaths during an average of 7.0 years of follow-up in UK Biobank and 7861 deaths over 10 years of mortality surveillance in HSE-SHS, for cardiovascular disease mortality, for instance, the age and sex adjusted hazard ratio for ever having smoked cigarettes (versus never) was 2.04 (95% confidence interval 1.87 to 2.24) in UK Biobank and 1.99 (1.78 to 2.23) in HSE-SHS, yielding a ratio of hazard ratios close to unity (1.02, 0.88 to 1.19). The overall pattern of agreement between studies was essentially unchanged when results were compared separately by sex and when baseline years and censoring dates were aligned. Conclusion Despite a very low response rate, risk factor associations in the UK Biobank seem to be generalisable.

0959-8138
m131
Batty, G. David
894f5dad-375f-40b6-8936-d9143b49f169
Gale, Catharine R.
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Kivimäki, Mika
a5788d83-a59c-477e-9ae9-8b7896ed098a
Deary, Ian J.
027158ae-fbfb-40ea-98b1-32d2690499ac
Bell, Steven
b3c6d282-d989-4455-8983-61cb506e073e
Batty, G. David
894f5dad-375f-40b6-8936-d9143b49f169
Gale, Catharine R.
5bb2abb3-7b53-42d6-8aa7-817e193140c8
Kivimäki, Mika
a5788d83-a59c-477e-9ae9-8b7896ed098a
Deary, Ian J.
027158ae-fbfb-40ea-98b1-32d2690499ac
Bell, Steven
b3c6d282-d989-4455-8983-61cb506e073e

Batty, G. David, Gale, Catharine R., Kivimäki, Mika, Deary, Ian J. and Bell, Steven (2020) Comparison of risk factor associations in UK Biobank against representative, general population based studies with conventional response rates: prospective cohort study and individual participant meta-analysis. BMJ, 368, m131, [m131]. (doi:10.1136/bmj.m131).

Record type: Article

Abstract

Objective To compare established associations between risk factors and mortality in UK Biobank, a study with an exceptionally low rate of response to its baseline survey, against those from representative studies that have conventional response rates. Design Prospective cohort study alongside individual participant meta-analysis of other cohort studies. Setting United Kingdom. Participants Analytical sample of 499 701 people (response rate 5.5%) in analyses in UK Biobank; pooled data from the Health Surveys for England (HSE) and the Scottish Health Surveys (SHS), including 18 studies and 89 895 people (mean response rate 68%). Both study populations were linked to the same nationwide mortality registries, and the baseline age range was aligned at 40-69 years. Main outcome measure Death from cardiovascular disease, selected malignancies, and suicide. To quantify the difference between hazard ratios in the two studies, a ratio of the hazard ratios was used with HSE-SHS as the referent. Results Risk factor levels and mortality rates were typically more favourable in UK Biobank participants relative to the HSE-SHS consortium. For the associations between risk factors and mortality endpoints, however, close agreement was seen between studies. Based on 14 288 deaths during an average of 7.0 years of follow-up in UK Biobank and 7861 deaths over 10 years of mortality surveillance in HSE-SHS, for cardiovascular disease mortality, for instance, the age and sex adjusted hazard ratio for ever having smoked cigarettes (versus never) was 2.04 (95% confidence interval 1.87 to 2.24) in UK Biobank and 1.99 (1.78 to 2.23) in HSE-SHS, yielding a ratio of hazard ratios close to unity (1.02, 0.88 to 1.19). The overall pattern of agreement between studies was essentially unchanged when results were compared separately by sex and when baseline years and censoring dates were aligned. Conclusion Despite a very low response rate, risk factor associations in the UK Biobank seem to be generalisable.

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Accepted/In Press date: 16 December 2019
e-pub ahead of print date: 12 February 2020
Published date: 12 February 2020
Additional Information: Funding Information: GDB is supported by the UK Medical Research Council (MR/P023444/1) and the US National Institute on Aging (1R56AG052519-01; 1R01AG052519-01A1). MK is supported by the UK Medical Research Council (MR/R024227), the US National Institute on Aging (NIH) (R01AG056477), NordForsk, and the Academy of Finland (311492). CRG is supported by the UK Medical Research Council (MRC-MC-UU-12011/2 and MRC-MC-UP- A620-1015). SB is supported by the NIHR Blood and Transplant Research Unit in Donor Health and Genomics (NIHR BTRU-2014- 10024), UK Medical Research Council (MR/L003120/1), British Heart Foundation (RG/13/13/30194), and NIHR Cambridge Biomedical Research Centre at the Cambridge University Hospitals NHS Foundation Trust. There was no direct financial or material support for the work reported in the manuscript. The funders of the studies had no role in study design, data collection, data analysis, data interpretation, or report preparation. Publisher Copyright: © Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to.

Identifiers

Local EPrints ID: 438167
URI: http://eprints.soton.ac.uk/id/eprint/438167
ISSN: 0959-8138
PURE UUID: d1b19b47-1125-4190-bc32-1646c18eabd0
ORCID for Catharine R. Gale: ORCID iD orcid.org/0000-0002-3361-8638

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Date deposited: 03 Mar 2020 17:45
Last modified: 17 Sep 2022 01:35

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Contributors

Author: G. David Batty
Author: Mika Kivimäki
Author: Ian J. Deary
Author: Steven Bell

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