Research activity in the Epidemiology and Prevention Research Unit
At the Institute for Social Medicine, Epidemiology and Health Economics at the Charité - Universitätsmedizin Berlin the study center Berlin Mitte of the nationwide German National Cohort is located.
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German National Cohort
The German National Cohort is the largest study on the history of common chronic diseases that has ever occurred in Germany. A total of 200,000 subjects have been examined since 2014 using the latest medical procedures. The approximately 30 survey and examination modules will be repeated every five years for the next two or three decades. This creates a huge amount of data on the origins, influencing factors, course and prevention options of common diseases.
The researchers are hoping for results on cancer, cardiovascular diseases, diabetes, dementia and many other diseases. Model is the US-American Framingham study, which exists since 1948 and is meanwhile in it´s third continual generation. More than 1,000 scientific publications were produced from this study, which provided, among other things, clear evidence of the negative effects of smoking, hypertension, obesity and diabetes.
The main phase of the German National Cohort at the Berlin-Mitte study center is currently the focus of the work in the epidemiology and prevention research unit.
Visit the website of the Studienzentrum Berlin-Mitte and read more about the course of the investigations.
Respiratory Illnesses and Allergies
Allergies like asthma, hay fever and eczema have increased markedly in recent decades, especially in industrial countries and particularly in children. In long-term studies and in close cooperation with pediatricians and dermatologists from the Charité (Prof. Wahn, Prof. Lau, Prof. Beyer, Prof. Zuberbier) and other European universities we are investigating the course of these illnesses from birth onwards as well as the genetic, environmental and lifestyle induced risk factors. The participants in the Multicenter Allergy Study (MAS) were interviewed and examined recently at the age of 20. For the first time this will allow us to evaluate prospectively gathered data from birth through to adulthood regarding asthma and allergies in Germany.
After MAS, further large birth cohort studies on allergies and asthma were started in Europe. Within the scope of the European Network of Excellence GA²LEN (Global Allergy and Asthma European Network; www.ga2len.net) we have begun gathering data from these birth cohorts in order to carry out combined statistical analyses. With these meta-analyses, insights into risk- and protective factors (pets?) can be obtained with greater statistical certainty as compared to single studies and regional and cultural differences can also be evaluated. In addition to this we have acquired data which is representative of the population in the state of Brandenburg regarding allergies, respiratory illnesses and skin disorders in adults up to the age of 70 with the BASAL-Study within the scope of the GA²LEN-Initiative.
For the purpose of the EU-project EuroPrevall we have been coordinating a birth cohort study since 2005 on the subject of food allergies in children in their first years of life. In the project ENRIECO, which was sponsored by the European Commission, the methods of all European birth- and pregnancy cohort studies regarding environmentally determined health risks for disorders in the context of pregnancy and childhood are being compiled (www.enrieco.org).
Complaints regarding the gastro-intestinal system are common and represent not only a considerable individual but also a social burden. In the scope of a prospective, multicenter, open cohort study (ProGERD), which was carried out in Germany, Austria and Switzerland, we examined the course of reflux disease (an infection of the esophagus caused by increased regurgitation of gastric acid, often leads to chronic heartburn) under the conditions of routine care. Our study showed that the patients' quality of life was considerably reduced, similar to that of patients with cardiovascular disease. Treatment with Esomeprazol led to a considerable alleviation of symptoms after a short time in 92% of patients or totally freed them of symptoms and therefore increased their quality of life.
With the associated medical, psychological, social and economic complications obesity is also a chronic disease of importance from a Public Health point of view. Concerning this issue, a Health-Technology-Assessment (HTA) report was carried out with the goal of evaluating surgery on the obese, both medically and economically, in comparison to other treatment methods. Bariatric measures can lead to a short- and middle-term loss of weight, accompanied by a regression of accompanying illnesses, especially Diabetes mellitus, and a reduced mortality rate. On the completion of this report it was however not possible to give preference to individual bariatric surgical procedures or to recommend certain procedures to specific patient groups.
For the diagnosis of complaints regarding the gastro-intestinal system we also created an informative HTA report, for example about the significance of the various testing procedures for the primary diagnosis of infection with Helicobacter pylori. This bacterium, which can be found in the human stomach, is the second most common infection in humans and is held responsible for a number of intestinal diseases. The aim of a further HTA report was to evaluate the diagnosis of acute abdominal pain with ultrasound in children and adults from a medical and economic perspective.
Psychiatry and Addiction
A further emphasis of this project division is research on psychiatric care, which has been coordinated by Anne Berghöfer since 2001. Aspects relating to optimizing psychiatric therapy for chronically, psychologically ill patients in both the out- and inpatient setting are treated in the same way as health economic aspects.
Working for many years at the Institute, Dr. Erika Sieber was delegated Representative for Addictions for the Medical Council of Berlin until retiring and established the core theme with a focus on addictive disorders.
Since 2001 the study projects are concerned with the long-term treatment of bipolar and unipolar affective disorders with Lithium and other long-term medication in special outpatient clinics, with the recognition and early treatment of depressive disorders in primary care and with the care of chronic pain patients. The research department was involved in the development and evaluation of a model for integrated care of chronically ill psychiatric patients in numerous states and with the participation of several health insurance companies.
One research project evaluated the effects of a special reimbursement structure, the Regional Psychiatry Budget, now the model project §64b SGB V, in the inpatient care sector on the quality of care of patients with mental disorders in a certain region. In addition, psychosocial care structures that are working across Social Code Books were examined that offer joint and cross-sectoral medical and social care for psychosocial problems.
Medicine for musicians
In Berlin there are a large number of professional musicians (orchestra musicians and self-employed) as well as musical laymen. A large number of studies indicate that up to 80% of musicians suffer from health problems. In particular, there are musculoskeletal pain and mental impairment, and there are a variety of specific disorders that are associated with the particular burden of performing music. Therefore, the Institute for Social Medicine, Epidemiology and Health Economics with its project area Epidemiology and Prevention is involved in the Berlin Center for Musician Medicine.
In the field of music medicine, various research projects are being initiated on music medicine and musician health.