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February 8, 2018

Improving health globally by studying health locally

By Elizabeth Zimmermann

Mayo Clinic has been partnering with Olmsted Medical Center and several other regional health care providers for more than 50 years in an initiative called the Rochester Epidemiology Project. This collaboration stretches across 27 counties in Minnesota and Wisconsin, allowing researchers to study health and illnesses in the people living in the region or in specific counties. Most recent additions to the collaboration include Olmsted County Health Services, Zumbro Valley Health Center and several dental practices.

This collaboration and sharing of medical information makes the area of Minnesota and Wisconsin one of the few places in the United States where “population-based” research can be accomplished. The results inform both our understanding of diseases as well as how we prevent and treat them.

Researchers from around the world have used the Rochester Epidemiology Project (affectionately known as the “REP”) to investigate questions across the spectrum of health and health care delivery. In this post, you’ll get just a glimpse of some of the topics for which they’ve sought clarity. Read on:

  • How common is my child’s eye problem?

Ophthalmology researchers used the REP to identify the incidence (how likely is my child to have this condition?), subtypes, and clinical characteristics of pediatric nystagmus – an eye condition that results in involuntary, repetitive eye movements and causes vision problems.

They chose to study this because although there are reasonably good statistics available showing how many people in the world have some form of nystagmus (the prevalence of the condition), there is not much information about the likelihood of a baby being born with this relatively rare disease.

After examining 30 years of records, they found that most diagnoses occurred by 6 months of age, and about one in every 821 babies is likely to be born with nystagmus.

They determined that the majority of cases were the result of non-malignant conditions, with only two of 71 patients’ condition associated with a malignancy of the central nervous system (brain or spinal cord tumor). For more information, you can access the study on PubMed.

Barrett’s esophagus is a condition that can lead to esophageal cancer. A known effective treatment to lessen the likelihood of progression to cancer is the use of proton pump inhibitors (medications that prevent acid reflux).

However, there is some evidence that these medications are linked to osteoporosis, which causes bones to become brittle and break easily. In this recent study, Mayo Clinic investigators examined the records of all patients in the Rochester Epidemiology Project database diagnosed with Barrett’s esophagus between 1989 and 2013. They compared the patients who were diagnosed with osteoporosis with those who did not have that second condition.

The researchers concluded that use of proton pump inhibitors by patients with Barrett’s esophagus did not increase their risk of developing osteoporosis-related fractures. They attribute the osteoporotic fractures instead to other “well-known risk factors such as older age, female gender and a higher co-morbidity score, which may reflect a more fragile medical state.”

  • Are blood clots caused by infections?

Most people know that blood clots in veins – categorized as venous thromboembolism – can cause a stroke or other life-threatening health concerns. However, you may not realize that a simple infection could lead to one of these dangerous clots.

Researchers at Mayo Clinic thought that perhaps infection might lead to venous thromboembolism in some patients. They used linked medical records from the Rochester Epidemiology Project to investigate the question, and found that indeed, "infection as a whole, as well as specific infection sites in particular are independent risk factors for venous thromboembolism."

Specifically they found pneumonia and urinary tract infections; as well as oral, intra-abdominal and bloodstream infections were associated with significantly increased odds of venous thromboembolism. You can access the full publication via PubMed to learn more, and if you or someone you care for has other risk factors for blood clots, you may want to talk to your doctor about preventive measures.

This is just a sampling of the research that comes out of the Rochester Epidemiology Project. If you have time, you can read about the REP’s beginnings and some other highlights in the interactive timeline. And if you’re curious about how prevalent a particular condition in the community, you might want to check out the data exploration portal.

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Tags: About, Barrett's esophagus, blood clot, Findings, Mayo Clinic Kern Center for the Science of Health Care Delivery, nystagmus, ophthalmology, osteoporosis, population health, proton pump inhibitors, REP, Rochester Epidemiology Project, venous thromboembolism

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