Harmonization of Respiratory Data From 9 US Population-Based Cohorts: The NHLBI Pooled Cohorts Study

Am J Epidemiol. 2018 Nov 1;187(11):2265-2278. doi: 10.1093/aje/kwy139.

Abstract

Chronic lower respiratory diseases (CLRDs) are the fourth leading cause of death in the United States. To support investigations into CLRD risk determinants and new approaches to primary prevention, we aimed to harmonize and pool respiratory data from US general population-based cohorts. Data were obtained from prospective cohorts that performed prebronchodilator spirometry and were harmonized following 2005 ATS/ERS standards. In cohorts conducting follow-up for noncardiovascular events, CLRD events were defined as hospitalizations/deaths adjudicated as CLRD-related or assigned relevant administrative codes. Coding and variable names were applied uniformly. The pooled sample included 65,251 adults in 9 cohorts followed-up for CLRD-related mortality over 653,380 person-years during 1983-2016. Average baseline age was 52 years; 56% were female; 49% were never-smokers; and racial/ethnic composition was 44% white, 22% black, 28% Hispanic/Latino, and 5% American Indian. Over 96% had complete data on smoking, clinical CLRD diagnoses, and dyspnea. After excluding invalid spirometry examinations (13%), there were 105,696 valid examinations (median, 2 per participant). Of 29,351 participants followed for CLRD hospitalizations, median follow-up was 14 years; only 5% were lost to follow-up at 10 years. The NHLBI Pooled Cohorts Study provides a harmonization standard applied to a large, US population-based sample that may be used to advance epidemiologic research on CLRD.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, N.I.H., Intramural

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Body Weights and Measures
  • Bronchiectasis / epidemiology
  • Bronchiectasis / physiopathology
  • Chronic Disease
  • Cohort Studies
  • Continental Population Groups / statistics & numerical data
  • Ethnic Groups / statistics & numerical data
  • European Continental Ancestry Group / statistics & numerical data
  • Female
  • Hispanic Americans / statistics & numerical data
  • Hospitalization / statistics & numerical data
  • Humans
  • Indians, North American / statistics & numerical data
  • Inhalation Exposure / statistics & numerical data
  • Lung Diseases, Obstructive / epidemiology*
  • Lung Diseases, Obstructive / ethnology
  • Lung Diseases, Obstructive / mortality
  • Lung Diseases, Obstructive / physiopathology*
  • Male
  • Middle Aged
  • National Heart, Lung, and Blood Institute (U.S.) / organization & administration*
  • National Heart, Lung, and Blood Institute (U.S.) / standards
  • Phenotype
  • Respiratory Function Tests
  • Risk Factors
  • Smoking / epidemiology
  • Socioeconomic Factors
  • United States / epidemiology
  • Young Adult