National Survey of Morbidity and Risk Factors (EMENO): Protocol for a Health Examination Survey Representative of the Adult Greek Population

Giota Touloumi; Anna Karakatsani; Argiro Karakosta; Eleni Sofianopoulou; Panagiotis Koustenis; Magda Gavana; Yannis Alamanos; Maria Kantzanou; George Konstantakopoulos; Xenia Chryssochoou; Alexis Benos; Apostolos Vantarakis; Christos Hadjichristodoulou; Gregory Chlouverakis; Gregory Trypsianis; Paraskevi V Voulgari; Konstantinos Makrilakis; Stavros Liatis; George Stergiou; EMENO Study Group

doi:10.2196/10997

National Survey of Morbidity and Risk Factors (EMENO): Protocol for a Health Examination Survey Representative of the Adult Greek Population

JMIR Res Protoc. 2019 Feb 4;8(2):e10997. doi: 10.2196/10997.

Authors

Giota Touloumi¹, Anna Karakatsani², Argiro Karakosta¹, Eleni Sofianopoulou^{1

3}, Panagiotis Koustenis⁴, Magda Gavana⁵, Yannis Alamanos⁶, Maria Kantzanou¹, George Konstantakopoulos⁷, Xenia Chryssochoou⁸, Alexis Benos⁵, Apostolos Vantarakis⁹, Christos Hadjichristodoulou¹⁰, Gregory Chlouverakis¹¹, Gregory Trypsianis¹², Paraskevi V Voulgari¹³, Konstantinos Makrilakis^{14

15}, Stavros Liatis^{14

15}, George Stergiou¹⁶; EMENO Study Group¹

Affiliations

¹ Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
² Second Pulmonary Department, "Attikon" University Hospital, Medical School, University of Athens, Athens, Greece.
³ Department of Public Health and Primary Care, School of Clinical Medicine, University of Cambridge, Cambridge, United Kingdom.
⁴ Department of Political Science and History, School of Political Science, Panteion University of Social and Political Science, Athens, Greece.
⁵ Department of Primary Health Care, General Practice and Health Services Research, Medical School, Aristotle University, Thessaloniki, Greece.
⁶ Institute of Epidemiology, Preventive Medicine and Public Health, Corfu, Greece.
⁷ First Department of Psychiatry, Eginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
⁸ Department of Psychology, Panteion University of Political and Social Sciences, Athens, Greece.
⁹ Environmental Microbiology Unit, Department of Public Health, Medical School, University of Patras, Patra, Greece.
¹⁰ Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Larisa, Greece.
¹¹ Laboratory of Biostatistics, School of Medicine, University of Crete, Crete, Greece.
¹² Laboratory of Medical Statistics, Medical School, Democritus University of Thrace, Thrace, Greece.
¹³ Rheumatology Clinic, Department of Internal Medicine, Medical School, University of Ioannina, Ioannina, Greece.
¹⁴ Hellenic Diabetes Association, Athens, Greece.
¹⁵ First Department of Propaedeutic Internal Medicine, Medical School, National and Kapodistrian University of Athens, Athens, Greece.
¹⁶ Hypertension Center STRIDE-7, Third Department of Medicine, Sotiria Hospital, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.

PMID: 30714576
PMCID: PMC6378546
DOI: 10.2196/10997

Abstract

Background: Main causes of death in Greece are cardiovascular diseases (CVDs), malignant neoplasms, respiratory diseases, and road traffic crashes. To assess the population health status, monitor health systems, and adjust policies, national population-based health surveys are recommended. The previous health surveys that were conducted in Greece were restricted to specific regions or high-risk groups.

Objective: This paper presents the design and methods of the Greek Health Examination Survey EMENO (National Survey of Morbidity and Risk Factors). The primary objectives are to describe morbidity (focusing on CVD, respiratory diseases, and diabetes), related risk factors, as well as health care and preventive measures utility patterns in a random sample of adults living in Greece.

Methods: The sample was selected by applying multistage stratified random sampling on 2011 Census. Trained interviewers and physicians made home visits. Standardized questionnaires were administered; physical examination, anthropometric and blood pressure measurements, and spirometry were performed. Blood samples were collected for lipid profile, glucose, glycated hemoglobin, and transaminases measurements. The survey was conducted from May 2013 until June 2016.

Results: In total, 6006 individuals were recruited (response rate 72%). Of these, 4827 participated in at least one physical examination, 4446 had blood tests, and 3622 spirometry, whereas 3580 provided consent for using stored samples for future research (3528 including DNA studies). Statistical analysis has started, and first results are expected to be submitted for publication by the end of 2018.

Conclusions: EMENO comprises a unique health data resource and a bio-resource in a Mediterranean population. Its results will provide valid estimates of morbidity and risk factors' prevalence (overall and in specific subdomains) and health care and preventive measures usage in Greece, necessary for an evidence-based strategy planning of health policies and preventive activities.

International registered report identifier (irrid): DERR1-10.2196/10997.

Keywords: Greece; cardiovascular diseases; chronic diseases; epidemiology; health survey; respiratory; risk factors.

©Giota Touloumi, Anna Karakatsani, Argiro Karakosta, Eleni Sofianopoulou, Panagiotis Koustenis, Magda Gavana, Yannis Alamanos, Maria Kantzanou, George Konstantakopoulos, Xenia Chryssochoou, Alexis Benos, Apostolos Vantarakis, Christos Hadjichristodoulou, Gregory Chlouverakis, Gregory Trypsianis, Paraskevi V Voulgari, Konstantinos Makrilakis, Stavros Liatis, George Stergiou, EMENO Study Group. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 04.02.2019.