Abstract
BackgroundLifeLines is a large prospective population-based three generation cohort study in the north of the Netherlands. Different recruitment strategies were adopted: recruitment of an index population via general practitioners, subsequent inclusion of their family members, and online self-registration. Our aim was to investigate the representativeness of the adult study population at baseline and to evaluate differences in the study population according to recruitment strategy.MethodsDemographic characteristics of the LifeLines study population, recruited between 2006–2013, were compared with the total adult population in the north of the Netherlands as registered in the Dutch population register. Socioeconomic characteristics, lifestyle, chronic diseases, and general health were further compared with participants of the Permanent Survey of Living Conditions within the region (2005–2011, N = 6,093). Differences according to recruitment strategy were assessed.ResultsCompared with the population of the north of the Netherlands, LifeLines participants were more often female, middle aged, married, living in a semi-urban place and Dutch native. Adjusted for differences in demographic composition, in LifeLines a smaller proportion had a low educational attainment (5% versus 14%) or had ever smoked (54% versus 66%). Differences in the prevalence of various chronic diseases and low general health scores were mostly smaller than 3%. The age profiles of the three recruitment groups differed due to age related inclusion criteria of the recruitment groups. Other differences according to recruitment strategy were small.ConclusionsOur results suggest that, adjusted for differences in demographic composition, the LifeLines adult study population is broadly representative for the adult population of the north of the Netherlands. The recruitment strategy had a minor effect on the level of representativeness. These findings indicate that the risk of selection bias is low and that risk estimates in LifeLines can be generalized to the general population.
Highlights
LifeLines is an observational cohort study aiming to unravel the interaction between genetic and environmental factors in the development of multifactorial diseases [1]
Our results suggest that, adjusted for differences in demographic composition, the LifeLines adult study population is broadly representative for the adult population of the north of the PLOS ONE | DOI:10.1371/journal.pone
Members were invited by LifeLines; those who gave their informed consent were included in the study as “family member”
Summary
LifeLines is an observational cohort study aiming to unravel the interaction between genetic and environmental factors in the development of multifactorial diseases [1]. The recruitment of more than 165 000 persons from the three northern provinces of the Netherlands, which is 10% of the population, was performed between 2006 and 2013 [2]. During this period, participants completed a number of questionnaires, underwent a physical examination, and biological samples including DNA were collected [1,2]. The three generation design has several advantages [1] Among others, it allows separating between genetic and non-genetic factors in familial transmission of diseases and it provides opportunities to study health effects of family factors and socio-economic mobility [1]. We expect that family ties within the cohort will help to limit non-response and attrition [1]
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