Abstract
BackgroundHealth problems, health behavior, and the consequences of bad health are often intertwined. There is a growing need among physicians, researchers and policy makers to obtain a comprehensive insight into the mutual influences of different health related, institutional and environmental concepts and their collective developmental processes over time.Methods/DesignSMILE is a large prospective cohort study, focusing on a broad range of aspects of disease, health and lifestyles of people living in Eindhoven, the Netherlands. This study is unique in its kind, because two data collection strategies are combined: first data on morbidity, mortality, medication prescriptions, and use of care facilities are continuously registered using electronic medical records in nine primary health care centers. Data are extracted regularly on an anonymous basis. Secondly, information about lifestyles and the determinants of (ill) health, sociodemographic, psychological and sociological characteristics and consequences of chronic disease are gathered on a regular basis by means of extensive patient questionnaires. The target population consisted of over 30,000 patients aged 12 years and older enrolled in the participating primary health care centers.DiscussionDespite our relatively low response rates, we trust that, because of the longitudinal character of the study and the high absolute number of participants, our database contains a valuable set of information.SMILE is a longitudinal cohort with a long follow-up period (15 years). The long follow-up and the unique combination of the two data collection strategies will enable us to disentangle causal relationships. Furthermore, patient-reported characteristics can be related to self-reported health, as well as to more validated physician registered morbidity. Finally, this population can be used as a sampling frame for intervention studies. Sampling can either be based on the presence of certain diseases, or on specific lifestyles or other patient characteristics.
Highlights
Health problems, health behavior, and the consequences of bad health are often intertwined
SMILE is a longitudinal cohort with a long follow-up period (15 years)
Patient-reported characteristics can be related to self-reported health, as well as to more validated physician registered morbidity
Summary
This manuscript describes a new scientific initiative, the SMILE study: a longitudinal dynamic cohort using both routinely collected medical information from the EMRs in general practice and periodically collected patient information using questionnaires. We believe our approach to be more effective, because of the many analytic opportunities that are created with relatively small additional efforts Possible disadvantage of this approach are: difficulties in deciding which (limited set of) concepts to measure. More extensive use of the data will be stimulated by continuous efforts to maintain and to further improve data quality In this regards continuous participation of both GPs and patients is of the utmost importance in a longitudinal study. For this type of research the setting of general practice linked to academic departments is especially suitable, covering both an unselected patient population and a broad scope of morbidity.
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