German health interview and examination survey for adults (DEGS) - design, objectives and implementation of the first data collection wave

BMC Public Health

Bärbel-Maria Kurth¹  Michael Thamm¹  Heribert Stolzenberg¹  Angelika Schaffrath Rosario¹  Anke-Christine Sass¹  Almut Richter¹  Hannelore Neuhauser¹  Gert BM Mensink¹  Detlef Laussmann¹  Hildtraud Knopf¹  Christin Heidemann¹  Ulfert Hapke¹  Judith Fuchs¹  Ute Ellert¹  Rüdiger Dölle¹  Stefan Dahm¹  Markus A Busch¹  Michael Lange¹  Heike Hölling¹  Antje Gößwald¹  Panagiotis Kamtsiuris¹  Christa Scheidt-Nave¹ 

[1] Department of Epidemiology and Health Monitoring, Robert Koch Institute, General-Pape-Strasse 62-66, 12101 Berlin, Germany

关键词: Follow-up;    Trends;    Population;    Germany;    Adults;    Examination;    Survey;    Indicators;    Health;   

Others  :  1163161
DOI  :  10.1186/1471-2458-12-730

 received in 2012-08-24, accepted in 2012-08-28,  发布年份 2012

【 摘 要 】

Background

The German Health Interview and Examination Survey for Adults (DEGS) is part of the recently established national health monitoring conducted by the Robert Koch Institute. DEGS combines a nationally representative periodic health survey and a longitudinal study based on follow-up of survey participants. Funding is provided by the German Ministry of Health and supplemented for specific research topics from other sources.

Methods/design

The first DEGS wave of data collection (DEGS1) extended from November 2008 to December 2011. Overall, 8152 men and women participated. Of these, 3959 persons already participated in the German National Health Interview and Examination Survey 1998 (GNHIES98) at which time they were 18–79 years of age. Another 4193 persons 18–79 years of age were recruited for DEGS1 in 2008–2011 based on two-stage stratified random sampling from local population registries. Health data and context variables were collected using standardized computer assisted personal interviews, self-administered questionnaires, and standardized measurements and tests. In order to keep survey results representative for the population aged 18–79 years, results will be weighted by survey-specific weighting factors considering sampling and drop-out probabilities as well as deviations between the design-weighted net sample and German population statistics 2010.

Discussion

DEGS aims to establish a nationally representative data base on health of adults in Germany. This health data platform will be used for continuous health reporting and health care research. The results will help to support health policy planning and evaluation. Repeated cross-sectional surveys will permit analyses of time trends in morbidity, functional capacity levels, disability, and health risks and resources. Follow-up of study participants will provide the opportunity to study trajectories of health and disability. A special focus lies on chronic diseases including asthma, allergies, cardiovascular conditions, diabetes mellitus, and musculoskeletal diseases. Other core topics include vaccine-preventable diseases and immunization status, nutritional deficiencies, health in older age, and the association between health-related behavior and mental health.

【 授权许可】

   
2012 Scheidt-Nave et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Hoffmeister H, Mensink GB, Stolzenberg H: National trends in risk factors for cardiovascular disease in Germany. Prev Med 1994, 23:197-205.
• [2]Bellach BM, Knopf H, Thefeld W: The German Health Survey 1997/98 (article in German). Gesundheitswesen 1998, 60(Suppl 2):59-68.
• [3]Hermann-Kunz E: Prevalence of hay fever in Germany-East-West comparison and temporal trends in German. Gesundheitswesen 1999, 61(Spec No):94-99.
• [4]Kurth BM, Kamtsiuris P, Hölling H, Schlaud M, Dölle R, Ellert U, Kahl H, Knopf H, Lange M, Mensink GB, Neuhauser H, Rosario AS, Scheidt-Nave C, Schenk L, Schlack R, Stolzenberg H, Thamm M, Thierfelder W, Wolf U: The challenge of comprehensively mapping children’s health in a nation-wide health survey: design of the German KiGGS-Study. BMC Publ Health 2008, 8:196.
• [5]Kurth BM, Lange C, Kamtsiuris P, Hölling H: Health monitoring at the Robert Koch Institute. Status and perspectives (in German). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2009, 52:557-570.
• [6]Gößwald A, Lange M, Kamtsiuris P, Kurth BM: DEGS: German Health Interview and Examination Survey for Adults: A nationwide cross-sectional and longitudinal study within the framework of health monitoring conducted by the Robert Koch Institute (in German). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2012, 55:775-780.
• [7]The World Medical Association (WMA): Declaration of Helsinki - Ethical principles of medical research involving human subjects. http://www.wma.net/en/30publications/10policies/b3/ webcite
• [8]Robert Koch-Institut: DEGS-Studie zur Gesundheit Erwachsener in Deutschland. Projektbeschreibung. Berlin: Robert Koch-Institut; 2009.
• [9]BIK Aschpurwis und Behrens GmbH: BIK Regionen: Ballungsräume, Stadtregionen, Mittel-/Unterzentrengebiete. Methodenbeschreibung zur Aktualisierung 2000. Hamburg; 2001.
• [10]Cox LH: A constructive procedure for unbiased controlled rounding. J Am Stat Assoc 1987, 82:520-524.
• [11]Kalton G: Introduction to Survey Sampling. Beverly Hills: Sage Publications; 1983.
• [12]Kish L: Survey Sampling. New York: John Wiley &Sons; 1965.
• [13]Newcombe RG: Two-sided confidence intervals for the single proportion: comparison of seven methods. Stat Med 1998, 17:857-872.
• [14]Collaborating Centre for Drug Statistics Methodology: Guidelines for ATC classification and DDD assignment 2010. http://www.whocc.no/filearchive/publications/2010guidelines.pdf webcite
• [15]American College of Sports Medicine: ACSM’s Guidelines for exercise testing and prescription 8th edition. Philadelphia: Lippincott Williams & Wilkins; 2010.
• [16]Haftenberger M, Heuer T, Heidemann C, Kube F, Krems C, Mensink GB: Relative validation of a food frequency questionnaire for national health and nutrition monitoring. Nutr J 2010, 9:36.
• [17]Jöckel KH, Babitsch B, Bellach BM, Bloomfield K, Hoffmeyer-Zlotnik J, Winkler J: Empfehlungen der Arbeitsgruppe “Epidemiologische Methoden” in der Deutschen Arbeitsgemeinschaft Epidemiologie der Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (GMDS) und der Deutschen Gesellschaft für Sozialmedizin und Prävention (DGSMP) zur Messung und Quantifizierung soziodemographischer Merkmale in epidemiologischen Studien. In Messung soziodemographischer Merkmale in der Epidemiologie. Volume 1. Edited by Ahrens W, Bellach BM, Jöckel KH. München: MMV Medizin Verlag; 1998.
• [18]Schroedter JH, Lechert Y, Lüttiger P: Die Umsetzung der Bildungsskala ISCED-1997 für die Volkszählung 1970, die Mikrozensus-Zusatzerhebung 1971 und die Mikrozensen 1976–2004 (Version 1). In ZUMA-Methodenbericht 2006/08. Mannheim; 2006.
• [19]Wittchen HU, Pfister H: DIA-X-Interviews: Manual für Screening-Verfahren und Interview. Frankfurt: Swets & Zeitlinger; 1997.
• [20]Kessler RC, Ustün TB: The World Mental Health (WMH) Survey Initiative Version of the World Health Organization (WHO) Composite International Diagnostic Interview (CIDI). Int J Methods Psychiatr Res 2004, 13:93-121.
• [21]Wittchen HU, Kessler RC, Ustün TB: Properties of the Composite International Diagnostic Interview (CIDI) for measuring mental health outcome. In Mental Health Outcome Measures. 2nd edition. Edited by Thornicroft G, Tansella M. London: Gaskell; 2001:212-227.
• [22]Morris JC, Heyman A, Mohs RC, Hughes JP, van Belle G, Fillenbaum G, Mellits ED, Clark C: The Consortium to Establish a Registry for Alzheimer’s Disease (CERAD). Part I. Clinical and neuropsychological assessment of Alzheimer’s disease. Neurology 1989, 39:1159-1165.
• [23]Luck T, Riedel-Heller SG, Wiese B, Stein J, Weyerer S, Werle J, Kaduszkiewicz H, Wagner M, Mösch E, Zimmermann T, Maier W, Bickel H, van den Bussche H, Jessen F, Fuchs A, Pentzek M, AgeCoDe Study Group: CERAD-NP battery: Age-, gender- and education-specific reference values for selected subtests. Results of the German Study on Ageing, Cognition and Dementia in Primary Care Patients (AgeCoDe). Z GerontolGeriatr 2009, 42:372-384.
• [24]Jacobi F, Wittchen HU, Hölting C, Sommer S, Lieb R, Höfler M, Pfister H: Estimating the prevalence of mental and somatic disorders in the community: aims and methods of the German National Health Interview and Examination Survey. Int J Methods Psychiatr Res 2002, 11:1-18.
• [25]Jacobi F, Wittchen HU, Holting C, Höfler M, Pfister H, Müller N, Lieb R: Prevalence, co-morbidity and correlates of mental disorders in the general population: results from the German Health Interview and Examination Survey (GHS). PsycholMed 2004, 34:597-611.
• [26]Tolonen H, Koponen P, Aromaa A, Conti S, Graff-Iversen S, Grøtvedt L, Kanieff M, Minell J, Natunen S, Primatesta P, Verschuren Viet L: Kuulasmaa K for the Feasibility of a European Health Examination Survey (FEHES) Project: Review of Health Examination Surveys in Europe. http://www.ktl.fi/attachments/suomi/julkaisut/julkaisusarja_b/2008/2008b18.pdf webcite
• [27]Tafforeau J, Cobo ML, Tolonen H, Scheidt-Nave C, Tinto A: Guidelines for the development and criteria for the adoption of Health Survey instruments. http://circa.europa.eu/Public/irc/dsis/health/library?l=/reports/healthsinterviewssurvey/guidelines_instruments/_EN_1.0_&a=d webcite
• [28]OECD: Health at a Glance 2011: OECD indicators. http://www.oecd.org/dataoecd/6/28/49105858.pdf webcite
• [29]National Institute for Health and Welfare: European Health Examination Survey. http://www.ehes.info webcite
• [30]Holzhausen M, Fuchs J, Busch M, Ernert A, Six-Merker J, Knopf H, Hapke U, Gaertner B, Kurzawe-Seitz I, Dietzel R, Schödel N, Welke J, Wiskott J, Wetzstein M, Martus P, Scheidt-Nave C: Operationalizing multimorbidity and autonomy for health services research in aging populations-the OMAHA study. BMC Health Serv Res 2011, 11:47.
• [31]De Heer W: International Response Trends: Results of an International Survey. J Off Stat 1999, 15:129-142.
• [32]Tolonen H, Helakorpi S, Talala K, Helasoja V, Martelin T, Prättälä R: 25-year trends and socio-demographic differences in response rates: Finnish adult health behaviour survey. Eur J Epidemiol 2006, 21:409-415.
• [33]Criqui M, Barrett-Connor E, Austin M: Differences between respondents and non-respondents in a population-based cardiovascular disease study. Am J Epidemiol 1978, 108:367-372.
• [34]Naughton C, Bennett K, Feely J: Prevalence of chronic disease in the elderly based on a national pharmacy claims database. Age Ageing 2006, 35:633-636.
• [35]Cox B, Van Oyen H, Cambois E, Jagger C, le Roy S, Robine JM, Romieu I: The reliability of the Minimum European Health Module. Int J Public Health 2009, 54:55-60.
• [36]Franke GH: SCL-90-R. Die Symptom-Checkliste von Derogatis.Deutsche Version - Manual.Zweite, vollständig überarbeitete und neu normierte Auflage. Göttingen: Beltz; 2002.
• [37]Fransen J, Langenegger T, Michel BA, Stucki G: Feasibility and validity of the RADAI, a self-administered rheumatoid arthritis disease activity index. Rheumatology (Oxford) 2000, 39:321-327.
• [38]Ware JE, Kosinski M, Bjorner JB, Turner-Bowker DM, Gandek B, Marusih ME: User’s manual for the SF-36v2 health survey. 2nd edition. Lincoln, RI: Quality Metric Incorporated; 2007.
• [39]Morfeld M, Bullinger M, Nantke J, Brähler E: The version 2.0 of the SF-36 Health Survey: results of a population-representative study (in German). Soz Praventivmed 2005, 50:292-300.
• [40]Kurth BM, Ellert U: The SF-36 questionnaire and its usefulness in population studies: results of the German Health Interview and Examination Survey 1998. Soz Praventivmed 2002, 47:266-277.
• [41]Riemann D, Backhaus J: Behandlung von Schlafstörungen. Weinheim: Psychologie Verlags Union; 1996.
• [42]Kroenke K, Spitzer RL, Williams JB: The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med 2001, 16:606-613.
• [43]Löwe B, Spitzer RL, Zipfel S, Herzog W: PRIME MD Patient Health Questionnaire (PHQ). 2nd edition. http://www.klinikum.uniheidelberg.de/fileadmin/Psychosomatische_Klinik/download/PHQ_Manual1.pdf webcite
• [44]Schulz P, Schlotz W: The Trier Inventory for the Assessment of Chronic Stress (TICS): Scale construction, statistical testing, and validation of the scale work overload. Diagnostica 1999, 45:8-19.
• [45]Schulz P, Schlotz W, Becker P: Das Trierer Inventar zum chronischen Stress (TICS) - Manual. Göttingen: Hogrefe; 2004.
• [46]Rumpf HJ, Meyer C, Hapke U, John U: Screening for mental health: Validity of MHI-5 using DSM-IV Axis I psychiatric disorders as gold standard. Psychiatry Res 2001, 105:243-253.
• [47]DZA (German Centre of Gerontology): German Aging Survey (DEAS) 2002 Interview. http://www.dza.de/fileadmin/dza/pdf/English/DEAS2002_Interview.pdf webcite
• [48]Ismail AA, O’Neill TW, Cockerill W, Finn JD, Cannata JB, Hoszowski K, Johnell O, Matthis C, Raspe H, Raspe A, Reeve J, Silman AJ: Validity of self-report of fractures: results from a prospective study in men and women across Europe. EPOS Study Group. European Prospective Osteoporosis Study Group. Osteoporos Int 2000, 11:248-254.
• [49]Lamb SE, Jorstad-Stein EC, Hauer K, Becker C: Development of a common outcome data set for fall injury prevention trials: the Prevention of Falls Network Europe consensus. J Am Geriatr Soc 2005, 53:1618-1622.
• [50]Kilpeläinen K, Aromaa A, ECHIM Core Group: European Health Indicators: Development and Initial Implementation.Final Report of the European Health Indicator Monitoring (ECHIM) Projekt. http://www.echim.org/docs/ECHIM_final_report.pdf webcite
• [51]Gore CJ, Booth ML, Bauman A, Owen N: Utility of pwc 75% as an estimate of aerobic power in epidemiological and population-based studies. Med Sci Sports Exerc 1999, 31:348-351.
• [52]Lange Andersen K, Shephard RJ, Denolin H, Varnauskas E, Masironi R: Fundamentals of Exercise Testing. Geneva: World Health Organisation; 1971.
• [53]Mohd Hairi F, Mackenbach JP, Andersen-Ranberg K, Avendano M: Does socio-economic status predict grip strength in older Europeans? Results from the SHARE study in non-institutionalised men and women aged 50+. J Epidemiol Community Health 2010, 64:829-837.
• [54]Hank K, Jürges H, Schupp J, Wagner GG: Isometric grip strength and social gerontological research: results and analytic potentials of SHARE and SOEP (in German). Z Gerontol Geriatr 2009, 42:117-126.
• [55]Podsiadlo D, Richardson S: The timed “Up & Go”: a test of basic functional mobility for frail elderly persons. J Am Geriatr Soc 1991, 39:142-148.
• [56]Guralnik JM, Simonsick EM, Ferrucci L, Glynn R, Berkman LF, Blazer DG, Scherr PA, Wallace RB: A short physical performance battery assessing lower extremity function: association with self-reported disability and prediction of mortality and nursing home admission. J Gerontol 1994, 49:M85-M94.
• [57]Guralnik JM, Ferrucci L, Simonsick EM, Salive ME, Wallace RB: Lower extremity function in persons over the age of 70 years as a predictor of subsequent disability. New Engl J Med 1995, 332:556-561.
• [58]Rossiter-Fornoff JE, Wolf SL, Wolfson LI, Buchner DM: A cross-sectional validation study of the FICSIT common data base static balance measures. Frailty and Injuries: Cooperative Studies of Intervention Techniques. J Gerontol A Biol Sci Med Sci 1995, 50:M291-M297.
• [59]von Aster M, Neubauer A, Horn R: Wechsler Intelligenztest für Erwachsene. Frankfurt/M: Harcourt Test Services; 2006.
• [60]Wechsler D: Wechsler Adult Intelligence Scale - third edition. San Antonio, TX: The Psychological Corporation; 1997.
• [61]Jagger C, Gillies C, Cambois E, Van Oyen H, Nusselder W, Robine J-M, the EHLEIS team: The Global Activity Limitation Indicator (GALI) measured function and disability similarly across European countries. J Clin Epidemiol 2010, 63:892-899.
• [62]John U, Meyer C, Hapke U, Rumpf HJ, Schumann A, Adam C, Alte D, Lüdemann J: The Fagerström Test for Nicotine Dependence in two adult population samples. Alcohol Drug Depend 2003, 20:1-6.
• [63]Bischof G, Reinhardt S, Grothues J, Meyer C, John U, Rumpf HJ: Development and evaluation of a screening instrument for alcohol-use disorders and at-risk drinking: the brief alcohol screening instrument for medical care (BASIC). J Stud Alcohol Drugs 2007, 68:607-614.
• [64]Dalgard OS, Dowrick C, Lehtinen V, Vazquez-Barquero JL, Casey P, Wilkinson G, Ayuso-Mateos JL, Page H, Dunn G, ODIN Group: Negative life events, social support and gender difference in depression: a multinational community survey with data from the ODIN study. Soc Psychiatry Psychiatr Epidemiol 2006, 41:444-451.
• [65]Schenk L, Bau AM, Borde T, Butler J, Lampert T, Neuhauser H, Weilandt C: A basic set of indicators for mapping migrant status. Recommendations for epidemiological practice (in German). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2006, 49:853-860.
• [66]Thamm M, Ellert U, Thierfelder W, Liesenkötter KP, Völzke H: Iodineintake in Germany. Results of iodine monitoring in the German Health Interview and Examination Survey for Children and Adolescents (KiGGS) (in German). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2007, 50:744-749.