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Core Research Activities

Comstock Center welcomes new investigators and initiatives. New initiatives often benefit from building on the rich history of research at the Center. Stored specimens allow for state-of-the-art laboratory studies of innovative hypotheses in well characterized cohorts. Outcome surveillance in several large cohorts can lead to efficient case-control designs with a large number of cases that are already identified. Previous data collection allows for tracing health and risk factors over decades allowing for a life-span approach to understanding the interplay of internal, external and behavioral factors in causing disease. Trained staff help in all phases of study implementation with a tradition of dedication to excellence.

Each of the major studies (e.g. CLUE, ARIC, CHS) has established procedures for proposing ancillary studies and manuscript proposals.

Cancer Surveillance (1948 to Present)

Beginning in 1948, cancer diagnoses were abstracted from Washington County Hospital discharge records and from death certificates of Washington County residents received from the State Health Department. Until 1968, records from the Western Maryland Medical Center and from the Veterans Administrations Hospital in Martinsburg, West Virginia, were also abstracted and added to the registry. Diagnoses were coded using the International Classification of Diseases, Versions 8 and 9 (ICD-8, 9). (For cancers, the codes are the same in each version.). A maximum of four cancer diagnoses were coded. Any history of cancer reported in the medical record was also recorded.  Note that any cancer that is often treated on an outpatient basis is probably under-represented in these data. Both the ICD code and the year of diagnosis are available.

Mortality Surveillance

Approximately 100 death certificates are processed monthly at the Center using MMDS software (MICAR, ACME, SuperMICAR), generating ICD codes for all listed causes and underlying cause of death. This data is used as a cross-reference for vital status for all Clue 2 participants. Obituaries, Social Security Death Index, National Death Index, cancer registry, and follow-up surveys are also used to monitor cohort deaths. Annually the State of Maryland provides the Center with an electronic file of WC resident deaths with underlying cause coded. This file includes resident deaths occurring outside of Washington County. Underlying cause is updated with the state-provided ICD code.

DESCRIPTION OF DATA SOURCES 

1963 private census, with 91,909 listings by last name, maiden name and household number.

1975 private census, estimated to be 90 percent complete, with 90,225 listings by last name, maiden name, birth date and household number.

CLUE I: Brief histories including medications, blood pressure determinations, and serum samples from 26,147 individuals (23,951 Washington County residents) in 1974.  Serum stored at -70oC.

CLUE II: Histories including height, weight, smoking and medications; blood pressure and serum cholesterol determinations; and plasma aliquots (including some stored to preserve ascorbic acid) and buffy coat stored at -70oC from 32,894 individuals (25,080 Washington County) in 1989. Of these, 25,151 returned food frequency questionnaires and a toenail clipping. 

ODYSSEY COHORT: Is composed of 8,394 Washington County residents who participated in two specimen banks: CLUE I, established in 1974, and CLUE II , established in 1989. The cohort has been followed prospectively since 1974. Genetic polymorphisms have been determined using DNA extracted from buffy coat specimens obtained from cohort participants in 1989 and stored at -70oC.

ARIC (Atherosclerosis Risk in Communities): ARIC is one of four centers funded by contract from the National Heart, Lung and Blood Institute. A comprehensive cardiovascular examination, including ultrasound examinations of major arteries and special tests for hemostatic factors, was given to approximately 4,000 randomly selected persons ages 45 to 65 in 1987 to 1989. Repeat examinations are given every three years, with annual telephone contacts between examinations. Surveillance of all hospitalized cases of myocardial infarction and coronary deaths is also being conducted. 

CHS (Cardiovascular Health Study): CHS is also one of four centers funded by contract from the National Heart, Lung and Blood Institute. The study involves a comprehensive cardiovascular examination of approximately 1,500 randomly selected persons older than 65 years in 1989-90. Mini-examinations are given annually.  

Sleep Heart Health Study: Recruited from subjects in ARIC and CHS. Tested whether sleep-related breathing disorders are associated with an increase risk of coronary heart disease and stroke.

HISTORICAL STUDIES

Migraine study obtained information from 10,169 persons between the ages of 12 and 29 in 1986-87 regarding headaches and related complaints. Subsamples were contacted for more detailed or specific studies. 

Childhood heights and weights: From 1933 to 1945, heights and weights were recorded annually on 13,206 school children in Hagerstown, most with multiple examinations.

Mental health survey of 2,761 randomly selected adults in 1972-74

 

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