Epidemiology Study and Evaluation of Prevention Strategies on Liver Diseases Using Database and Serum Samples Collected from Community-Based Comprehensive Screenings in Taiwan during 2003 to 2013

During 2003 and 2013, around 300,000 residents have been checked under comprehensive health screening program in Tainan. Not only their health data was computerized, but also a serum bank was established. Even calling for projects, the valuable health resource has not been used in academic research. There are some barriers, such as validation of the database, ethical consideration and linkage with national database. The current 3-year project will have different tasks and aims in each year. In the first year, we will activate the database as a decoded easy-to-use database including valid individual information with it serum sample codes and health events. The health events will be obtained from national databases of overall mortality, cancer registration, and anti-viral treatment of chronic hepatitis B and C. We will create two datasets, one will be for cross-sectional study which includes only information in the first visit of each participant and the other will be for longitudinal study which includes information of participants with repeated measurements. After these two datasets established, we will analyze these decoded databases as an academic researcher. In the second year, we will conduct epidemiological studies of liver disease, including REVEAL-like study, differentiation between cohort effect and age effect in hepatitis B and C infections and health effects of series changes of blood biochemical tests. Comparing with REVEAL study, we have larger sample size, older participants’ age, incorporation of anti-viral treatment of hepatitis B and C, and including two important variables as fasting blood sugar and platelet count. For cost-effect considerations, nested case-control study will be an adequate design. Selected serum samples will be tests for viral loads of HBV and HCV. The seldom database included the wide age range as 11 years in a same birth cohort. It should be quite a good material for study differentiation between cohort effect and age effect in hepatitis B and C infections. Using trajectory analysis, datasets with repeated measurement samples can be objectively divided into different patterns. This study will explore that relation between health events and series pattern of biochemical tests rather than a single time spot. In the third year, we will evaluate the effects of preventive strategies of liver diseases, including a national strategy as anti-viral treatment of hepatitis B and C; countywide strategies as repeated hepatitis markers screening, ultrasonographic screening for hepatocellular carcinoma on the high risk groups, and further management of detected hepatitis cases with elevated ALT; and a local strategy as establishment of an assessable hepatology clinic in a mountain-side township Yujing. We will calculate the reduction incidence and mortality of liver diseases as academic studies. We will further try to find gaps between public health screening to NHI reimbursed medical care. In conclusion, this 3-year comprehensive project will activate a valuable large health database, conduct epidemiology study of liver disease in current status as well as evaluate the ongoing national and local preventive strategies of liver disease. It should be a particle projects.

Project ID:PC10308-1324
External Project ID:MOST103-2314-B182-017