ESC Geoffrey Rose Lecture on Population Sciences: Prof. Christian Torp-Pedersen
27 Aug 2021
For over a quarter of a century the presenter of this year’s ESC Geoffrey Rose Lecture on Population Sciences, Christian Tobias Torp-Pedersen, Professor of Cardiology at Nordsjaellands Hospital, Hillerød, Denmark, has conducted work on nationwide registries in Denmark that have helped to shape guidelines for cardiovascular medicine.
What first got you interested in cardiology?
As a young trainee, my rotation in cardiology coincided with the arrival of the department’s first echocardiogram and I was fascinated that this could actually show you the heart. The experience led directly to me conducting echocardiography studies, which formed the basis of much of our early epidemiological work. My love of epidemiology really became established in the 1980s, when we were able to analyse what was then a huge database of 7,000 patients with myocardial infarction to determine prognostic factors.
Tell us something about your lecture
I have split my lecture into what I see as the three aspects of nationwide registries: the good, the bad and the ugly. An example of ‘the good’ is the research we were able to conduct on bystander efforts. We linked nationwide data on out-of-hospital cardiac arrests in Denmark to functional outcome data and were able to show that bystander cardiopulmonary resuscitation and defibrillation reduced the risk of brain damage, nursing home admission and any-cause death compared with no bystander resuscitation.1
For ‘the bad’, I make the point that when you use ‘nationwide’ data, you have to trust the scientific community of that country to help criticise the data as they understand the full context. For example, a Danish registry-based study investigated the side effects of the Oxford-Astra Zeneca COVID-19 vaccine, but to interpret the data correctly, you had to know that the Danish health board had previously written letters to everyone who got the vaccine.
‘The ugly’ deals with ethics and fair data. Fair data – that everything should be transparent – is a topic of much discussion. The problem is balancing the rights of data protection with the ability to have adequate access to data to enable critical review of study findings. In terms of ethics, we need to ask, ‘How voluntarily have individuals allowed access to their data?’. Many people are surprised at how much personal information is available on some national databases, such as ours in Denmark.
What do you see as current and future challenges in population-based studies?
As highlighted by the introduction of the European General Data Protection Regulation, the ability to continue the work we do is a constant challenge. Other challenges include increasing amounts of legal regulations and an underappreciation of the time needed to conduct this type of research, which can lead to problems with funding and collaborations.
Where is this research heading in the future?
I believe that in the future, we will be able to gather enormous amounts of data on individuals that will make it easier to investigate questions about the relationship between, for instance, dietary habits, exercise and health. For example, using data from a credit card receipt app, we are seeing a disparity between what patients tell us they are eating and their actual dietary habits. This increasing access to different types of data should help us to define much more accurately what a person needs to do to remain healthy.
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1. Kragholm K, et al. N Engl J Med. 2017;376:1737–1747.