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Comparative Study
. 2012 Sep 14:12:143.
doi: 10.1186/1471-2288-12-143.

The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms

Arnulf Langhammer  1 , Steinar Krokstad, Pål Romundstad, Jon Heggland, Jostein Holmen
Affiliations
Comparative Study

The HUNT study: participation is associated with survival and depends on socioeconomic status, diseases and symptoms

Arnulf Langhammer et al. BMC Med Res Methodol. .

Abstract

Background: Population based studies are important for prevalence, incidence and association studies, but their external validity might be threatened by decreasing participation rates. The 50 807 participants in the third survey of the HUNT Study (HUNT3, 2006-08), represented 54% of the invited, necessitating a nonparticipation study.

Methods: Questionnaire data from HUNT3 were compared with data collected from several sources: a short questionnaire to nonparticipants, anonymous data on specific diagnoses and prescribed medication extracted from randomly selected general practices, registry data from Statistics Norway on socioeconomic factors and mortality, and from the Norwegian Prescription Database on drug consumption.

Results: Participation rates for HUNT3 depended on age, sex and type of symptoms and diseases, but only small changes were found in the overall prevalence estimates when including data from 6922 nonparticipants. Among nonparticipants, the prevalences of cardiovascular diseases, diabetes mellitus and psychiatric disorders were higher both in nonparticipant data and data extracted from general practice, compared to that reported by participants, whilst the opposite pattern was found, at least among persons younger than 80 years, for urine incontinence, musculoskeletal pain and headache. Registry data showed that the nonparticipants had lower socioeconomic status and a higher mortality than participants.

Conclusion: Nonparticipants had lower socioeconomic status, higher mortality and showed higher prevalences of several chronic diseases, whilst opposite patterns were found for common problems like musculoskeletal pain, urine incontinence and headache. The impact on associations should be analyzed for each diagnosis, and data making such analyses possible are provided in the present paper.

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Figures

Figure 1
Figure 1
Prevalence of diseases (%) based on GP records, HUNT questionnaire 1 (Q1) and QNP by age group.
Figure 2
Figure 2
Overall survival by participation in HUNT 1 in men and women. Age used as timescale.
Figure 3
Figure 3
Overall survival by participation in HUINT 2 in men and women. Age used as timescale.
Figure 4
Figure 4
Overall survival by participation in HUNT 3 in men and women. Age used as timescale.
Figure 5
Figure 5
Risk of death by participation in HUNT 1 in men and women adjusted for age (estimated at 50 years of age at participation).
Figure 6
Figure 6
Risk of death by participation in HUNT 2 in men and women adjusted for age (estimated at 50 years of age at participation).
Figure 7
Figure 7
Risk of death by participation in HUNT 3 in men and women adjusted for age (estimated at 50 years of age at participation).
See this image and copyright information in PMC

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