Trajectories of Urologic Disease: Follow-up of BACH

波士顿地区社区卫生（BACH）研究正在填补流行病学方面的知识空白， 泌尿系统问题-特别是不同种族/民族、性别、年龄和 社会经济地位。对5，506名成年人（3，205名女性，2，301名男性; 1，770名 2002-2005年，成功招募了1，877名黑人、1 877名西班牙裔、1 859名白色人。2小时的面谈 获得泌尿系统症状、社会人口统计学、测量的人体测量、健康状况等信息 和药物使用（处方药和OTC），生活方式和心理社会因素，以及医疗保健 利用率从大多数（70%）受试者中获得静脉血样（20 ml）。论文题目 由科学咨询委员会确定并优先考虑： 在国家和国际会议上提出;发表/接受了6篇同行审查的论文; 13 已提交并正在审查; 8个正在积极编写;已确定59个专题供今后编写文件。 我们建议将BACH从横断面设计过渡到前瞻性队列设计：努力保持在 与受试者的接触，以及最近（2006年）非常成功地尝试重新采访500名受试者（4+ 年）表明，超过80%（n=4.130）可以重新招募。前瞻性随访特征良好的 受试者提供了一个机会，以解决有关泌尿系统症状的流行病学问题： 同一受试者的自然史（进展/缓解），与主要慢性 疾病，药物流行病学，生活经历/事件的作用，寻求帮助的行为，以及正式和 非正式成本（烦恼、痛苦和生活质量）。它将提供急需的发病率， 有机会测试基线关联的稳健性，并帮助解开病理生理途径。 面谈将继续亲自进行（通常使用同一基线面谈者），以避免 由于数据收集模式不同而产生的差异。对基线数据的分析为许多新的 纵向问题。 BACH的独特之处包括：随机社区抽样：包括种族/族裔 少数民族;<$足够数量的男性和女性;<$30 -80岁的广泛年龄跨度：<$其重点 症状（而不是不明确的条件）;<$使用经验证的现场仪器：<$其多学科 方向：<$其代表性和普遍性;<$生物标本的现成可用性;以及 努力与所有BACH受试者保持联系。 这项研究将探讨“泌尿系冰山”-泌尿系症状的发病率在人口中，风险 因素，随时间的变化，对生活质量的影响，卫生保健的使用，以及新出现的负担， 提示泌尿系统疾病的症状。

The Boston Area Community Health (BACH) study is filling knowledge gaps in the epidemiology of urologic problems - especially variations in prevalence and risk factors by race/ethnicity, gender, age, and socioeconomic status. A random population sample of 5,506 adults (3,205 females, 2,301 males; 1,770 Black, 1,877 Hispanic, 1,859 White) was successfully recruited (2002-2005). A 2-hour in-person interview obtained information on urologic symptoms, sociodemographics, measured anthropometries, health status and pharmaceutical usage (both prescribed and OTC), lifestyles and psychosocial factors, and health care utilization. A venous blood sample (20 mis) was obtained from a majority (70%) of subjects. Paper topics were identified and prioritized by a Scientific Advisory Committee: 43 posters and abstracts have been presented at national and international meetings; 6 peer-reviewed papers have appeared/been accepted; 13 submitted and under review; 8 are in active development; 59 topics have been identified for future papers. We propose to transition BACH from a cross-sectional to a prospective cohort design: efforts to remain in contact with subjects and a recent (2006) highly successful attempt to re-interview 500 subjects (after 4+ years) show that over 80% (n=4.130) can be re-recruited. Prospective follow-up of well-characterized subjects provides an opportunity to address questions concerning the epidemiology of urological symptoms: natural history (progression/remission) within the same subject, longitudinal relationship with major chronic diseases, pharmacoepidemiology, the role of life experiences/events, help-seeking behavior, and formal and informal costs (bother, distress and quality of life). It will provide much needed incidence rates, an opportunity to test the robustness of baseline associations, and help unravel pathophysiologic pathways. Interviews will continue to be conducted in-person (often using the same baseline interviewer) to avoid variations due to different data gathering modes. Analyses of the baseline data have informed many novel longitudinal questions. Unique features of BACH include: ¿ a random community-based sample: ¿ inclusion of race/ethnic minorities; ¿ sufficient numbers of both males and females: ¿ the broad age-span of 30-80 years: ¿ its focus on symptoms (rather than ill-defined conditions); ¿ use of validated field instruments: ¿ its multidisciplinarv orientation: ¿ its representativeness and generalizabilitv: ¿ the ready availability of biologic specimens: and the efforts to remain in current contact with all BACH subjects. This study will examine the "urologic iceberg" - the incidence of urologic symptoms in the population, risk factors, changes over time, impact on quality of life, use of health care, and the emerging burden of symptoms suggestive of urologic disease.