Data and biospecimen collection for biobanking is typically focused on biomarker research, for the development of diagnostics or therapies or other disease-related activity. However, the Understanding Society: UK Household Longitudinal Study is collecting blood samples for these biomarkers, and potentially for genetic analyses to inform policy and broad social decision making at many levels. Although the study is primarily about providing independent, up-to-date evidence to policy makers in the UK, including broad health-related information, the data being collected allows investigation of a variety of interesting questions.
For instance, how critical to health and well-being are parks and other green spaces? A preliminary analysis found significant benefits, to both physical and mental health, of living within five kilometers of the coast!
As one participating researcher noted, average exists only on a spreadsheet. To generate the truly detailed data needed for “evidence-based” policy at all levels, the study is following 40,000 households in the UK—England, Scotland, Wales, and Northern Ireland—that were randomly invited to participate in 2008. The study includes the households from the British Household Panel Survey (BHPS), which has followed 10,000 individuals in 5,000 households since 1991, thus providing researchers with nearly 25 years of longitudinal data—and nearly three billion data points—already available for analysis.
Households have been surveyed annually (beginning in 2009) regarding changes that occurred over the past 12 months. All members of the household aged 16 and older respond to the annual questionnaire, which takes about an hour (children aged 10–15 complete a shortened 15-minute version). The content of the questionnaires in each round of Understanding Society is the result of a complicated balancing of questions that are asked every year, questions that are event triggered (i.e., only asked after specific events such as leaving school or a divorce), and regular periodic questions (such as on social networks, environmental attitudes). All the annual surveys contain health-related questions as well.
One innovation implemented in this longitudinal study is Computer Assisted Personal Interviewing (CAPI) software. Participants’ responses to the health questions are entered directly into the computer by the interviewer, and the data is encrypted and transferred via secure web portal.
To dramatically enhance the value of the data for health and medical research, health assessments and blood samples were added to the study. The assessments and blood collections were performed twice—after the 2010 survey and following the 2011 survey. A visiting nurse collected blood samples as well as additional data, including height, weight, blood pressure, percentage of body fat, waist measurement, lung function, and hand grip strength. Among the eligible participants, 58 percent (15,591) completed the health assessment and 38 percent (10,175) also donated a blood sample in 2010; response among volunteers in 2011 was nearly identical.
The study leadership partnered with Fisher BioServices UK to process and biobank the specimens, which were sent overnight to the company’s facility in Bishops Stortford. Following best practices for optimal sample integrity, specialized biosample technicians extracted high-quality, high-purity DNA samples, and also processed the samples into aliquots of whole blood, serum and plasma. The processed specimens are now stored at -80°C in barcoded 96-well racks; the biobank contains nearly 158,000 serum samples, 52,000 plasma samples, and 75,000 DNA extractions. Distribution of samples for biomarker research has already begun. (watch a video on the journey of a biobank sample)
The blood samples will be used for a range of biomarker research and also to support genetic analyses that could identify confounding factors in the study of health at a population level. For instance, analysis shows that people living in the same household experience a similar level of health, but specific reasons remain to be investigated.
However, the study is looking at many bigger questions (beyond the value of living near the beach), such as: Does low income lead to poor health, or vice versa? (Results show casual or correlational relationships in both directions.) What elements influence transition into and out of child poverty? (Families were significantly more likely to enter poverty when the number of children increased from two to three.) Details of the study design as well as summaries of completed research are available at www.understandingsociety.ac.uk.
For those who are designing similar longitdiunal studies or conducting biomarker research, one critical consideration you must factor in is your biosample integrity management plan. This issue was discussed by Dr. Debra Barnes's recent blog post " Know Your Samples: How Resilient are Your BioMarkers?"
Understanding Society was commissioned by the UK Economic and Social Research Council; Scientific leadership is provided by the Institute for Social and Economic Research (ISER) of the University of Essex, the University of Warwick, and the London School of Economics.
If you missed it, below is another interesting approach on managing a mega-cohort study.