OBJECTIVE To compare established associations between risk factors and mortality in UK Biobank, a study with an exceptionally low rate of response to its baseline survey, against those from representative studies that have conventional response rates. DESIGN Prospective cohort study alongside individual participant meta-analysis of other cohort studies. SETTING United Kingdom. PARTICIPANTS Analytical sample of 499 701 people (response rate 5.5%) in analyses in UK Biobank; pooled data from the Health Surveys for England (HSE) and the Scottish Health Surveys (SHS), including 18 studies and 89 895 people (mean response rate 68%). Both study populations were linked to the same nationwide mortality registries, and the baseline age range was aligned at 40-69 years. MAIN OUTCOME MEASURE Death from cardiovascular disease, selected malignancies, and suicide. To quantify the difference between hazard ratios in the two studies, a ratio of the hazard ratios was used with HSE-SHS as the referent. RESULTS Risk factor levels and mortality rates were typically more favourable in UK Biobank participants relative to the HSE-SHS consortium. For the associations between risk factors and mortality endpoints, however, close agreement was seen between studies. Based on 14 288 deaths during an average of 7.0 years of follow-up in UK Biobank and 7861 deaths over 10 years of mortality surveillance in HSE-SHS, for cardiovascular disease mortality, for instance, the age and sex adjusted hazard ratio for ever having smoked cigarettes (versus never) was 2.04 (95% confidence interval 1.87 to 2.24) in UK Biobank and 1.99 (1.78 to 2.23) in HSE-SHS, yielding a ratio of hazard ratios close to unity (1.02, 0.88 to 1.19). The overall pattern of agreement between studies was essentially unchanged when results were compared separately by sex and when baseline years and censoring dates were aligned. CONCLUSION Despite a very low response rate, risk factor associations in the UK Biobank seem to be generalisable.

中文翻译：

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英国生物银行的危险因素关联与具有传统反应率的代表性、基于一般人群的研究的比较：前瞻性队列研究和个体参与者荟萃分析。


目的 比较英国生物银行（一项基线调查响应率极低的研究）中风险因素与死亡率之间已建立的关联与传统响应率的代表性研究中的关联。设计前瞻性队列研究以及其他队列研究的个体参与者荟萃分析。设置英国。参与者 英国生物银行分析中的 499 701 人的分析样本（响应率为 5.5%）；汇总了英格兰​​健康调查 (HSE) 和苏格兰健康调查 (SHS) 的数据，包括 18 项研究和 89 895 人（平均响应率为 68%）。两个研究人群都与相同的全国死亡率登记相关，基线年龄范围为 40-69 岁。主要结局指标 心血管疾病、特定恶性肿瘤和自杀导致的死亡。为了量化两项研究中风险比之间的差异，使用了以 HSE-SHS 为参考的风险比比率。结果 相对于 HSE-SHS 联盟，英国生物样本库参与者的风险因素水平和死亡率通常更为有利。然而，对于危险因素和死亡率终点之间的关联，研究之间发现了密切的一致性。根据英国生物银行平均 7.0 年随访期间的 14 288 例死亡和 HSE-SHS 10 年死亡率监测中的 7861 例死亡，例如心血管疾病死亡率，年龄和性别调整后的风险比在英国生物银行中，吸烟者（与从不吸烟者相比）为 2.04（95% 置信区间为 1.87 至 2.24），在 HSE-SHS 中为 1.99（1.78 至 2.23），产生的风险比接近于统一（1.02、0.88 至 1.19）。 当按性别分别比较结果以及基线年份和审查日期一致时，研究之间的总体一致性模式基本上没有变化。结论 尽管响应率非常低，但英国生物银行的风险因素关联似乎具有普遍性。