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Professor Zhengming Chen from the Nuffield Department of Population Health will deliver the 2019 Archie Cochrane Lecture at Green Templeton College.

Many important genetic and non-genetic causes of major diseases still await discovery.

Several big blood-based prospective studies have been undertaken this century, including the China Kadoorie Biobank (CKB) and UK Biobank, both based in Oxford. Each recruited 500,000 apparently healthy adults, recording lifestyle and physiological factors and storing blood. CKB covered ten diverse areas distributed across China, and after more than 10 years of follow-up through electronic linkage to hospital records and death registries, it has recorded more than one million disease episodes, including more than 50,000 well-characterised strokes or heart attacks.

Major findings are now emerging in CKB, some expected and some intriguingly unexpected but novel, including assessment of any causal protective effects of moderate alcohol drinking on stroke and heart disease using the East Asian specific “flushing” genes. The big maturing biobanks in the Eastern and Western populations with different lifestyles, environments and genetic architectures will greatly improve our understanding about aetiology of many diseases.

Zhengming Chen came to Green Templeton (then-Green College), Oxford, in late 1987, initially for one year, to analyse the Shanghai Factory Workers cohort. Subsequently he managed to pursue DPhil study in Oxford based on the Shanghai cohort data he brought with him.

The study showed that even at cholesterol levels well below those considered "normal" in Western populations, lower cholesterol still meant lower risk of IHD. This informed the design of large randomised trials in the UK (e.g. Heart Protection Study) that went on to show the benefits of lowering LDL cholesterol irrespective of presenting levels.

Zhengming previously studied medicine at Shanghai Medical University in China. His main research has focused on the determinants of chronic disease and development of evidence-based medicine.

Since mid-1990s, he has conducted several large randomised trials of treatment for MI, stroke and cancer in China, totalling more than 100,000 patients. These trials not only generated important findings that have changed the clinical practice worldwide (e.g. early aspirin in acute stroke, combined antiplatelet therapy in heart attack), but also helped establish the tradition of large randomised trials in China.

Building on the large collaborative epidemiological studies that the department established in China during 1980-90s, Zhengming initiated and established the CKB of 0.5 million adults, and has been the Lead Principal Investigator, together with Professor Liming Li in China, since its inception in 2003. CKB will continue indefinitely and the wealth range of exposure and disease outcome data collected or to be generated will lead to many novel findings over the next few decades.

Forthcoming events

Infectious Disease Seminar Series: Hepatitis B diagnosis, prevention and treatment: laboratory approaches to the elimination agenda

Monday, 06 February 2023, 1pm to 2pm @ BDI Seminar Room LG 0-1, Old Road Campus, Headington, OX3 7LF

Richard Doll Seminar: Edgar Sydenstricker: Household Equivalence Scales and the Causes of Pellagra

Tuesday, 07 February 2023, 1pm to 2pm @ Richard Doll Lecture Theatre, Richard Doll Building, Old Road Campus, OX3 7LF

Ethox seminar- Feminist-Ethical Perspectives on Digital (Health) Technologies

Tuesday, 14 February 2023, 11am to 12.30pm @ Big Data Institute, Lower Ground Seminar Room 1, Oxford Population Heath, University of Oxford

Richard Doll Seminar - E-Freeze trial results

Tuesday, 14 February 2023, 1pm to 2pm @ Richard Doll Lecture Theatre, Richard Doll Building, Old Road Campus, OX3 7LF

Infectious Disease Seminar Series: Informing on Neisseria gonorrhoeae treatment and management through pathogen genomics

Monday, 20 February 2023, 1pm to 2pm @ BDI Seminar Room LG 0-1, Old Road Campus, Headington, OX3 7LF

Richard Doll Seminar- Triangulation of evidence in aetiological epidemiology: principles, prospects and limitations.

Tuesday, 21 February 2023, 1pm to 2pm @ Richard Doll Lecture Theatre, Richard Doll Building, Old Road Campus, OX3 7LF

Aetiological epidemiology is concerned with the identification of causal influences on disease risk. Randomized controlled trials are, when possible, the cornerstone of knowledge as to whether interventions based on aetiological studies are merited. It is not feasible to subject all of the many candidate causes to large-scale RCTs, however, even in situations where they are in principle possible. Triangulation of evidence is an approach that attempts to formally combine findings from different domains to strengthen causal inference. Triangulation embraces the variety of evidence thesis, that inferential strength depends not only on the quantity of available evidence, but also on its variety: the greater the variety, the stronger the resulting support. An essential condition is that the systematic errors and biases are unrelated across different study types. For example, the effect of raising circulating HDL cholesterol on the risk of coronary heart disease can be estimated from RCTs or through Mendelian randomization using genetic variants related to HDL level. Both the results of RCTs and Mendelian randomization studies could be biased. However, the potential biases in one study design would not influence estimates from the other approach: the biases are unrelated to each other. In observational epidemiology approaches that can be applied include the use of negative control exposures or outcomes; the deliberate use of data from contexts in which confounding structures differ; the use of instrumental variables and related approaches, such as regression discontinuity; quasi-experimental studies; the estimation of the expected magnitude of associations generated by confounding and the incorporation of mechanistic data, amongst others. Pre-registration of protocols for the triangulation of evidence increases confidence in the findings produced.