in 2014 Annual Report
EMGO+ in 2014 Annual Report
Colophon & Credits Printed matter: VUmc DPC/Huisdrukkerij Circulation: 250 Paper size: Executive (184 x 267 mm) Location & date: Amsterdam, May 2015
Design & layout: Evelien de Boer Photography: Ton Dijkstra / Martijn Schuit / Ruben van Vliet Images: Shutterstock.com / Wordle.net Cover images: Shutterstock.com Appendices can be found online: www.emgo.nl/annual-report
Contact EMGO Institute for Health and Care Research Van der Boechorststraat 7 1081 BT Amsterdam
Phone
+31 (0)20 444 8180
emgo@vumc.nl
Website
www.emgo.nl
CONTENTS P REFACE ......................................................................................................7 1.
R ESEARCH AREA ...........................................................................................9 Lifestyle, Overweight, and Diabetes .......................................... 10 Mental Health ......................................................................... 11 Quality of Care........................................................................ 12 Musculoskeletal Health ............................................................ 13
2.
O RGANIZATION ......................................................................................... 14
3.
C OMPOSITION ........................................................................................... 18
4.
R ESEARCH ENVIRONMENT AND EMBEDDING ................................................ 21
5.
Q UALITY AND SCIENTIFIC RELEVANCE ........................................................ 23 LOD — 2014 highlights and key publications ............................. 23 MH — 2014 highlights and key publications .............................. 25 QoC — 2014 highlights and key publications ............................. 26 MSH — 2014 highlights and key publications............................. 28 Affiliated members .................................................................. 29 Triple-E, KCVG, DEDIPAC, NL-SH ......................................................... 30
6.
E DUCATION AND T RAINING : E PID M ........................................................... 35
7.
Q UALITY CONTROL .................................................................................... 37 Science Committee .................................................................. 37 Quality Committee .................................................................. 38 PhD Committee ....................................................................... 38 Methodological expertise centers ............................................. 39
8.
S CIENTIFIC OUTPUT ................................................................................... 41
9.
E ARNING CAPACITY ................................................................................... 45
10.
A CADEMIC REPUTATION ............................................................................ 47
11.
S OCIETAL IMPACT ..................................................................................... 49
12.
SWOT A NALYSIS ...................................................................................... 52
Annual Report 2014 | EMGO+ | 6
PREFACE The EMGO+ Institute is a multidisciplinary research institute that brings together 650 researchers from departments of three different science communities, i.e. from the VU University Medical Center, the VU University Faculty of Psychology and Education, and the Faculty of Earth and Life Sciences. Since its inception in 1987 our institute aims to facilitate multidisciplinary research in the trans- and extramural health care domains, to optimize the quality of that research, to actively support acquisition of research funds, to build and maintain unique research expertise and infrastructure, and last-but-not least to maintain the translational focus of the research to ensure its societal relevance and impact on daily clinical practice. The governance of our institute is characterized by a ‘flat’ organization with broad involvement of the key opinion leaders (e.g. department heads, program directors, full professors and professors by special appointment) in major policy issues, and an institute-wide involvement in major quality control cycles. A lean administrative structure is maintained for day-to-day management, the multiple roles of the institute in the governance of VU/VUmc research and the external relations of the institute. In this annual report we present with pride and pleasure the core information about who we are, what we do, what we strive for, and what we have accomplished. You will find the information organized in a largely similar way as in 2013. Small changes in presentation reflect the 2014 standardization and harmonization of the annual report cycle across all VU University / VU University Medical Center research institutes, using the new Standard Evaluation Protocol (SEP) 2015-2021 of the Association of Universities in the Netherlands (VSNU), the Netherlands Organisation for Scientific Research (NWO), and the Royal Netherlands Academy of Arts and Sciences (KNAW) as the main guideline. We hope you will enjoy reading this report!
Yours sincerely, On behalf of the EMGO Institute for Health and Care Research,
Prof. Eco de Geus, PhD Director
Prof. Henriëtte van der Horst, MD, PhD Prof. Willem van Mechelen, MD, PhD Vice-director Vice-director
Annual Report 2014 | EMGO+ | 7
Figure 1: EMGO+ research themes
Annual Report 2014 | EMGO+ | 8
1
RESEARCH AREA
Mission and objectives The current EMGO+ mission is to generate, conduct and publish excellent research of international standing to improve public and occupational health, mental health care, primary care, rehabilitation and long-term care. In the above fields, the EMGO+ Institute’s objectives are to: Strengthen the evidence-base for the current practice in prevention and care Perform cutting-edge research to innovate prevention and care Develop new methodology in study design, instrumentation and analyses Provide advanced education and training for researchers and researcherpractitioners
EMGO+ studies include observational research and intervention studies and are always focused on health outcomes to enable the promotion of evidence-based medical practice. Many studies are either executed within large population-based cohorts or in public health and extramural medical practice settings, such as general practices, specialized mental health care organizations, residential homes for the elderly, nursing homes, schools, worksites and occupational health care settings. In addition, a variety of intramural studies are conducted on organization, safety, effectiveness and quality of care in the hospital.
Programs All research projects carried out at EMGO + are embedded in one of our four research programs, three of which link to the main burdens of disease in the Netherlands as well as internationally: 1.
Lifestyle, Overweight and Diabetes (LOD)
2.
Mental Health (MH)
3.
Musculoskeletal Health (MSH)
whereas projects in the fourth program 4.
Quality of Care (QoC)
focusses on how to optimize physician-patient communication and decision making, increase patient participation, and on how to improve the safety of care in the above mentioned disease areas as well as in cancer.
Annual Report 2014 | EMGO+ | 9
Lifestyle, Overweight and Diabetes Mission Overweight and Diabetes are two of the main public health problems of our society and are strongly linked to common Lifestyle determinants such as physical inactivity and poor dietary habits. Physical inactivity and overweight are also main factors contributing to the development of cardiovascular disease. This research program aims to curb the obesity and diabetes epidemics by identification of the primary lifestyle and biological determinants and by evaluation of efficient ways to improve lifestyle in order to prevent disease and to improve outcomes in people with chronic diseases such as diabetes and cardiovascular disease.
Program directors: Prof. Marjolein Visser, PhD and Prof. Mai Chin A Paw, PhD
Specific research themes 1.
Pathophysiology and epidemiology of overweight and diabetes. This theme includes experimental and epidemiological studies of the biological, genetic and behavioral determinants of overweight and diabetes and their potential interrelations.
2.
Prevention of overweight and diabetes. Research projects pertaining to this theme aim to modify unhealthy lifestyles with a particular emphasis on improving dietary intake and promoting or increasing physical activity and reducing sedentariness.
3.
Care for patients with overweight and diabetes. Projects addressing the effectiveness and efficiency of health care aimed at chronic disease management of obesity and type-2 diabetes are central in this theme.
Annual Report 2014 | EMGO+ | 10
Mental Health Mission Common mental disorders have a major impact on public health and are among the conditions with the worldwide highest disease burden. By conducting observational as well as intervention studies, the Mental Health program contributes to a better evidence-base for the prevention and treatment of mental disorders in order to improve mental health in the population.
Program directors: Prof. Brenda Penninx, PhD and Prof. Hans Koot, PhD [photo: Martijn Schuit]
Specific research themes 1.
Epidemiology of mental health. This theme includes observational research in the community setting, the general practice setting as well as the mental health care setting that increases our knowledge of the occurrence, the determinants and consequences of mental health disorders.
2.
Prevention and treatment of mental disorders. This theme refers to research that contributes to evidence-based information on innovative prevention and treatment interventions to improve mental health and reduce associated disability.
3.
Developmental perspective in mental health. This theme refers to research that specifically examines developmental trajectories of psychopathology across the lifespan.
Annual Report 2014 | EMGO+ | 11
Quality of Care Mission A long healthy life requires not only disease-specific prevention and care, but also attention for more generic themes such as effective health communication. To ensure optimal care, issues such as taking patient perspectives into account in prevention and care, and patient safety are important. In the Quality of Care program, research focuses on the organization of care, for example regulations for end-of-life care; on health care professionals, for example educational programs in genetics, and on individual health care consumers, for example the quality of life of chronically ill and information needed to make health decisions.
Program directors: Prof. Bregje Onwuteaka-Philipsen, PhD and Prof. Sophia Kramer, PhD [photo: Ton Dijkstra]
Specific research themes 1.
Health, Communication and Decision Making. Research concentrates on improving the quality of information about e.g. health risks and treatments, and improving the communication between patients and doctors in order to enable patients to have the role in the decision making process regarding their treatment.
2.
Disease, Disability and Participation. Research focuses on personal factors and environmental factors that might hinder or help maintaining functional autonomy, participation and quality of life of people with chronic illness or a disability.
3.
Effectiveness and Safety of Care. Describing and monitoring the quality and safety of both prevention and care is the focus of this theme. Important topics are the development and subsequent testing of specific quality indicators as well as the effectiveness of interventions to improve collaboration between professionals or organization of care in order to optimize quality and safety of care.
Annual Report 2014 | EMGO+ | 12
Musculoskeletal Health Mission A recent WHO study on global burden of disease showed that musculoskeletal disorders rank highest in terms of the disabilityadjusted-life-year (DALYs) in industrialized countries. To reduce this burden the Musculoskeletal Health program seeks knowledge about the development and lifelong maintenance of a healthy musculoskeletal system and about the occurrence, prognosis, prevention and treatment of musculoskeletal disorders. The research program contributes to evidence-based practice for musculoskeletal disorders and health in the setting of occupational health care, primary health care, and rehabilitation practice. Furthermore, the research program strongly contributes to the development of research methodology
Program directors: Prof. Allard van der Beek, PhD and Prof. Raymond Ostelo, PhD [photo: Ton Dijkstra]
Specific research themes Epidemiology of musculoskeletal disorders. This theme includes observational research on the determinants and consequences of musculoskeletal disorders in the settings of public health, occupational health, primary and secondary health care, and rehabilitation practice. Prevention of musculoskeletal disorders. The knowledge gained from the first theme is translated into programs for setting-specific prevention of musculoskeletal disorders, and implementation and evaluation of these programs. Treatment of musculoskeletal disorders. An important topic within this theme is research on the (cost) effectiveness of treatments that improve societal participation of patients with musculoskeletal disorders.
Annual Report 2014 | EMGO+ | 13
2
ORGANIZATION
Figure 2: Organization of the EMGO + Institute in 2014
Annual Report 2014 | EMGO+ | 14
2
ORGANIZATION
Strategic management lies with the Executive Board consisting of the Director and two members selected from the heads of the departments participating in the EMGO + Institute. Figure 2 outlines the organization of the EMGO + Institute. The Executive Board answers to the Board of Deans representing the VU University Medical Center, VU University Faculty Earth and Life Sciences, and VU University Faculty Psychology and Education. Strategic advice on positioning of the institute in the national and international context is obtained from the External Advisory Board, the composition of which is shown in table 1.
Name
Affiliation
Function
Drs. A.M.P. van Bolhuis
National Institute for Public Health and the Environment (RIVM) University of Leiden
Director Public Health and Health Services
Prof. dr. S.E. Buitendijk Prof. dr. R. van Dyck (chair)
Prof. dr. V.W.M. van Hinsbergh
Prof. dr. J.A. Knottnerus
Dr. H. Kroneman Prof. dr. K. Stronks
Vice Rector Magnificus and member of the Executive Board VU University Medical Center Emeritus professor Psychiatry, former head of the department of Psychiatry VU University Medical Center Emeritus professor Physiology, former Director of the Institute for Cardiovascular Research ICaR-VU Scientific Council for Chair WRR / Professor of Government Policy (WRR) / General Medicine Maastricht University Department for Social Chief Medical Officer Benefits (UWV) Academic Medical Center Head of the department of Amsterdam, University of Social Medicine, Amsterdam Amsterdam Medical Center
Table 1: Advisory Board of the EMGO + Institute in 2014
Intercollegiate connectivity with the directors of the four other VUmc research institutes is realized by VUmc Research Council membership of the EMGO + director. The Research Council, headed by the VUmc dean, takes responsibility for general research policy and the research infrastructure of the VUmc. The Research Council also provides advice to the VUmc Executive Board on how to spend the ex-ante research funding part of the VUmc performance-based funding model. Intercollegiate connectivity with the directors of the other VU research institutes is realized by participation of the EMGO + director in the biannual discussion of general VU research policy of the Rector with all research institute directors and the Faculty research directors.
Annual Report 2014 | EMGO+ | 15
2
ORGANIZATION Departments
Head of department
VU
FALW Health Sciences (incl. Nutrition and Health) FPP Biological Psychology
VU
FPP Clinical Psychology
VU
FPP Developmental Psychology Hans Koot FPP Clinical Child & Family Carlo Schuengel Studies
VU
VU
Research staff in numbers in FTE
Maurits van Tulder
63
31,6
Dorret Boomsma
25
14,7
Pim Cuijpers
60
31,3
21
13,2
28
11,3
197
102,1
total VU VUmc Anesthesiology Clinical Genetics (incl. VUmc Community Genetics) Clinical Pharmacology & VUmc Pharmacy VUmc Epidemiology & Biostatistics General Practice & Elderly Care VUmc Medicine Internal Medicine (incl. VUmc Endocrinology; Nutrition and Dietetics)
Stephan Loer
5
2,3
Hanne Meijers-Heijboer
17
6,8
Noortje Swart
3
1,1
Johannes Brug
59
27,2
Henriëtte van der Horst
64
30,7
Mark Kramer
12
4,5
VUmc Medical Humanities
Guy Widdershoven
34
17,7
VUmc Medical Psychology
Frank Snoek
10
5,3
VUmc Midwifery Science
Gea Vermeulen
17
6,8
VUmc Obstetrics & Gynaecology
Christianne de Groot
4
1,6
VUmc Ophthalmology Otolaryngology, Head & Neck VUmc Surgery Pediatrics (incl. Child & VUmc Adolescent Psychiatry) VUmc Psychiatry - GGZ inGeest
Stevie Tan
8
3,4
René Leemans
19
7,6
Hans van Goudoever
28
12,3
Aartjan Beekman
69
30,9
VUmc Public & Occupational Health
Willem van Mechelen
112
47,9
VUmc Rehabilitation Medicine
Vincent de Groot
9
3,1
total VUmc
470
209,2
total
667 *
311,3
Table 2: Departments participating in the EMGO + Institute in 2014 *16 researchers are employed by multiple departments (15 by two and 1 by three departments), so grand total of EMGO + researchers is 650.
Annual Report 2014 | EMGO+ | 16
2
ORGANIZATION
Day-to-day management The Director and the Manager assisted by administrative support staff and three Committees carry out the day-to-day management of the institute. The Science Committee discusses and, with the help of reviewers, judges all project proposals and consists of a mix of midcareer and senior scientists representing EMGO + scientific and methodological expertise. The quality officer chairs the Quality Committee. Their role is to introduce all EMGO+ researchers to the quality guidelines laid down in the EMGO + quality handbook (http://www.emgo.nl/kc/), to advise on policies regarding scientific quality and integrity, and to perform yearly audits of research projects. The PhD Committee organizes the introductory day for PhDs, maintains an intervision system for PhDs, and reviews the PhD training- and education plans. It also produces PhD handbooks with tips and tricks, including the recently produced ‘Finish your PhD’ manual to guide students through the final six months of their PhD project.
Program directors The eight program directors provide the scientific leadership of the institute. Per program two directors ensure sufficient interfaculty cross talk and scientific focus within the program. Together with the Executive Board they facilitate productivity in scientific and societal output as well as in external fund raising. Broad support for scientific and strategic policy is ensured through quarterly meetings of the Executive Board and program directors with the Management Committee that consists of the heads of participating departments (listed in table 2).
Multidisciplinary nature of the Institute The multidisciplinary nature of the EMGO+ Institute is amply illustrated by the diversity of the participating departments listed in table 2. At the VU University the largest contribution comes from the Health Sciences and Clinical Psychology departments, whereas at the VU University Medical Center the departments of Public and Occupational Health, General Practice & Elderly Care Medicine, Epidemiology and Biostatistics, and Psychiatry are the largest contributors in keeping with the extramural roots of the institute. However, there is also a strong contribution of a diversity of clinical departments (e.g. Clinical Genetics, Otolaryngology, Head & Neck Surgery, Medical Psychology, Internal Medicine, Rehabilitation Medicine) reflecting the importance of clinical evaluation research and evidence-based practice in trans- and intramural research.
Annual Report 2014 | EMGO+ | 17
3
COMPOSITION
The total number of scientific personnel in 2014 was 650 individuals amounting to ~312 full time research FTE committed to the EMGO + Institute. The VU University Medical Center is the largest contributor with ~210 research FTE, followed by Psychology and Education (~71 research FTE) and Earth and Life Sciences (~32 research FTE). The ratio VU / VUmc formation in FTE is 33% / 67%. The break down per job category is provided in table 3. Scientific core staff includes professors, associate professors, assistant professors. Other scientific staff includes senior researchers, postdocs and junior researchers. PhD students consist of standard PhDs (employed) and contract PhDs (externally or internally funded, but not employed). To provide a historical context, the data from previous years has been added. The full list of the 650 EMGO+ researchers is provided in appendix 1 (see www.emgo.nl/ annual-report). To unambiguously define EMGO + researchers the following definitions, in accordance with the VU University guidelines, were used throughout: An EMGO+ researcher is any tenured or untenured academic personnel that has been listed as part of EMGO+ by one of the department heads in table 2, or takes part in an EMGO+ project, where An EMGO+ project is any project that has been reviewed by the Science Committee and positively judged to fit the EMGO + research programs and to be of sufficient scientific and methodological quality. For each EMGO+ researcher the department head is asked to indicate the total amount of time (in FTE) that the researcher spends on EMGO + projects; this is the basis of the research FTE in table 3. We compare the indicated research time to the mean research time for the rank of the researcher (e.g. postdoc 100%, assistant professor 60%, associate professor 40% and full professor 30%) and ask the heads of department for confirmation in case of a large deviation.
Selection of participants The above-mentioned definitions also largely determine how researchers are selected to be part of the EMGO+ Institute. Selection is primarily based on the department to which the individual belongs, where the individual must also be participating in one or more projects approved by the Science Committee in the past three years. The selection of EMGO+ departments is done by the Executive Board, in close consultation with the Management Committee. Current EMGO+ departments have been carried forward from 2013. New departments can apply for EMGO + membership if the bulk of their research falls in one or more of the research themes of the four programs and if they have a good track record in publication and fund raising. A good track record is defined relative to the average EMGO+ performance, using a minimum of 75% of the average over the past two years as a guideline. The Executive Board decides whether the research of the department fits the EMGO + themes after seeking the advice of the program directors. New departments can obtain an affiliate membership status for two years (after which membership is reevaluated). During this period input and output of the affiliated groups are not yet incorporated in the tables of this annual report. Annual Report 2014 | EMGO+ | 18
3
COMPOSITION
EMGO+ Institute
2009
2010
2011
2012
2013
2014
Scientific core staff *
54,8
74,0
74,9
63,8
74,5
60,9
PhD students
97,3
109,4
117,3
133,8
138,4
136,4
Other scientific staff
94,7
101,7
99,4
101,1
101,9
113,9
Total research staff
246,8
285,0
291,5
298,7
314,8
311,3
Lifestyle, Overweight and Diabetes
2009
2010
2011
2012
2013
2014
Scientific core staff
13,3
16,3
15,5
16,1
20,0
11,4
PhD students
23,6
26,3
23,8
21,1
22,2
26,7
Other scientific staff Total research staff
29,2
29,6
31,3
23,2
23,6
28,4
66,1
72,2
70,6
60,4
65,8
66,5
Mental Health
2009
2010
2011
2012
2013
2014
Scientific core staff
16,3
22,7
22,6
22,5
24,7
25,0
PhD students
40,1
45,8
53,1
46,2
49,1
57,4
Other scientific staff Total research staff
27,0
28,7
19,8
33,3
29,2
38,7
83,4
97,2
95,5
102,0
102,9
121,2
Quality of Care
2009
2010
2011
2012
2013
2014
Scientific core staff
14,3
19,3
22,5
14,3
19,4
16,9
PhD students
19,6
20,0
20,7
42,7
41,0
36,2
Other scientific staff Total research staff
23,0
27,5
36,1
36,1
41,4
36,7
56,9
66,8
79,3
93,1
101,9
89,8
Musculoskeletal Health
2009
2010
2011
2012
2013
2014
Scientific core staff
10,9
15,7
14,2
10,9
10,4
7,6
PhD students
14,0
17,3
19,7
23,8
26,1
16,1
Other scientific staff Total research staff
15,5
15,8
12,3
8,6
7,7
10,1
40,4
48,9
46,2
43,2
44,2
33,8
Table 3: Total research FTE for the institute and per program * in the SEP for the previous years (2009-2015) a distinction in the job categories was made between: i) tenured staff (professors, associate professors, assistant professors and senior researchers); and ii) non-tenured staff (junior researchers and postdocs). The numbers in this table from the years 2009-2013 still correspond with this approach (tenured staff – scientific core staff / non-tenured staff – other scientific staff). In the 2015-2021 SEP (the protocol used in this annual report) senior researchers are listed in the job category ‘other scientific staff’, explaining the increase in this category and the parallel decrease in FTE in scientific core staff.
Financial input Table 4 provides an overview of the various sources for financing the research personnel in the EMGO+ Institute. A total of 26% of the researchers’ salaries comes from direct University funding (‘1e geldstroom’). 72% comes from public funding agencies like ZonMw, NWO and the European Union, or the Ministry of Health and Welfare, or from charitable societies and charity funds like the Dutch Heart Foundation. Currently only a small part of the total amount of FTE’s is funded by industry (~2%). Annual Report 2014 | EMGO+ | 19
3
COMPOSITION
EMGO+ Institute
2009 2010 2011 2012 2013 2014 2014
Direct funding Research staff: Research grants (RG)
79,5 66,4
86,8 89,8
81,5 92,0
26% 30%
Research staff: Contract research (CR)
91,1
99,8 112,5 137,3 148,1 131,3
42%
Research staff: Other funding (OF)
9,8
8,6
80,9 93,3 4,8
74,6 81,6 5,3
79,3 83,1 4,3
6,4
External funding (total RG + CR + OF) 167,3 198,3 210,6 224,1 235,5 229,8
2% 74%
Total internal+external
246,8 285,0 291,5 298,7 314,8 311,3 100%
Lifestyle, Overweight and Diabetes
2009 2010 2011 2012 2013 2014 2014
Direct funding Research staff: Research grants (RG)
21,3 17,8
23,9 17,2
20,2 20,6
22,5 13,8
20,7 14,3
14,5 16,1
22% 24%
Research staff: Contract research (CR)
24,4
24,7
27,6
22,5
29,9
32,8
49%
Research staff: Other funding (OF)
2,6
6,4
2,2
1,6
0,9
3,1
5%
External funding (total RG + CR + OF)
44,8
48,3
50,4
37,9
45,2
52,0
78%
Total internal+external
66,1
72,2
70,6
60,4
65,8
66,5
100%
Mental Health
2009 2010 2011 2012 2013 2014 2014
Direct funding Research staff: Research grants (RG)
26,9 22,4
29,7 39,5
29,3 40,7
23,7 38,8
29,4 39,0
34,8 51,6
29% 43%
Research staff: Contract research (CR)
30,8
27,5
25,3
38,7
34,5
34,3
28%
Research staff: Other funding (OF)
3,3
0,6
0,2
0,8
0,0
0,5
0%
External funding (total RG + CR + OF)
56,5
67,5
66,2
78,3
73,5
86,4
71%
Total internal+external
83,4
97,2
95,5 102,0 102,9 121,2 100%
Quality of Care
2009 2010 2011 2012 2013 2014 2014
Direct funding Research staff: Research grants (RG)
18,3 15,3
12,7 21,8
11,9 21,6
14,6 18,0
13,5 21,0
16,6 18,6
18% 21%
Research staff: Contract research (CR)
21,0
30,6
43,3
57,7
64,0
51,8
58%
Research staff: Other funding (OF)
2,3
1,6
2,4
2,8
3,4
2,8
3%
External funding (total RG + CR + OF)
38,6
54,1
67,3
78,5
88,3
73,3
82%
Total internal+external
56,9
66,8
79,3
93,1 101,9 89,8
100%
Musculoskeletal Health
2009 2010 2011 2012 2013 2014 2014
Direct funding Research staff: Research grants (RG)
13,0 10,9
20,5 11,3
19,5 10,4
13,8 11,0
15,7 8,8
15,7 5,7
46% 17%
Research staff: Contract research (CR)
14,9
17,0
16,3
18,4
19,7
12,4
37%
Research staff: Other funding (OF)
1,6
0,0
0,0
0,0
0,0
0,0
0%
External funding (total RG + CR + OF)
27,4
28,4
26,7
29,4
28,5
18,1
54%
Total internal+external
40,4
48,9
46,2
43,2
44,2
33,8
100%
Table 4: Sources of funding of the research staff for the institute and per program (in FTE’s)
Annual Report 2014 | EMGO+ | 20
4 RESEARCH ENVIRONMENT AND EMBEDDING EMGO+ researchers have extensive national and international collaborations, the majority of which are academic in nature and concern joint participation in program grants (e.g. KP7 EU), multicenter trials, meta-analytic consortia, exchange of datasets and software tools, exchange of staff and (PhD) students, European policy development, and joint papers or educational modules. 71% of the 184 recorded research collaborations are international in nature, spanning 31 different countries on all continents (a collaboration may include several countries). Main international ties are with the UK (44), the USA (41 contacts), Germany (22 contacts), Spain (12 contacts), Sweden (11 contacts) and Australia and Denmark (both 10 contacts). A word cloud of the cities to which EMGO + is connected is shown in figure 3. The full list of recorded collaborations is provided in appendix 2 (see www.emgo.nl/annual-report, for most consortia and other research networks, only the coordinating institute is specified in the appendix).
Figure 3: Cities of universities, institutes, centers, and hospitals with which EMGO + collaborated in 2014. Font size reflects the amount of collaborations with the same city
There are 25 professors by special appointment active in the EMGO + Institute, usually on the basis of a 0.2 FTE appointment. An important function of the special professorships is to link EMGO+ to non-university based research institutes and societal stakeholders in health care research, like health insurance companies, (mental) health care providers or national research institutes such as NIVEL, RIVM and TNO. In 2014 EMGO + had 6 visiting professors and 16 visiting researchers all with an honorary appointment (presence at the institute is typically condensed in a few periods of weeks/months yearly). These appointments support longstanding international collaborations or act to forge new ones. A full list of professors by special appointment and visiting professors is provided in appendix 3 (see www.emgo.nl/annual-report). Annual Report 2014 | EMGO+ | 21
Figure 4: Some of the universities/institutes with which EMGO + researchers collaborated in 2014
Annual Report 2014 | EMGO+ | 22
5
QUALITY AND SCIENTIFIC RELEVANCE
Although not perfect, journal impact factors provide an international benchmark to test the quality of the scientific output of the institute. With help of the VUmc METIS officer, we obtained the relative impact factors of all journals in which we publish using Thomson Reuter’s journal citation reports (JCR) table. This table assigns all journals to a number of domains and computes the relative ranking of the journal within its own domain. All EMGO+ publications were then classified by the rank order of the journal as belonging to the top 10% or top 25% in their respective domain. We then counted the number of publications in top 10% and top 25% for the entire institute and each of the four programs. As shown in table 5, more than a quarter of our publications is in the top 10% of its field and another 57% belongs to the top 25%. EMGO+
LOD
MH
QoC
MSH
1209
236
419
334
220
Top 10% impact factor
317 (26%)
53 (22%)
134 (32%)
67 (20%)
63 (29%)
Top 25% impact factor
686 (57%) 148 (63%) 254 (61%) 155 (46%)
129 (59%)
Refereed articles
Table 5: Total number of refereed publications in 2014 and proportion in top 10% and top 25% journals in the relevant research field
Below we give a few examples of representative publications per program, as well as general scientific highlights. Taken together we conclude that our scientific output remains to be of the highest standard while maintaining a strong emphasis on applied medical research.
Lifestyle, Overweight and Diabetes 2014 Highlights Pocket Guide Dietetics launched: This pocket guide, authored by Hinke Kama and Nicolette Walford at the VU department of Dietetics & Food Sciences, provides an overview of definitions, norm values and cut points for optimal diagnosis of nutritional status. The city of Amsterdam, VU/VUmc, UvA/AMC and HvA jointly agreed to invest 8 million Euro in the Sarphati Institute, a unique ‘triple helix’ research institute in which the University, industry and government join forces in the field of public health combating overweight, diabetes and cardiovascular disease. Willem van Mechelen’s honorary visiting professorship at the University College Dublin (UCD) has been extended for a period of four years. Earlier in 2011 Van Mechelen was appointed as visiting professor at the UCD for a period of three years. For the period of his appointment Van Mechelen will be assigned to the UCD School of Public Health, Physiotherapy and Population Sciences. Ingeborg Brouwer was appointed full professor of Nutrition for Healthy Living with special emphasis on fatty acids at the VU department of Health Sciences. Annual Report 2014 | EMGO+ | 23
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QUALITY AND SCIENTIFIC RELEVANCE At the annual symposium of the Netherlands Society for Human Movement Sciences (VvBN), the VvBN Dissertation Award was awarded to Judith de Meij for her thesis entitled ‘Jump-in, development and evaluation of an intervention to promote sports participation and physical activity in children’. De Meij prepared her thesis within the EMGO + Institute and the VUmc department of Public & Occupational Health. Giel Nijpels was appointed Knight of the Order of OrangeNassau. He received this royal award for his services to healthcare in general and in particular for the health of diabetes patients. Nijpels was honored during the farewell symposium in honor of his retirement. Gerrit van den Berg’s paper ‘Explaining Socioeconomic Inequalities in Childhood Blood Pressure and Prehypertension: The ABCD Study’ was selected as one of the Hypertension Top Papers for 2014 in the category of population science. The editors of Hypertension established this award to recognize the best original papers published in the Journal in the categories of basic, clinical, or population sciences.
2014 Key publications & chapters Ballegooijen, A.J. van, Kestenbaum, B., Sachs, M.C., Boer, I.H. de, Siscovick, D.S., Hoofnagle, A.N., Ix, J.H., Visser, M. & Brouwer, I.A. (2014). Association of 25Hydroxyvitamin D and Parathyroid Hormone With Incident Hypertension MESA (Multi-Ethnic Study of Atherosclerosis). Journal of the American College of Cardiology, 63(12), 1214-1222. 10.1016/j.jacc.2014.01.012 Huppertz, C., Bartels, M., Jansen, I.E., Boomsma, D.I., Willemsen, G., Moor, M.H.M. de & Geus, E.J.C. de (2014). A Twin-Sibling Study on the Relationship Between Exercise Attitudes and Exercise Behavior. Behavior Genetics, 44(1), 45-55. 10.1007/s10519-013-9617-7 Poelman, M.P., Vet, E.W.M.L. de, Velema, E., Seidell, J.C. & Steenhuis, I.H.M. (2014). Behavioural strategies to control the amount of food selected and consumed. Appetite, 72, 156-165. 10.1016/j.appet.2013.09.015 Pols-Vijlbrief, R. van der, Dekker, J.M., Stehouwer, C.D.A., Boer, M.R. de, Nijpels, G., Snoek, F.J. & Adriaanse, M.C. (2014). Symptom burden and its association with change in glucose metabolism status over a 7-year period: the Hoorn Study. Diabetic Medicine, 31(6), 747-753. 10.1111/dme.12406. Velde, S.J. te, Chin A Paw, M.J.M., Bourdeaudhuij, I. de, Bere, E., Maes, L., Moreno, L., Jan, N., Kovacs, E., Manios, Y. & Brug, J. (2014). Annual Report 2014 | EMGO+ | 24
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QUALITY AND SCIENTIFIC RELEVANCE Parents and friends both matter: simultaneous and interactive influences of parents and friends on European schoolchildren's energy balance-related behaviours - the ENERGY cross-sectional study. International Journal of Behavioral Nutrition and Physical Activity, 11, 82.
Number of articles in top 10% of the publications relevant to the discipline: 53 Number of articles in top 25% of the publications relevant to the discipline: 148
Mental Health 2014 Highlights Researchers from our Mental Health program obtained two new large Horizon 2020 EU-projects, both led by our University. Researchers from the VU department of Biological Psychology (Bartels/Boomsma) received funding for the ACTION project, to examine aggression in young children. In addition, researchers from the VUmc department of Psychiatry (Smit) and VU department Clinical Psychology (Riper) received new funding for the MASTERMIND project which will examine the management of mental health disorders through advanced technology and services (teleHealth). Dorret Boomsma was selected as Academy Professor from the Dutch Royal Academy of Sciences and Arts (KNAW) which allows her to focus for the coming five years on specific research activities. Three large new grants were obtained: Pol van Lier received an ERC Consolidator Grant in which he will examine how early peer relations affect DNA methylation and neurocognitive development in children. Another project, led by Annemieke van Straten (funded by ZonMw Doelmatigheid), will examine the effectiveness of online cognitive behavioural therapy in insomnia. In addition, Aartjan Beekman and Jack Dekker received a large NWO ‘Geweld tegen Psychiatrische Patienten’-research grant to examine victimization in depressed patients. The Netherlands Study of Depression and Anxiety (NESDA) has obtained a renewal of structural VU University Medical Center funding to continue the existing research infrastructure and conduct new follow-up assessments in the subsequent five years. At the VUmc department of Psychiatry, Patricia van Oppen was appointed full professor of Psychotherapy in the Psychiatry. Berno van Meijel received an honorary professorship on Mental Health Nursing in close collaboration with the Hogeschool InHolland and Parnassia. 2014 Key publications & chapters Cuijpers, P., Vogelzangs, N., Twisk, J., Kleiboer, A.M., Li, J. & Penninx, B.W. (2014). Comprehensive meta-analysis of excess mortality in depression in the general community versus patients with specific illnesses. American Journal of Psychiatry, Annual Report 2014 | EMGO+ | 25
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QUALITY AND SCIENTIFIC RELEVANCE 171(4), 453-462. Dols, A., Kupka, R.W., Lammeren, A. van, Beekman, A.T., Sajatovic, M. & Stek, M.L. (2014). The prevalence of latelife mania: a review. Bipolar Disorders, 16(2), 113-118. Verhoeven, J.E., Revesz, D., Epel, E.S., Lin, J., Wolkowitz, O.M. & Penninx, B.W.J.H. (2014). Major depressive disorder and accelerated cellular aging: results from a large psychiatric cohort study. Molecular Psychiatry, 19(8), 895-901. Wiersma, J.E., Schaik, D.J.F. van, Hoogendoorn, A.W., Dekker, J.J.M., Van, H.L., Schoevers, R.A., Blom, M.B.J., Maas, K., Smit, J.H., McCullough, J.P., Beekman, A.T.F. & Oppen, P.C. van (2014). The effectiveness of the cognitive behavioral analysis system of psychotherapy for chronic depression: A randomized controlled trial. Psychotherapy and Psychosomatics, 83(5), 263-269. Wright, F.A., Sullivan, P.F., Brooks, A.I., Zou, F., Sun, W., Xia, K., Madar, V., Jansen, R., Chung, W., Zhou, Y.H., Abdellaoui, A., Batista, S., Butler, C., Chen, G., Chen, T.H., D’Ambrosio, D., Gallins, P., Ha, M.J., Hottenga, J.J., Huang, S., Kattenberg, V.M., Kochar, J., Middeldorp, C.M., Qu, A., Shabalin, A., Tischfield, J., Todd, L., Tzeng, J.Y., Grootheest, G., Vink, J.M., Wang, Q., Wang, W., Wang, W., Willemsen, G., Smit, J.H., Geus, E.J.C. de, Yin, Z., Penninx, B.W.J.H. & Boomsma, D.I. (2014). Heritability and genomics of gene expression in peripheral blood. Nature Genetics, 46(5), 430-437. Ballegooijen, W. van, Cuijpers, P., Straten, A. van, Karyotaki, E., Andersson, G., Smit, J.H. & Riper, H. (2014). Adherence to internet-based and face-to-face cognitive behavioural therapy for depression: a meta-analysis. PLoS One, 9:e100674(7).
Number of articles in top 10% of the publications relevant to the discipline: 134 Number of articles in top 25% of the publications relevant to the discipline: 254
Quality of Care 2014 Highlights On January 20th, 2014 the International School for Philosophy (‘Wijsbegeerte’; ISVW) officially launched its vocational education on Moral Case Deliberation. Amongst the initiators and supervisors of this job training are two members of EMGO+’s Quality of Care program: Bert Molewijk en Guy Widdershoven. Bert Molewijk also co-edited the Dutch Handbook on moral case deliberation which was published in 2014. Dorly Deeg and Suzan van der Pas received a prestigious NETSPAR Theme Grant. With the use of LASA data, they will investigate changes in retirement ages for pensioners, health, income and death. Annual Report 2014 | EMGO+ | 26
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QUALITY AND SCIENTIFIC RELEVANCE Eileen Hutton received the Lifetime Achievement Award 2014 from the Association of Ontario Midwives. Eileen Hutton is the first professor of midwifery in the Netherlands. She assisted in the creation of a PhD program at the EMGO + Institute to prepare midwives for academia. The quality of care research project entitled ‘Is physicianassisted death on its way to becoming normal medical treatment?’ (Public Health at the End of life) was awarded for funding in the VUmcAMC call-for-joint-proposals. The project leaders from VUmc are Bregje OnwuteakaPhilipsen en Guy Widdershoven and from AMC Dick Willems en Susan van de Vathorst.
2014 Key publications & chapters Houwink, E.J.F., Muijtjens, A.M.M., Teeffelen, S.R. van, Henneman, L., Rethans, J.J., Jagt, L.E.J. van der, Luijk, S.J. van, Dinant, G.J., Vleuten, C. van der & Cornel, M.C. (2014). Effectiveness of oncogenetics training on general practitioners' consultation skills: a randomized controlled trial. Genetics in Medicine, 16(1), 4552. 10.1038/gim.2013.69 Oosterveld-Vlug, M.G., Pasman, H.R.W., Gennip, I.E. van, Muller, M.T., Willems, D.L. & Onwuteaka-Philipsen, B.D. (2014). Dignity and the factors that influence it according to nursing home residents: a qualitative interview study. Journal of Advanced Nursing, 70(1), 97-106. 10.1111/jan.12171 Zekveld, A.A., Heslenfeld, D.J., Johnsrude, I.S., Versfeld, N.J. & Kramer, S.E. (2014). The eye as a window to the listening brain: Neural correlates of pupil size as a measure of cognitive listening load. NeuroImage: Clinical, 101, 76-86. 10.1016/ j.neuroimage.2014.06.069 Roo, M.L. De, Miccinesi, G., Onwuteaka-Philipsen, B.D., Noortgate, N. Den, Block, L., Bonacchi, A., Donker, G.A., Alonso, J.E.L., Moreels, S., Deliens, L. & Francke, A.L. (2014). Actual and Preferred Place of Death of Home-Dwelling Patients in Four European Countries: Making Sense of Quality Indicators. PLoS One, 9(4), e93762. Dessel, N. van, Boeft, M. den, Wouden, J.C. van der, Kleinstauber, M., Leone, S.S., Terluin, B., Numans, M.E., Horst, H.E. van der & Marwijk, H.W.J. van (2014). Nonpharmacological interventions for somatoform disorders and medically unexplained physical symptoms (MUPS) in adults. Cochrane Database of Systematic Reviews, 11, CD011142. Number of articles in top 10% of the publications relevant to the discipline: 67 Number of articles in top 25% of the publications relevant to the discipline: 155
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QUALITY AND SCIENTIFIC RELEVANCE
Musculoskeletal Health 2014 Highlights The Amsterdam Collaboration on Health & Safety in Sports (a joint initiative of VUmc and AMC) was recognized by the International Olympic Committee (IOC) as IOC Research Center for Prevention of Injury and Protection of Athlete Health. Vincent de Groot was appointed as full professor of Rehabilitation Medicine. Martine Crins, PhD student, won the prize for the best student presentation ISOQOL at the Annual Conference of the International Society for Quality of Life Research for her presentation on ‘Dutch- versus English-language calibrations: Impact on theta estimates of the Dutch-Flemish PROMIS Pain Behavior and Pain Interference Item Banks’. Maurits van Tulder was ranked first of a group of 33,200 other researchers in the Expertscape’s ranking, making him the world’s most leading back pain expert. The Expertscape classification is based on an objective data-driven tool using the number of peer-reviewed publications in PubMed. Joost Dekker obtained a large grant from the EU (€ 517.000) grant for a study on Prevention and personalized treatments in knee osteoarthritis. 2014 Key publications & chapters Buffart, L.M., Galvao, D.A., Brug, J., Chin A Paw, M.J.M. & Newton, R.U. (2014). Evidence-based physical activity guidelines for cancer survivors: Current guidelines, knowledge gaps and future research directions. Cancer Treatment Reviews, 40(2), 327-340. Coenen, P., Gouttebarge, V., Burght, A.S.A.M. van der, Dieen, J.H. van, Fringsdresen, M.H.W., Beek, A.J. van der & Burdorf, A. (2014). The effect of lifting during work on low-back pain – a health impact assessment based on a metaanalysis. Occupational and Environmental Medicine, 71(12), 871-877. Holla, J.F.M., Leeden, M. van der, Heijmans, M.W., Roorda, L.D., Bierma-Zeinstra, S.M.A., Boers, M., Lems, W.F., Steultjens, M.P.M. & Dekker, J. (2014). Three trajectories of activity limitations in early symptomatic knee osteoarthritis: a 5-year follow-up study. Annals of the Rheumatic Diseases, 73(7), 1369-1375. Janssen, K.W., Hendriks, M.R.C., Mechelen, W. van & Verhagen, E. (2014). The CostEffectiveness of Measures to Prevent Recurrent Ankle Sprains Results of a 3-Arm Randomized Controlled Trial. American Journal Sports Medicine, 42(7), 1534-1541. Kamper, S.J., Apeldoorn, A.T., Chiarotto, A., Smeets, R.J.E.M., Ostelo, R.W.J.G., Guzman, J. & Tulder, M.W. van (2014). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain. Cochrane Database of Systematic Reviews, 9, CD000963. Annual Report 2014 | EMGO+ | 28
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Number of articles in top 10% van de publications relevant to the discipline: 63 Number of articles in top 25% van de publications relevant to the discipline: 129
Affiliated members Department Athena (hereafter Athena) has been an affiliated partner of EMGO + since 2013. Athena is part of the VU University’s Faculty of Earth and Life Sciences and its mission is to realize excellence in transdisciplinary research on innovation and communication in the health and life sciences, with a specific focus on processes of social inclusion and diversity. The central question in the Athena research program is how science and technology can contribute to the improvement of health and well-being and sustainable development in an equitable manner. Research is focused on the domains of health and sustainable development. Within the domain of health, research is conducted on four themes: citizen/patient participation in health research, care and policy; mental health and disability, human rights and participation; maternal health; sustainable health systems. About three-quarter of the research projects in this domain are located in the Netherlands, the others are executed in countries such as India, Indonesia, Vietnam, Ethiopia, Tanzania, South Africa and thus focus on global health. 21 researchers of Athena participated in EMGO + (part-time), equaling a research staff involvement of 8.0 FTE. One of Athena’s researchers is a member of the Science Committee of EMGO+. The output for 2014 realized by Athena staff participating in EMGO+ in the domain of health is listed in appendix 19 as well as the acquired projects in 2014 (see www.emgo.nl/annual-report). The Center of Expertise on Gender Dysphoria (GD) of VUmc is the only center in the Netherlands that offers a complete package of multidisciplinary care for gender dysphoric people of all ages. GD is the feeling of incongruence between the experienced gender and the assigned sex. In severe GD, persons may wish to change their body in line with their gender identity by medical treatment. Once transgenderism is diagnosed, the person undergoes a comprehensive treatment program including lengthy hormone treatment to acquire more masculine or feminine features, and finally, if desired, gender confirming surgery. The care of people with GD is complex and sustained, and involves many disciplines which all cooperate within the center. The treatment is organized in a health care regime which takes more than four years. More than 5,000 patients have been treated in this center, and annually over 400 adults, adolescents and children present themselves for treatment. The research of the center is subdivided research in three main themes: Fundamental Studies, Etiology and Development and Quality of Care. The general aim of the multidisciplinary research is to better understand the condition, to better understand the effects and side effects of treatment, and to develop and improve quality of care for subjects with gender dysphoria. Towards this aim studies are performed to increase basic knowledge and to study etiology and development of the disorder. Furthermore, the research group aims to improve and develop treatment strategies, investigate the effects of treatments, and assess quality of care. The output for 2014 realized by GD staff participating in EMGO + is listed in appendix 19 (see www.emgo.nl/annual-report). Annual Report 2014 | EMGO+ | 29
Triple-E (EMGO+eHealth-Excellence) Triple-E is a research network from VUmc, VU University and GGZ inGeest, wherein close multidisciplinary collaboration in the field of e(Mental) Health is initiated and facilitated. Triple-E aims to improve the accessibility, quality and (cost-) effectiveness of the (mental) healthcare for patients through the use of innovative ICT and improved multi-disciplinary collaboration. This means prevention, treatment and tailored care preferably in the natural environment of the patient, and with the patient in control. In this network all relevant stakeholders’ perspectives are accounted for, such as patients, health care providers, health insurance companies, governmental bodies, health care related industries and technology developers. One of the main challenges is to integrate and translate research outcomes into routine healthcare programs. Leading position: Triple-E is an ambitious initiative to strengthen the leading position of the Netherlands in the field of eMental Health and to expand it to eHealth in general. It presents the Amsterdam metropolitan region as a leading international eHealth knowledge network, and the Amsterdam Zuidas as a European core area of multi-disciplinary scientific research and economic eHealth activities. Thanks to the efforts of the researchers connected within Triple-E, the Netherlands may strengthen this ambition of tailored and (cost-) effective care and its leading position in the field of eHealth. This leading position of the Netherlands is not only shown by the large number of (inter)national scientific publications and current research projects. The Netherlands is currently a world leader in the implementation of eMental-Health in health care practice. Furthermore, eHealth is prominently reflected in Dutch policy objectives and actions of relevant stakeholders, such as the Ministry of Health, health insurers and innovative industrial partners. For more information, visit: www.triple-emgo.nl
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Dutch Research Center for Insurance Medicine (KCVG) The Dutch Research Center for Insurance Medicine (Kenniscentrum Verzekeringsgeneeskunde (KVCG)) is a joint initiative of the Coronel Institute of Occupational Health from the Academic Medical Center, the Department of Social Medicine from the University Medical Center Groningen, the Department of Public and Occupational Health within VU University Medical Center, and the Social Medical Affairs Division of the Dutch Employee Insurance Schemes Implementing Body (Uitvoeringsinstituut Werknemersverzekeringen (UWV)). The mission of the KVCG is to contribute to the optimal social participation of the working age population with health problems through optimizing insurance medicine assessment and guidance.
Aim of the KCVG The aim of the KCVG research programme is to develop scientifically based methods, guidelines and tools for insurance medicine, and to determine the effectiveness of interventions. The UVW has set up an academic workplace that provides the KCVG with manpower, experience and a large database with data related to benefits. Some of the subjects that are dealt with by the KCVG are: (1) causes and consequences of health-related incapacity for work; (2) prevention and reduction of health-related incapacity for work; and (3) consequences of new nationwide regulations for insurance medicine. KCVG further promotes the quality and scientific basis of insurance medicine by developing and evaluating methods, guidelines, tools and interventions. It also aims to raise the issue of insurance medicine in medical education, and to support the medical specialist training for insurance physicians. More information: http://www.kcvg.nl/
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DEDIPAC Knowledge Hub Eating, moving and sitting. Those are the three behaviours studied by the DEDIPAC Knowledge Hub. DEDIPAC stands for ‘DEterminants of DIet and Physical ACtivity and is coordinated by prof. dr. Johannes Brug, with support of Anne Loyen, dr. Hidde van der Ploeg and dr. Jeroen Lakerveld. This three-year project brings together researchers from different disciplines and countries to understand the determinants of dietary, physical activity and sedentary behaviours. The ultimate goal is to ensure Europeans will eat healthier, move more and sit less. The Knowledge Hub hosts almost 300 researchers from approximately 70 research institutes in 12 European countries. The work is divided into three so-called Thematic Areas, which focus on 1) measurement of the behaviours, 2) determinants and 3) evaluation of interventions and benchmarking. Since EMGO+ took the lead and officially started the Knowledge Hub in December 2013 there has also been a lot of scientific progress. Around 25 systematic literature reviews have been conducted, determinant frameworks are developed and soon the practical toolboxes will become available to support researchers and policymakers with choosing the right surveillance and evaluation methods. In summary, the establishment of the DEDIPAC Knowledge Hub brought many researchers together who clearly benefit from this new infrastructure.
For more information, visit www.dedipac.eu
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Netherlands Twin Register The Netherlands Twin Register (NTR) was set up in 1987 at the VU University Amsterdam to study the contribution of genes and environment to individual differences in health, lifestyle and personality. More than 200,000 persons (twins and their family members) are now registered. These include families where the twins are followed from birth onwards with parents providing information on their development (e.g. growth, school performance, childhood problems). Teacher ratings are also obtained and at age 14 twins are asked to complete surveys themselves. The NTR also encompasses a cohort of adult twins, who have been followed from adolescence or (young) adulthood onwards, to study the development of health and psychopathology in relation to lifestyle and personality. The NTR investigates the cause of individual differences: why do some people smoke, why are some liable to depression, or ADHD? To what degree is diabetes a genetic disorder? Monozygotic twin pairs have the same DNA sequence, while dizygotic twin pairs, siblings and parents with their offspring share on average 50% of their segregating genes. Using the large data collection in twins and family members, the NTR has demonstrated the influence of genes for physiological traits (e.g. cholesterol, blood pressure), diseases such as asthma and migraine, behaviors such as smoking, exercise participation and alcohol use and psychological traits such as depression and extraversion. Currently the NTR investigates which genes influence these traits and their interplay with the environment. Twin aspects, e.g. whether twins should stay together at school, if they differ from singletons, also receive attention. NTR established national growth curves for newborn twins, and searches for the genes that cause twinning.
For more information on the NTR, see www.tweelingenregister.org
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Netherlands Longitudinal Study on Hearing (NL-SH) According to the latest available data in the Netherlands, approximately 2.2 million people over 19 years of age (17% of the population) have hearing problems. Due to the ageing of our society, this number will increase drastically in the coming years. The Netherlands Longitudinal Study on Hearing (NL-SH) is an ongoing prospective longitudinal cohort study among adults ranging from 18 to 70 years. Almost 3000 adults are participating in the study. The main aim of the NLSH is to identify the determinants of hearing impairment and the impact of hearing ability on activity and participation in a large range of life domains. These include social life, participation in work, use of health care. The NL-SH uses an online digit-triplet speech-in-noise test (known as the National Hearing Test: www.hoortest.nl) to test each individual’s hearing ability. Questionnaires administered via the internet are used to examine all other variables (e.g. general health, psychosocial health, demographics, lifestyle, medication use, coping, work characteristics (need for recovery, sick leave)). Worldwide there are only a few studies containing longitudinal data about hearing status and the effects on functioning of adults over time, indicating that the NL-SH dataset consists of unique data. Follow-up measurements are planned for every five years. The NL-SH is carried out and coordinated at the department of OtolaryngologyHead and Neck Surgery, section Ear & Hearing of the VU University Medical Center, in collaboration with the departments of Public and Occupational Health and Ophthalmology. Since 2010, Phonak AG a world-leading hearing aid manufacturer in Switzerland, is a collaborating partner. This provides exciting opportunities to share knowledge and combine research and industry perspectives.
More info: www.hooronderzoek.nl
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EDUCATION AND TRAINING
Since 1989 the department of Epidemiology & Biostatistics organizes a postgraduate epidemiology program called EpidM. The program includes a Master’s Program in Epidemiology and offers additional courses in epidemiological and advanced statistical methods. The Master’s Program is a 2,5 years, part-time program of 60 EC. The theoretical part (27 EC) consists of six compulsory courses and three optional courses. The program also includes a scientific internship (33 EC). The Master’s Program trains postgraduates from a range of disciplines (Medicine, Health Sciences, Biomedical Sciences, Pharmaceutical Sciences etc.). It focuses on applied research in primary care and public health. The program provides the methodological tools for evidence-based medicine and evidence-based health policy. The students taking part in the program are researchers (including PhD students) and professionals working in the health services field. They often combine their work (including clinical work) with research activities. The research that they carry out at their place of work represents their scientific internship. The Master’s Program has been accredited by the Accreditation Organization of The Netherlands and Flanders (NVAO). NVAO independently ensures the quality of higher education in the Netherlands and Flanders by assessing and accrediting programs and contributes to enhancing this quality. This means that upon successful completion of the program students will receive a Master of Science degree. The Master’s Program has also been visited for an external evaluation by the Dutch Epidemiological Society (Vereniging voor Epidemiologie) and they confirmed the program meets the requirements for a registration as an epidemiologist. In 2014, 22 students enrolled in the Master’s Program. Furthermore, 398 students attended one or more courses of EpidM, resulting in a total of 607 course registrations. 24% of these students were PhD students within EMGO+, 9% were researchers of the VU University Medical Center, and the remaining 67% were researchers employed at a range of other universities (including VU University). The epidemiology program EpidM is entirely funded from course fees and is not supported by regular government funding for higher education. PhD students of the EMGO + institute get a 25% discount on the course fees. The fact that the program attracts certainly enough students to be in a financially good shape, indicates that the program is well attended, and the course evaluations indicate that the program is well appreciated by the participating students. More information can be found on http://www.epidm.nl
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QUALITY CONTROL
The EMGO+ Institute has a number of institute specific resources that strongly facilitate scientific integrity and scientific quality in all phases of research, including study design, data collection, data analysis and reporting. The EMGO + Institute attaches much importance to providing an environment that encourages good conduct in research and discourages misconduct, and to providing tools that maximize high quality research. However, as the institute has no formal role in the governance of research personnel, the responsibility for actual behavior remains with the department heads.
Science Committee The Science Committee advises the Executive Board on the quality and feasibility of all research proposals that have been submitted to the Executive Board for formal inclusion in one of the EMGO+ research programs. The committee also gives solicited and unsolicited advice to the Executive Board on all matters concerning research policy, and prioritizes awards and (travel) grant proposals funded by the institute itself. The Science Committee is a representative reflection of midcareer and senior scientists in the institute with at least two members from each of the four EMGO + research programs. A proposal is first sent to the appropriate program directors to evaluate the proposal on its relevance to the EMGO+ mission and its fit within the program’s scientific mission. When both criteria are met, the scientific quality of the proposal is assessed by the Science Committee. If the proposal has been funded by a peer reviewed grant organization such as ZonMw and KWF, it will be globally assessed by one member of the Science Committee. All other proposals will be extensively reviewed by one member of the Science Committee and one senior researcher within EMGO+. The reviewers assess the theoretical soundness of the research questions, the methodological quality and the feasibility of the proposal. The reviewers are requested to return the proposal with their recommendation to the Science Committee within two weeks. The outcome categories are: Positive, with recommendations for improvement Negative, offering the possibility of resubmission after the recommendations have been processed Negative In case of a negative assessment by (one of) the reviewers, the proposal will be assessed by a second (global assessment) or third reviewer (extensive assessment) who is a member of the Science Committee. The judgment of this reviewer will be final. The Science Committee sends its advice to the Executive Board who makes a final decision regarding approval of research proposals. Only after approval of the Executive Board, a project will be embedded within EMGO+. In addition, approval of the EMGO + Science Committee is required before a project is submitted to the Medical Ethical Committee of the VU University Medical Center. Annual Report 2014 | EMGO+ | 37
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QUALITY CONTROL
A full list of discussed protocols in 2014 is presented in appendix 4 (see www.emgo.nl/ annual-report). In total, 84 research protocols were reviewed in 2014 of which 73 were approved at the end of 2014.
Quality Committee The Quality Committee is responsible for developing, implementing and maintaining a system for quality improvement and control for the institute. The system is aimed at supporting and improving the research process. Moreover, the Quality Committee advises the Executive Board on quality issues. To fulfill its tasks the Quality Committee audits research projects, maintains and expands a web-based quality manual (http://www.emgo.nl/kc/) and provides personal introductions to all newly appointed researchers within the institute. In 2014 the Quality Committee has audited ten research projects. The quality officer has given 49 personal introductions in proper scientific conduct for newly appointed investigators with a focus on privacy, medical ethical committee, experimental log books, data organization and back-up, and the guidelines in the quality manual guidelines most directly relevant to the individual researcher. Three incidents of possible violations of privacy protection were reported to the quality officer, all of which have been handled through the appropriate channels. To improve handling of privacy-sensitive data and documentation of the research process, the Quality Committee developed an action plan based on a behavioral change model. A standard file structure and a checklist for documentation became available. A set of privacy indicators was developed to create more awareness in the EMGO+ departments on the topic of privacy.
PhD Committee The PhD Committee consists of three senior investigators and four PhD students. They advise the Executive Board on matters concerning education, supervision and assessment of PhD students. The PhD Committee is responsible for reviewing the ‘education and supervision agreement’ that is designed and signed by the PhD student and supervisors at the beginning of each PhD project. This agreement lists the obligatory and individually selected courses that the student must complete alongside the PhD research project for the amount of at least 30 ECTS. The overall aim of the agreement is to ensure a course program that is tailored to the needs of the individual PhD student and project requirements. Beyond its review and advice functions, the committee organizes the introduction of new PhDs into the institute and its committees and expertise, offers assistance when PhD students find themselves in a dispute with their supervisors, and directs and supports a ‘PhD student intervision system’ that connects a group of new PhD Annual Report 2014 | EMGO+ | 38
7
QUALITY CONTROL
students to one of the PhD representatives to provide a way to discuss common or personal issues among each other. Moreover, the PhD representatives have written and are responsible for updating the ‘PhD manual’ and the ‘finish your PhD manual’, which are documents that serve PhD students with the necessary information to start and finish their PhD projects successfully. Finally, the PhD representatives have a signaling function for their research program.
Methodological expertise centers Researchers in the institute can obtain support for a number of crucial steps in the research process of which we highlight three elements here, clinimetrics, epidemiology, and statistical analysis. Knowledge center on Measurement Instruments The mission of the knowledge center on Measurement Instruments is to optimize the quality of measurement in health science and medical research by consultations, education, and research. For this purpose, the center gives advice and cooperates with researchers from different fields of health science and medical research in searching for available measurement instruments, examining the quality of the available measurement instruments, choosing the most appropriate measurement instrument for a certain purpose, and designing and performing studies on measurement properties of measurement instruments. Important international research projects are the work of the COSMIN initiative (www.cosmin.nl) which aims to improve the selection of health measurement instruments, and the Dutch-Flemish PROMIS group (www.dutchflemishpromis.nl), which aims to translate, validate, and implement high quality IRT-based PROMIS instruments and Computer Adaptive Tests in the Netherlands and Flanders. In 2014 the VUmc working group on Patient-Reported Outcome Measures (PROMs) was set up to bring researchers and clinicians in VUmc together to exchange knowledge and experience on using PROMs in research and clinical practice. Eight new grants were obtained for research on the development and validation of different measurement instruments. E&B Xpert E&B Xpert is part of the VUmc department of Epidemiology and Biostatistics. It supports researchers at the beginning of their research in choosing a study outcome, with sample size calculations and in preparing a plan for the statistical analysis of their data. E&B Xpert also assists researchers in analyzing data resulting from their studies, in presenting the results in reports and papers and in answering reviewers' questions on statistical issues. E&B Xpert supports ranges from short consultations via e-mail, telephone or in person to long-term participation in medical and biomedical research projects. Statisticians, epidemiologists, health economists and clinimetricians provide the expertise and support. Annual Report 2014 | EMGO+ | 39
Figure 5: Some EMGO + dissertations in 2014
Annual Report 2014 | EMGO+ | 40
8
SCIENTIFIC OUTPUT
Publications or other forms of scientific output are considered EMGO + output if and only if the institute has been mentioned in the affiliations of one (or more) of the co-authors, and the co-author was an EMGO+ researcher in the year of publication. Table 6 lists the number of refereed papers that were published in 2014 as well as other scientific output. Although the bulk of the output is in the form of papers in scientific journals, EMGO + researchers also produce many book chapters and professional publications in clinical practice oriented journals, thus contributing to the necessary knowledge transfer to professionals in several health care settings. Appendix 5 provides a full list of the 2014 EMGO+ publications, ordered per program and by the main categories used in table 6. EMGO+ Institute
2009
2010
2011
2012
2013
2014
Refereed articles
632
786
851
954
1124
1209
Non-refereed articles
130
157
17
18
11
5
Books and book chapters
50
131
82
110
102
65
PhD-theses
51
52
42
61
77
58
Professional publications
76
75
110
164
218
200
Publications aimed at the general public
39
4
5
18
23
23
978
1205
1107
1325
1555
1560
2009
2010
2011
2012
2013
2014
128
139
218
205
259
236
Non-refereed articles
37
15
3
2
0
1
Books and book chapters
3
15
4
17
10
4
PhD-theses
10
3
9
10
20
11
Professional publications
10
9
5
15
21
21
Publications aimed at the general public
2
1
2
2
0
2
190
182
241
251
310
275
2009
2010
2011
2012
2013
2014
245
270
288
321
376
419
Non-refereed articles
56
42
7
7
3
0
Books and book chapters
22
62
38
57
31
10
PhD-theses
16
29
18
30
28
10
Professional publications
31
12
44
49
47
54
Publications aimed at the general public
7
0
0
3
11
9
377
415
395
467
496
502
Quality of Care
2009
2010
2011
2012
2013
2014
Refereed articles
115
199
210
229
298
334
Non-refereed articles
28
76
6
8
7
4
Books and book chapters
16
47
36
32
50
35
PhD-theses
14
10
9
16
18
20
Professional publications
33
39
51
81
142
109
Publications aimed at the general public
25
3
3
11
11
12
231
374
315
377
526
514
Total publications Lifestyle, Overweight and Diabetes Refereed articles
Total publications Mental Health Refereed articles
Total publications
Total publications
Annual Report 2014 | EMGO+ | 41
8
SCIENTIFIC OUTPUT
Musculoskeletal Health Refereed articles
2009
2010
2011
2012
2013
2014
144
178
135
199
191
220
Non-refereed articles
9
24
1
1
1
0
Books and book chapters
9
7
4
4
11
16
PhD-theses
11
10
6
5
11
17
Professional publications
2
15
10
19
8
16
Publications aimed at the general public
5
0
0
2
1
0
180
234
156
230
223
269
Total publications
Table 6: EMGO+ scientific output in 2009-2014 for the institute and per program
Table 6 also lists the number of PhD theses completed in 2014. In 2014, 264 PhD students were working on their PhD thesis within the institute, representing ~137 research FTE (see table 3). 36 PhD students were external, i.e. they were not appointed by VUmc. A total of 58 PhD theses were produced in 2014, the titles of which give a very good overview of the EMGO+ research output (see appendix 6, (www.emgo.nl/annualreport).
Figure 6: FTE total research staff, number of dissertations, refereed articles, non-refereed articles and other publications
International benchmarking A major aim of the institute is to generate scientific innovation and impact, for which quality is often more important than quantity. In the Netherlands the research performance of all eight medical faculties is externally benchmarked by the Center for Science and Technology Studies (CWTS; www.cwts.nl) of the University of Leiden. This Annual Report 2014 | EMGO+ | 42
8
SCIENTIFIC OUTPUT
CWTS analysis has a one-year lag in citations and a two-year lag in publications. The analysis does not include publications with a VU University only. But, for the EMGO + Institute this constitutes only 17% of our papers, as many are co-authored by authors employed at VUmc and VU University (and quite often by authors with a dual appointment). According to the most recent CWTS bibliometric analysis EMGO + researchers co-authored 2590 scientific publications in Thomson Reuters Web of science core collection between 2009 and 2012. For comparisons between faculties and between institutes CWTS calculates a so-called MNCS indicator for which 1 represents world average. The 2014 CWTS bibliometric analysis of research papers in peer-reviewed international scientific journals reports an average MNCS indicator of 1.59 for EMGO +’s research. This reflects that the scientific impact of EMGO +’s research is 59% above world average in the scientific fields that EMGO + contributes to. To allow a more field-specific comparison of EMGO+ researchers to the world average, figure 7 presents the total number of publications (p) between 2009 and 2012, and MNCS (based on the number of citations between 2009 and 2013), for the subject categories according to web of science in which we publish at least 20 papers. The categories ‘Medicine, general and internal’ and ‘Multidisciplinary Sciences’ contain a number of very generic, high impact journals such as Science, Nature and the New England Journal of Medicine, giving this categories a very high MNCS. Two striking features are evident in the figure. First, EMGO + remains very true to its transdisciplinary nature by publishing in a large number of fields. Second, the weighted citation score of EMGO+ researchers is above the world average across the board, and more than 50% higher than the world average for 11 out of the 28 categories listed.
. NV
&
,E IC BL U P
Figure 7: CWTS analysis of the EMGO+ Institute’s publication profile 2009-2012 (only VUmc authored publications or joint VU/VUmc authored publications are included)
Annual Report 2014 | EMGO+ | 43
Annual Report 2014 | EMGO+ | 44
9
EARNING CAPACITY
As shown in table 7 (next page) and figure 8, the earning capacity of the EMGO + Institute has decreased from almost € 27 million in 2014 to ~€21 million in 2014. The largest decrease in funding (~4.3 million Euo) can be attributed to a loss of European funding, whereas the rest is largely due to reduced NWO/ZonMW funding. These unfortunate trends reflect the sign of times. The 2013 gap between the FP7 programs and the start of Horizon 2020 has clearly affected funding awarded in 2014. 2014 has also seen a noticeable national decrease in research funding by ZonMW/NWO. Notwithstanding these decreases, the bulk of our research remains externally funded, with public organizations as the main source (‘2e en 3e geldstroom’) and ZonMw/NWO (€ 4,2 million) and the European Union (€ 3,3 million) still as the main contributors. Appendix 7 (www.emgo.nl/ annual-report) lists all grants and funding acquired by EMGO + researchers in 2014. Because our research is focused on societally relevant questions we are confident that sufficient funding opportunities for EMGO + researchers will keep presenting themselves nationally and internationally. A good example is provided by the LOD program. The steep decrease in funding in 2014 has already been balanced by the huge success of their participation in the Sarphati Initiative in 2015, which involves 8 million Euro funding by the City of Amsterdam that is expected to act as a multiplier for further research funds from private partners. Such encouraging developments should not, however, detract us from the harsh fact that the economic tide has not fully turned and we actively support our researchers in focusing on the grand challenges of the Horizon 2020 agenda of the European Union and in reaching out for public private partnerships. The planned merger of the AMC and VUmc provides a unique opportunity to do so, by uniting an even larger number of Public Health researchers in a joint research institute.
Figure 8: Past and current acquisition of research funds for the institute
Annual Report 2014 | EMGO+ | 45
9
EARNING CAPACITY
EMGO+ RG
2009
2010
10.538.287 18.815.942
CR
8.582.927
OF Total
580.960 19.702.174
9.713.825
2011
2013
2014
9.891.265 14.726.635 10.572.350
6.307.295
7.423.260
437.078 190.600 28.966.845 17.505.125
2012
6.383.789 15.483.945 350.000 21.460.424
930.535 26.986.830
12.713.226 2.389.170 21.409.691
Of which European funding: €3,342,014 in 2014 (~16%) and €7,672,424 in 2013 (28%) LOD
2009
2010
2011
2012
2013
2014
RG
3.829.800
3.716.977
1.150.369
2.277.395
2.153.790
689.833
CR
737.800
2.200.517
1.541.115
1.001.199
5.789.680
287.261
OF
447.400
169.953
32.500
1.500
117.780
194.000
5.015.000
6.087.447
2.723.984
3.280.094
8.061.250
1.171.094
2009
2010
2011
2012
2013
2014
RG
2.976.000
7.892.491
5.147.627
2.994.078
2.371.326
2.457.118
CR
2.872.900
3.399.377
2.060.524
3.170.810
4.698.185
6.272.407
Total MH
OF
0
1
158.100
125.000
108.300
1.338.970
5.848.900
11.291.869
7.366.251
6.289.888
7.177.811
10.068.495
2009
2010
2011
2012
2013
2014
RG
3.720.000
4.489.200
2.271.571
7.806.707
4.219.864
2.807.652
CR
3.045.000
1.796.925
2.765.767
1.846.428
4.287.823
2.202.184
OF
95.000
267.121
0
220.860
360.380
759.200
6.860.000
6.553.246
5.037.338
9.873.995
8.868.067
5.769.036
2009
2010
2011
2012
2013
2014
RG
12.500
2.717.274
1.321.698
1.648.455
1.827.370
352.692
CR
1.927.200
2.317.006
1.055.854
365.352
708.257
3.951.374
OF
38.600
3
0
2.640
344.075
97.000
1.978.300
5.034.283
2.377.552
2.016.447
2.879.702
4.401.066
Total QoC
Total MSH
Total
Table 7: Past and current acquisition of research funds in € for the institute and per program (RG = Research Grants; CR = Contract Research; OF = Other Funding)
Annual Report 2014 | EMGO+ | 46
10
ACADEMIC REPUTATION
EMGO+ was externally evaluated in 2010 according to the standard evaluation protocol of the KNAW (i.e. the Dutch Royal Academy of Arts and Sciences). The institute, as well as its four research programs, was rated as excellent. In its evaluation report, the evaluation committee was very positive about the institute’s viability and future perspectives. This external evaluation covered the 2004-2009 period. In 2013 a midterm review of the EMGO+ Institute was conducted by the University Review Committee (‘Universitaire Toetsings Commissie’). The committee concluded that “The results presented over the 2010-2012 period are impressive and the transparent and structured presentation of the institute’s performance in the midterm review is exemplary. The EMGO + Institute is a strong research institute with research programs that perform at a top level”. The excellent reputation of EMGO+ researchers is further illustrated by the many invited lectures given at scientific meetings (appendix 8), the awards and honors they obtained in 2014 (appendix 9) as well as their prominence in the organization of conferences and congresses (appendix 10) and their gate keeping positions as grant reviewers, (associate) editors of international journals or executive board/committee members of academic societies (appendix 11). The appendices mentioned in this chapter can be found on the EMGO+ website: www.emgo.nl/annual-report.
Annual Report 2014 | EMGO+ | 47
Figure 9: Photo impression of the EMGO + Annual Meeting2014 [photo: Ruben van Vliet]
Annual Report 2014 | EMGO+ | 48
11
SOCIETAL IMPACT
EMGO+ aims to produce excellent scientific research, but this research only fulfills its potential when it benefits society at large. Striving for societal impact not only justifies our use of public funds, but also provides focus for our research projects and direction for the institute’s policy. We use the indicators proposed by the Dutch Health Council to evaluate and monitor the societal impact of our research. In 2014 EMGO + researchers contributed to at least 53 clinical guidelines / health policy reports on various topics, reflected in the form of co-authorships. These guidelines and policy reports contribute to evidence-based practice and thus represent an important aspect of the societal impact of our research. A detailed list of these EMGO + contributions to a directive, protocol or policy note can be found in appendix 12 (see www.emgo.nl/annual-report). In addition to the clinical guidelines and health policy reports, there are articles in national professional journals, articles written for the general public and (chapters in) handbooks that we consider contributing to the societal impact of our research. These products are included in appendix 5 (see www.emgo.nl/annual-report), in particular under the headings professional and popular publications. Appendix 11 lists the EMGO+ memberships of civil society advisory bodies in the public or commercial field through which we can translate our scientific insights directly into policy, medical practice and medical products. The results of EMGO+ research projects attract substantial attention from the media (see appendix 14, www.emgo.nl/annual-report). Our researchers were interviewed on television at least 25 times, and 14 interviews on national public radio were broadcasted. Interviews and articles about research projects and their results were published locally or nationally in at least 40 newspapers (online and print) and 41 magazine articles (online and print) and in at least 15 different other online sources (e.g. weblogs, newsfeeds and online newsletters). The internet is arguably the most important source of health information. Therefore, websites can be highly relevant for measuring the societal impact of EMGO+’s research. EMGO+ maintains a number of own websites, in part conveying general information, in part explaining the rationale and/or the results of our ongoing Fig. 10 EMGO+ researchers on television in 2014 research and research collaborations. The list of our most important websites is given in appendix 15 (see www.emgo.nl/annual-report). A further indicator of societal impact is the many invitations EMGO + researchers receive to deliver lectures to health care professionals, policy makers and non-professionals. Topics covered in these presentations can be gleaned from appendix 16 (see www.emgo.nl/annual-report), which provides an overview of the 2014 lectures for various non-scientific audiences. Annual Report 2014 | EMGO+ | 49
11
SOCIETAL IMPACT
Our researchers are frequently involved in teaching programs based on the results of EMGO+ research projects. We have a major contribution to the regular curriculum of the bachelor and master programs of medicine (VUmc), psychology & educational science (VU FPP) and health sciences (VU- FALW) as well as to the Master of Epidemiology. We also provide a substantial contribution to the ‘life long learning’ of healthcare professionals. Examples of EMGO+ involvement in this post initial education are listed in appendix 17 (see www.emgo.nl/annual-report). In order to have a true impact on the daily practice of extramural and transmural health care EMGO+ has established over the years a number of Research & Expertise Centers and the so-called Academic Collaborative Centers (‘Academische Werkplaatsen’). The Research & Expertise Centers active in 2014 are listed in appendix 18 (see www.emgo.nl/ annual-report). These centers cover specific topics of applied research and develop and provide expertise relevant to health care practice. The Academic Collaborative Centers are formal collaborations between EMGO+ and practice settings to conduct practice-based research of strong methodological rigor. Table 8 lists the EMGO + Academic Collaborative Centers active in 2014. In these collaborative networks, practice, research, education and policy are brought together by direct collaboration between clinicians, teachers, researchers and managers. Academic Aim Collaborative Center Child and Youth Improve knowledge transfer Health Care between health policy, research and education in child and youth health care. Providing scientific evidence for child health care practice and innovation. Healthcare Inspection Build a scientific evidence-base (AWP Toezicht) for health care inspection activities and to provide insight in the process and effects of inspection activities on health care. Insurance Medicine Improve the quality of work disability assessments and developing and evaluating new return-to-work strategies and tools. Occupational and Prevention of work-related Environmental Health complaints and disease, and Service VU-AMD effective return-to work intervention for those off work because of sickness. Improving work conditions, lifestyle and workers health. Prezens Provide evidence-based advice and support in case of sadness, anxiety, stress and other psychological symptoms. Annual Report 2014 | EMGO+ |
Partner(s) Municipal Health Services of Amsterdam, Hollands Noorden, ZaanstreekWaterland, Gooi & Vechtstreek and the Child Health Care organization Kennemerland. Healthcare Inspection (IGZ), IBMG, NIVEL, IQ Healthcare
National Institute for Employee Benefits (UWV), AMC, UMCG VU University/VU University Medical Center, department for Occupational Health and Safety (AMD)
GGZ inGeest
50
11
SOCIETAL IMPACT
Occupational and Prevention of work-related Environmental Health complaints and disease, and Service KLM effective return-to work intervention for those off work because of sickness. Improving work conditions, lifestyle and workers health. Occupational and Prevention of work-related Environmental Health complaints and disease, and Service Tata Steel effective return-to work intervention for those off work because of sickness. Improving work conditions, lifestyle and workers health. Network of Academic Integrate scientific research, General Practices medical education, vocational training and innovation in general -practice care.
KLM Health Services
Anxiety Disorders
Psychiatrie VUmc, Poliklinieken Angst- en dwangstoornissen, Poliklinieken bipolaire stoornissen (Altrecht, Dimence) GGZ inGeest
Tata Steel
1. Huisartsen coรถperatie Groot Zuid, 2. Stichting Amsterdamse Gezondheidscentra (SAG). 3. HOED Leonard Springer, Haarlem. University Network of Build a bridge between research Amaris Zorggroep, Organizations for and practice in long-term elderly Amstelring, Argos Elderly care (UNO) care, especially in nursing homes. Zorggroep, Beweging 3.0, Careyn, Cordaan, Evean, Hilverzorg, Quarijn, Sint Jacob, Viva Zorggroep, Vivium, Warande, et al.
Depression Bipolar disorders
Care for the Intellectually Disabled
Establish the biological basis of anxiety and compulsion disorders, unipolar and bipolar depression, and their comorbidity with somatic disorders to develop innovative interventions for patients treated for these disorders. Develop academic research on developmental pathways, personalized treatment and quality of care for people with intellectual disabilities in the Institution.
s'Heerenloo Instituut
Table 8: EMGO+ Academic Collaborative Centers
For a large part, funding for the research done within the academic collaborative centers comes from the societal stakeholders (e.g. companies, services, institutions) so these activities directly qualify as valorization. Economic product-based valorization of research, for instance in public-private partnerships, has not yet been strongly developed in the EMGO+ (see appendix 13), although the four embedded PhDs are already providing good bridgeheads into industry.
Annual Report 2014 | EMGO+ | 51
SWOT ANALYSIS of the EMGO+ INSTITUTE
12 Strengths
Weaknesses
Inclusive in its broad extra-, trans- and intramural
Still underdeveloped networks with SME and industry,
scope, but focused in its actual research by the thematic research programs (mass and focus).
hampering the formation of public private partnerships for research on EMGO+ themes.
Optimal environment on the VU/VUmc campus for
Small number of (tenured) junior staff members
multidisciplinary collaboration.
(relative to the large number of PhD students).
Methodological rigor and innovation in both clinical
Low number of international staff and PhD students.
and public health evaluation (including costeffectiveness analysis), and epidemiological research. Widely respected for its promotion and control of the quality of the scientific process and scientific conduct.
Low coherence in EMGO+ research on Aging, in spite of societal urgency and substantial amount of EMGO+ researchers working on this theme.
Internationally renowned longitudinal cohort studies (e.g. LASA, NESDA, NTR, Hoorn, AGGO). High volume and high quality scientific output. Longstanding focus on societal relevance and translational research (e.g. through academic collaborative centers, and collaboration with many clinical departments and national institutions such as NIVEL, TNO and RIVM). Large societal impact, as indicated by frequent media coverage and memberships of national and international policy advisory groups. Good performance in the acquisition of external research funding (76% of total funding).
Opportunities EMGO+ research themes figure prominently on European research agenda (Horizon 2020).
S W O T
Main themes of EMGO+ are recognized as the major drivers of direct and indirect costs (musculoskeletal problems, mental disorders, obesity/diabetes, lack of evidence for many ‘vested’ clinical routines). Re-emergence of the appreciation of prevention.
The potential of E-health and M-health applications in our field. Increased focus in government policy on the need for primary care and public health reform in order to provide evidence-based and affordable healthcare. AMC/VUmc collaboration in extramural, transmural,
Threats Thinning of mid-career levels and poor long-term career perspectives for PhDs. Continued reduction in core
(VUmc/VU) research funding and in the budgets of competitive national grant agencies (NWO/ZonMW) and an increase in the volume of the competition in the European arena, leading to low to very low a priori hit rates for collaborative grants. Strong dependency on external funding threatens high risk projects and true innovation. The complex merger of VUmc and AMC will require a prolonged period of effort and attention to this important process that may distract somewhat of the primary scientific endeavor.
and clinical and public health evaluation research within an UMCA institute could lead to a world class institute for evidence-based medicine.
Annual Report 2014 | EMGO+ | 52
Annual Report 2014 | EMGO+ | 53
EMGO Institute for Health and Care Research VU University Medical Center Van der Boechorststraat 7 1081 BT Amsterdam
Phone : +31 (0)20 444 8180 Email: emgo@vumc.nl Website: www.emgo.nl