Issuu on Google+

ANNUAL REPORT

2015


Colophon & Credits Printed matter: VUmc DPC/Huisdrukkerij Circulation: 250 Paper size: Executive (184 x 267 mm) Location & date: Amsterdam, May 2016

Design & layout: Caroline Kampshoff & Evelien de Boer Photography: Ton Dijkstra (page 10 and 11), Ruben van Vliet (page 46), Evelien de Boer (page 4). Images: Shutterstock.com, Wordle.net, Tagxedo.com 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

Email

emgo@vumc.nl

Website

www.emgo.nl


CONTENTS P REFACE ...................................................................................................... 5 1.

R ESEARCH

AREA

.......................................................................................... 7

Lifestyle, Overweight, and Diabetes ............................................ 8 Mental Health ........................................................................... 9 Quality of Care ....................................................................... 10 Musculoskeletal Health ............................................................ 11 2.

O RGANIZATION .......................................................................................... 12

3.

C OMPOSITION ............................................................................................ 16

4.

R ESEARCH

5.

Q UALITY

ENVIRONMENT AND EMBEDDING

AND SCIENTIFIC RELEVANCE

................................................ 19

........................................................ 21

LOD — 2015 highlights and key publications ............................. 21 MH — 2015 highlights and key publications .............................. 22 QoC — 2015 highlights and key publications ............................. 24 MSH — 2015 highlights and key publications ............................ 26 Affiliated members .................................................................. 27 Sarphati Amsterdam, InterRAI, Cohort Booster, MooDFOOD……….28 6.

E DUCATION

7.

Q UALITY

AND

T RAINING : E PID M ........................................................... 32

CONTROL .................................................................................... 34

Science Committee .................................................................. 34 Quality Committee .................................................................. 35 PhD Committee ....................................................................... 35 Methodological expertise centers ............................................. 36 8.

S CIENTIFIC

OUTPUT

................................................................................... 39

9.

E ARNING

CAPACITY

................................................................................... 43

10.

A CADEMIC

REPUTATION ............................................................................. 45

11.

S OCIETAL

RELEVANCE ................................................................................ 47

12.

SWOT A NALYSIS ....................................................................................... 50


FLTR Prof. Brenda Penninx, Prof. Eco de Geus, and Prof. Willem van Mechelen, MD

Annual Report 2015 | EMGO+ | 4


PREFACE The EMGO+ Institute is a multidisciplinary research institute that brings together 721 researchers from departments of three different science communities, i.e., from the VU University Medical Center, the VU University Faculty of Behavioural and Movement Sciences, 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 of the institute, its many external relations, and the multiple roles of the institute in the organization of VU/VUmc research. 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 2014. This reflects the 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 Director

Prof. Willem van Mechelen, MD Vice-director

Annual Report 2015 | EMGO+ | 5

Prof. Brenda Penninx Vice-director


Figure 1: Wordcloud of all international refereed EMGO+ articles in 2015

EMGO+ HEADLINES 2015 721 researchers 332 research FTEs 275 PhD students, PhD theses completed 93 Research funds acquisition €25 M 27% of the salaries of research staff comes from direct funding Laureates:   

Spinoza Award winners = 1 Royal Academy members = 4 ERC consolidator = 2 / ERC advanced = 1 / VICI = 2

Refereed articles 1263, of which 27% in top10% impact factor journals 2014 MNCS performance index = 1.59 (59% above world average)

Annual Report 2015 | EMGO+ | 6


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+ research includes qualitative and quantitative approaches, observational cohort and intervention studies and is always focused on 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 2015 | EMGO+ | 7


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. Mai Chin A Paw and Prof. Ingeborg Brouwer

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 2015 | EMGO+ | 8


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. Pim Cuijpers and Prof. Patricia van Oppen

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 2015 | EMGO+ | 9


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. Sophia Kramer and Prof. Martine de Bruijne

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 2015 | EMGO+ | 10


Musculoskeletal Health Mission WHO studies on global burden of disease showed that musculoskeletal disorders rank highest in terms of the disability-adjusted-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 and Prof. Raymond Ostelo

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 2015 | EMGO+ | 11


2

ORGANIZATION

Figure 2: Organization of the EMGO + Institute in 2015

Annual Report 2015 | EMGO+ | 12


2

ORGANIZATION

Strategic management lies with the Executive Board consisting of the Director and two members selected from the senior staff 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 (VUmc), VU University Faculty Earth and Life Sciences (FALW), and VU University Faculty Behavioural and Movement Sciences (FGB). 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 Prof. R. van Dyck (chair)

Affiliation Function VU University Medical Center Emeritus professor Psychiatry, former head of the department of Psychiatry

Drs. A.M.P. van Bolhuis

National Institute for Public Health and the Environment (RIVM)

Director Public Health and Health Services

Prof. S.E. Buitendijk

University of Leiden

Vice Rector Magnificus and member of the Executive Board

Prof. V.W.M. van Hinsbergh

VU University Medical Center Emeritus professor Physiology, former Director of the Institute for Cardiovascular Research ICaR-VU

Prof. J.A. Knottnerus

Scientific Council for Government Policy (WRR) / Maastricht University

Chair WRR / Professor of General Medicine

Dr. H. Kroneman

Employee Insurance Agency (UWV) Erasmus MC, University Medical Center Rotterdam

Chief Medical Officer

Prof. J.P. Mackenbach

Chair of the Department of Public Health

Table 1: Advisory Board of the EMGO + Institute in 2015

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 2015 | EMGO+ | 13


2

ORGANIZATION Research staff (in numbers)

Research staff (in FTE)

Maurits van Tulder

70

34,3

Jacqueline Broerse Dorret Boomsma Pim Cuijpers Hans Koot

19 27 68 23

8,2 16,0 37,8 12,8

Carlo Schuengel

27

12,1

total VU

234

121,2

2

0,9

13

8,0

Noortje Swart

3

1,1

Hans Berkhof (a.i.) Henriëtte van der Horst

63

25,5

62

25,2

Mark Kramer

16

7,0

Guy Widdershoven Frank Snoek Gea Vermeulen Christianne de Groot Stevie Tan

40 10 24 4 10

13,6 6,3 7,1 1,6 4,3

René Leemans

25

9,6

Hans van Goudoever

31

11,0

Aartjan Beekman Willem van Mechelen Vincent de Groot

84 104 10

39,2 46,9 3,6

total VUmc

501

210,7

total

735 *

331,9

Departments

Head of department (in 2015)

VU

FALW Health Sciences

VU VU VU VU

FALW Athena Institute FGB Biological Psychology FGB Clinical Psychology FGB Developmental Psychology FGB Clinical Child & Family Studies

VU

VUmc Anesthesiology Clinical Genetics VUmc (incl. Community Genetics) Clinical Pharmacology & VUmc Pharmacy VUmc Epidemiology & Biostatistics General Practice & Elderly Care VUmc Medicine Internal Medicine VUmc (incl. Endocrinology; Nutrition and Dietetics) VUmc Medical Humanities VUmc Medical Psychology VUmc Midwifery Science VUmc Obstetrics & Gynaecology VUmc Ophthalmology Otolaryngology, Head & Neck VUmc Surgery Pediatrics VUmc (incl. Child & Adolescent Psychiatry) VUmc Psychiatry - GGZ inGeest VUmc Public & Occupational Health VUmc Rehabilitation Medicine

Stephan Loer Hanne MeijersHeijboer

Table 2: Departments participating in the EMGO + Institute in 2015 *14 researchers were employed by multiple departments, so grand total of EMGO + researchers is 721.

Annual Report 2015 | EMGO+ | 14


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, 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 PhD students, 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, Psychiatry, General Practice & Elderly Care Medicine, and Epidemiology and Biostatistics 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, Pediatrics) reflecting the importance of clinical evaluation research and evidence-based practice in trans- and intramural research.

Annual Report 2015 | EMGO+ | 15


3

COMPOSITION

The total number of scientific personnel in 2015 was 721 individuals amounting to ~332 full time research FTE committed to the EMGO+ Institute. The VU University Medical Center is the largest contributor with ~211 research FTE, followed by the Faculty of Behavioural and Movement Sciences (~79 research FTE) and the Faculty of Earth and Life Sciences (~42 research FTE). The ratio VU/VUmc formation in FTE is 37% / 63%. 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 have been added. The full list of EMGO+ researchers is provided in appendix 1. 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. For each researcher, we compare the indicated research time by the department heads 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 (when applicable) to the research time of the same researcher in previous years. In case of a large deviation we ask the heads of department for confirmation of the indicated research time.

Selection of participants The above-mentioned definitions also 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. EMGO+ departments are carried forward from the previous year provided they keep meeting the criteria used to admit new departments. 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 Annual Report 2015 | EMGO+ | 16


3

COMPOSITION

obtain an affiliate membership status for two years (after which full membership is considered using above criteria). During this period input and output of the affiliated departments are not yet incorporated in the tables of this annual report. EMGO+ Scientific core staff * PhD students Other scientific staff Total research staff Lifestyle, Overweight and Diabetes Scientific core staff PhD students Other scientific staff Total research staff Mental Health Scientific core staff PhD students Other scientific staff Total research staff Quality of Care Scientific core staff PhD students Other scientific staff Total research staff Musculoskeletal Health Scientific core staff PhD students Other scientific staff Total research staff

2010

2011

2012

2013

2014

2015

74,0 109,4 101,7 285,0

74,9 117,3 99,4 291,5

63,8 133,8 101,1 298,7

74,5 138,4 101,9 314,8

60,9 136,4 113,9 311,3

61,7 139,2 131,1 331,9

2010

2011

2012

2013

2014

2015

16,3 26,3 29,6 72,2 2010

15,5 23,8 31,3 70,6 2011

16,1 21,1 23,2 60,4 2012

20,0 22,2 23,6 65,8 2013

11,4 26,7 28,4 66,5 2014

8,8 26,4 31,4 66,6 2015

22,7 45,8 28,7 97,2 2010

22,6 53,1 19,8 95,5 2011

22,5 46,2 33,3 102,0 2012

24,7 49,1 29,2 102,9 2013

25,0 57,4 38,7 121,2 2014

25,7 65,0 44,3 134,9 2015

19,3 20,0 27,5 66,8 2010

22,5 20,7 36,1 79,3 2011

14,3 42,7 36,1 93,1 2012

19,4 41,0 41,4 101,9 2013

16,9 36,2 36,7 89,8 2014

18,6 38,3 42,8 99,7 2015

15,7 17,3 15,8 48,9

14,2 19,7 12,3 46,2

10,9 23,8 8,6 43,2

10,4 26,1 7,7 44,2

7,6 16,1 10,1 33,8

8,5 9,6 12,6 30,7

Table 3 (SEP D3a) – Total research FTE for the institute and per program * in the previous Standard Evaluation Protocol (2009 -2015) that was used in the annual reports 2009 2013, 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 the 2014 and 2015 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 27% of the researchers’ salaries comes from direct University funding (‘1e geldstroom’). 71% 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 2015 | EMGO+ | 17


3

COMPOSITION

EMGO+ Institute

2010

2011

2012

2013

2014

2015

2015

Direct funding

86,8

80,9

74,6

79,3

81,5

90,4

27%

Research staff: Research grants (RG)

89,8

93,3

81,6

83,1

92,0

87,3

26%

Research staff: Contract research (CR)

99,8

112,5

137,3

148,1

131,3

149,6

45%

Research staff: Other funding (OF)

8,6

4,8

5,3

4,3

6,4

4,7

2%

External funding (total RG + CR + OF)

198,3

210,6

224,1

235,5

229,8

241,6

73%

Total internal+external

285,0

291,5

298,7

314,8

311,3

331,9

100%

Lifestyle, Overweight and Diabetes

2010

2011

2012

2013

2014

2015

2015 (%)

Direct funding

23,9

20,2

22,5

20,7

14,5

16,6

25%

Research staff: Research grants (RG)

17,2

20,6

13,8

14,3

16,1

13,9

21%

Research staff: Contract research (CR)

24,7

27,6

22,5

29,9

32,8

34,4

51%

Research staff: Other funding (OF)

6,4

2,2

1,6

0,9

3,1

1,7

3%

External funding (total RG + CR + OF)

48,3

50,4

37,9

45,2

52,0

50,1

75%

Total internal+external

72,2

70,6

60,4

65,8

66,5

66,6

100%

Mental Health

2010

2011

2012

2013

2014

2015

2015 (%)

Direct funding

29,7

29,3

23,7

29,4

34,8

39,5

29%

Research staff: Research grants (RG)

39,5

40,7

38,8

39,0

51,6

52,0

38%

Research staff: Contract research (CR)

27,5

25,3

38,7

34,5

34,3

42,6

32%

Research staff: Other funding (OF)

0,6

0,2

0,8

0,0

0,5

0,9

1%

External funding (total RG + CR + OF)

67,5

66,2

78,3

73,5

86,4

95,4

71%

Total internal+external

97,2

95,5

102,0

102,9

121,2

134,9

100%

Quality of Care

2010

2011

2012

2013

2014

2015

2015 (%)

Direct funding

12,7

11,9

14,6

13,5

16,6

21,3

22%

Research staff: Research grants (RG)

21,8

21,6

18,0

21,0

18,6

18,1

18%

Research staff: Contract research (CR)

30,6

43,3

57,7

64,0

51,8

58,2

58%

Research staff: Other funding (OF)

1,6

2,4

2,8

3,4

2,8

2,1

2%

External funding (total RG + CR + OF)

54,1

67,3

78,5

88,3

73,3

78,4

78%

Total internal+external

66,8

79,3

93,1

101,9

89,8

99,7

100%

Musculoskeletal Health

2010

2011

2012

2013

2014

2015

2015 (%)

Direct funding

20,5

19,5

13,8

15,7

15,7

13,0

42%

Research staff: Research grants (RG)

11,3

10,4

11,0

8,8

5,7

3,3

11%

Research staff: Contract research (CR)

17,0

16,3

18,4

19,7

12,4

14,4

47%

Research staff: Other funding (OF)

0,0

0,0

0,0

0,0

0,0

0,0

0%

External funding (total RG + CR + OF)

28,4

26,7

29,4

28,5

18,1

17,7

58%

Total internal+external

48,9

46,2

43,2

44,2

33,8

30,7

100%

Table 4: Sources of funding of the research staff for the institute and per program (in FTE’s)

Annual Report 2015 | EMGO+ | 18


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., Horizon 2020 or Marie Curie ITN, 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. 64% of the 266 recorded research collaborations are international in nature, spanning 40 different countries on all continents (a collaboration may include several countries). Main international ties are with the United States (41 contacts), the United Kingdom (39 contacts), Australia (17 contacts), Belgium (16 contacts), Germany (16 contacts) and Sweden and Denmark (both 11 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 (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 2015. Font size reflects the amount of collaborations with the same city

There are 26 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 2015 EMGO+ had 11 visiting professors and 6 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. Annual Report 2015 | EMGO+ | 19


Figure 4: Some of the universities/institutes with which EMGO + researchers collaborated in 2015

Annual Report 2015 | EMGO+ | 20


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 55% belongs to the top 25%.

Refereed articles Top 10% impact factor Top 25% impact factor

EMGO+

LOD

MH

QoC

MSH

1263

239

506

311

207

338 (27%) 700 (55%)

55 (23%) 133 (56%)

137 (27%) 296 (58%)

65 (21%) 148 (48%)

81 (39%) 123 (59%)

Table 5: Total number of refereed publications in 2015 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 2015 Highlights 

Prof. Marjolein Visser made it onto Thompson Reuters list of most influential scientific minds in 2015, based on her scientific output of top-cited papers in their fields.

Dr Coosje Dijkstra has been awarded with the Young Professional Award during the congress ‘Voeding Nederland 2015’, for her research on socio-economic differences in healthy food choices.

The International Olympic Committee named the Amsterdam Collaboration between VUmc and AMC on Health & Safety in Sports (ACHSS) as IOC Research Center for Prevention of Injury and Protection of Athlete Health.  EMGO+ LOD researchers Marjolein Visser, Ingeborg Brouwer, Margreet Olthof, Hanneke Wijnhoven and Ilse Reinders obtained funding for PROMISS: PRevention Of Malnutrition In Senior Subjects in Europe.  On the 1st of July Professor Ingeborg Brouwer accepted the Chair on Food for a Healthy Life with special attention to fatty acids with her inaugural lecture ‘A Healthy Diet for a Healthy Future’.

Annual Report 2015 | EMGO+ | 21


5

QUALITY AND SCIENTIFIC RELEVANCE 2015 Key publications & chapters

 Altenburg, T.M. & Chin A Paw, M.J.M. (2015). Bouts and breaks in children's sedentary time: currently used operational definitions and recommendations for future research. Preventive Medicine, 77, 1-3. doi: 10.1016/j.ypmed.2015.04.019  Reinders, I., Murphy, R.A., Martin, K.R., Brouwer, I.A., Visser, M., White, D.K., Newman, A.B., Houston, D.K., Kanaya, A.M., Nagin, D.S. & Harris, T.B. (2015). Body Mass Index Trajectories in Relation to Change in Lean Mass and Physical Function: The Health, Aging and Body Composition Study. Journal of the American Geriatrics Society, 63 (8), 1615-1621. doi: 10.1111/jgs.13524 Walraven, I., Mast, M.R., Hoekstra, T., Jansen, A.P.D., Rauh, S.P., Rutters, F., Heijden, A.A.W.A. van der, Elders, P.J.M., Moll, A.C., Polak, B.C.P., Dekker, J.M. & Nijpels, G. (2015). Real-world evidence of suboptimal blood pressure control in patients with type 2 diabetes. Journal of Hypertension, 33 (10), 2091-2098. doi: 10.1097/HJH.0000000000000680 Wijden, C.L. van der, Waal-Delemarre-van de, H.A., Mechelen, W. van, & Poppel, M.N.M. van (2015). The relationship between moderate-to-vigorous intensity physical activity and insulin resistance, insulin-like growth factor (IGF-1)-system 1, leptin and weight change in healthy women during pregnancy and after delivery. Clinical Endocrinology, 82 (1), 68-75. doi: 10.1111/cen.12593 Wijnhoven, H.A.H., Meij, B.S. van der & Visser, M. (2015). Variety within a cooked meal increases meal energy intake in older women with a poor appetite. Appetite, 95, 571-576. doi: 10.1016/j.appet.2015.08.029

Number of articles in top 10% of the publications relevant to the discipline: 55 Number of articles in top 25% of the publications relevant to the discipline: 133

Mental Health 2015 Highlights 

Prof. Rose-Marie Dröes, VUmc/EMGO+ professor of psychosocial care for people with dementia, received €495,000 from several funding organizations for her project “Ontmoetingscentra 3.0”, a 3 year study into the implementation of three new tailored interventions (DemenTalent, STAR online training and Dementelcoach) in meeting centers for people with dementia and their caregivers. With colleagues from the European INTERDEM network Dröes has also received a prestigious Marie Curie Grant of 3,2 million euros for the INDUCT project. The INDUCT project focuses on the application of technology for people with dementia. 15 Early stage researchers (PhDs) of several EU countries will research the usefulness and effectiveness of technical applications that may promote the functioning and well-being of people Annual Report 2015 | EMGO+ | 22


5

QUALITY AND SCIENTIFIC RELEVANCE with dementia.

The international Genetics of Personality Consortium, led by researchers of the VU department of Biological Psychiatry, has found first the gene for neuroticism. This large international consortium is a collaboration between 30 research groups with more than 70,000 participants included in Europe, the United States and Australia. The first results of this project are published in JAMA Psychiatry in 2015.

Prof. Irma Verdonck has received €353,000 from the SAG-fonds for her pilot study OncoKompas 2.0.

At the department of Clinical Psychology, Heleen Riper was appointed professor of eMental-health. Sander Koole was appointed professor of clinical psychology, specialising in emotion regulation.

2015 Key publications & chapters 

Berg, D.P.G. van den, Bont, P.A.J.M. de, Vleugel, B.M. van der, Roos, C., Jongh, A. de, Minnen, A. van & Gaag, M. van der (2015). Prolonged exposure vs eye movement desensitization and reprocessing vs waiting list for post traumatic stress disorder in patients with a psychotic disorder: A randomized clinical trial. JAMA Psychiatry, 72 (3), 259-267. doi: 10.1001/jamapsychiatry.2014.2637

Nivard, M.G., Dolan, C.V., Kendler, K.S., Kan K.J., Willemsen, G., Beijsterveldt C.E. van, Lindauer, R.J., Beek, J.H. van, Geels, L.M., Bartels, M., Middeldorp, C.M., Boomsma, D.I. (2015). Stability in symptoms of anxiety and depression as a function of genotype and environment: a longitudinal twin study from ages 3 to 63 years. Psychological Medicine, 45(5):1039-49, 2015  Peyrot, W., Lee, S.H., Milaneschi, Y., Abdellaoui, A., Byrne, E.M., Esko, T., Geus, E.J.C. de, Hemani, G., Hottenga, J.J., Kloiber, S., Levinson, D.F., Lucae, S., Martin, N.G., Medland, S.E., Metspalu, A., Milani, L., Noethen, M.M., Potash, J.B., Rietschel, M., Rietveld, C.A., Ripke, S., Shi, J., Willemsen, G., Zhu, Z., Boomsma, D.I., Wray, N.R., Posthuma, D., Middeldorp, C.M. & Penninx, B.W.J.H. (2015). The association between lower educational attainment and depression owing to shared genetic effects? Results in ~ 25 000 subjects. Molecular Psychiatry, 20 (6), 735-743. doi: 10.1038/mp.2015.50

Voort, T.Y. van der, Meijel, B. van, Goossens, P.J., Hoogendoorn, A.W., Draisma, S., Beekman, A. & Kupka, R.W. (2015). Collaborative care for patients with bipolar disorder: randomised controlled trial. British Journal of Psychiatry, 206 (5), 393400. doi: 10.1192/bjp.bp.114.152520

Weitz, E.S., Hollon, S.D., Twisk, J., Straten, A. van, Huibers, M.J.H., David, D., Annual Report 2015 | EMGO+ | 23


5

QUALITY AND SCIENTIFIC RELEVANCE DeRubeis, R.J., Dimidjian, S., Dunlop, B.W., Cristea, I.A., Faramarzi, M., Hegerl, U., Jarrett, R.B., Kheirkhah, F., Kennedy, S.H., Mergl, R., Miranda, J., Mohr, D.C., Rush, A.J., Segal, Z.V., Siddique, J., Simons, A.D., Vittengl, J.R. & Cuijpers, P. (2015). Baseline Depression Severity as Moderator of Depression Outcomes Between Cognitive Behavioral Therapy vs Pharmacotherapy: An Individual Patient Data Metaanalysis. JAMA Psychiatry, 72 (11), 1102-1109. doi: 10.1001/ jamapsychiatry.2015.1516

Number of articles in top 10% of the publications relevant to the discipline: 137 Number of articles in top 25% of the publications relevant to the discipline: 296

Quality of Care 2015 Highlights 

Prof. Cordula Wagner has been awarded with the NVZ (Dutch association for hospitals in the Netherlands) penning. She was honored for her pioneering role in the field of patient safety in hospitals. With her recommendations she contributed concretely to the reduction of avoidable morbidity and mortality in hospitals. For 20 years, Wagner has been engaged in scientific research into the development and implementation of quality systems and its effects on the quality of care. In recent years, she focused mainly on patient safety in hospitals.

In 2015, VUmc launched a new university practice in elderly care medicine. Nowadays, elderly people continue to stay longer in their own homes. Because of that, GP's are faced with an increase in heavy care needs. An active role in primary care for specialists in elderly care medicine can have a positive effect in this process. This is what will happen in the new practice, carried out in collaboration with Amstelring. One of the initiators is Cees Hertogh, Professor in elderly care medicine and geriatric ethics.

Since April 1st 2014, Dutch UMC’s are allowed to start with the Non Invasive Prenatal Test (NIPT). It is a blood test for pregnant women to screen the foetus on the most frequent chromosome abnormalities. The NIPT is preferred by the majority of women, as was shown in the first data analyses in 2015. The NIPT consortium, in which the Dutch UMC’s cooperate with professional organizations, offers the NIPT in context of the TRIDENT study (Trial by Dutch laboratories for Evaluation of Non-invasive Prenatal Testing). Quality of Care researchers Dr. Lidewij Henneman and Prof. Martina Cornel are involved in the TRIDENT study. Annual Report 2015 | EMGO+ | 24


5 

QUALITY AND SCIENTIFIC RELEVANCE Media attention for QoC scientific research results reached a record in 2015. Very often, a news item focusing on a QoC research result appeared in (inter)national newspapers, radio & TV programs or at relevant Internet sites. Most of the QoC groups were represented in the media. Examples of topics per group that received a lot of media attention are: moral case deliberation, acute care in mental health settings and technology as a solution for the aging population (Medical Humanities), physician-assisted suicide (Public Health at the End of Life), pregnancy and prenatal care (Midwifery Science), the TRIDENT study and a new prenatal test for Down (Community Genetics), successful aging (Epidemiology of Aging), the use of antibiotics in nursing homes (General Practice and Elderly Care Medicine), health risk communication (Quality, Risk and Safety in Health Care) and acceleration of hearing loss from the age of 50 (Ear & Hearing).

2015 Key publications & chapters 

Snijdewind, M.C., Willems, D.L., Deliens, L., Onwuteaka-Philipsen, B.D. & Chambaere, K. (2015). A Study of the First Year of the End-ofLife Clinic for Physician-Assisted Dying in the Netherlands. JAMA internal medicine, 175 (10), 1633-1640. Porsius, J.T., Claassen, L., Smid, T., Woudenberg, F., Petrie, K.J. & Timmermans, D.R.M. (2015). Symptom reporting after the introduction of a new high-voltage power line: A prospective field study. Environmental Research, 138, 112-117. Leeuwen, K.M. van, Bosmans, J.E., Jansen, A.P.D., Hoogendijk, E.O., Muntinga, M.E., Hout, H.P.J. van, Nijpels, G., Horst, H.E. van der & Tulder, M.W. van (2015). Cost-Effectiveness of a Chronic Care Model for Frail Older Adults in Primary Care: Economic Evaluation Alongside a Stepped-Wedge ClusterRandomized Trial. Journal of the American Geriatrics Society, 63 (12), 2494-2504.  Metselaar, S., Molewijk, A.C. & Widdershoven, G. (2015). Beyond Recommendation and Mediation: Moral Case Deliberation as Moral Learning in Dialogue. American Journal of Bioethics, 15 (1), 50-51. Strien, A.M. van, Keijsers, C.J.P.W., Derijks, H.J. & Marum, R.J. van (2015). Rating scales to measure side effects of antipsychotic medication: A systematic review. Journal of Psychopharmacology, 29 (8), 857-866.

Number of articles in top 10% of the publications relevant to the discipline: 65 Number of articles in top 25% of the publications relevant to the discipline: 148 Annual Report 2015 | EMGO+ | 25


5

QUALITY AND SCIENTIFIC RELEVANCE

Musculoskeletal Health 2015 Highlights 

Prof. Joost Dekker has received the Dutch Rheumatology Medal, awarded for ‘honor and merit’ by the Dutch Society for Rheumatology.

Two MSH articles are highly ranked (# 3 and #6) in Elsevier ScienceDirect’s Top 100 downloaded articles by Netherlands-based authors, and Dr. Caroline Terwee is one of the most frequently cited scientists, based on an assessment of the 3,000 most influential scientist worldwide by Thomson Reuters.

MSH researchers published an extensive multidisciplinary guidance ‘participatory approach at the workplace’, involving seven national societies and professional associations, and translated this into a practical training for different professionals.

2015 Key publications & chapters 

Crins, M.H.P., Roorda, L.D., Smits, N., Vet, H.C. de, Westhovens, R., Cella, D., Cook, K.F., Revicki, D., Leeuwen, J. van, Boers, M., Dekker, J. & Terwee, C.B. (2015). Calibration and validation of the DutchFlemish PROMIS pain interference item bank in patients with chronic pain. PLoS One, 10 (7):e0134094. doi: 10.1371/journal.pone.0134094. Esch, M. van der, Knoop, J., Leeden, M. van der, Roorda, L.D., Lems, W.F., Knol, D.L. & Dekker, J. (2015). Clinical phenotypes in patients with knee osteoarthritis: a study in the Amsterdam osteoarthritis cohort. Osteoarthritis and Cartilage, 23 (4), 544-549. doi: 10.1016/j.joca.2015.01.006. Kamper, S.J., Apeldoorn, A.T., Chiarotto, A., Smeets, R.J.E.M., Ostelo, R.W.J.G., Guzman, J. & Tulder, M.W. van (2015). Multidisciplinary biopsychosocial rehabilitation for chronic low back pain: Cochrane systematic review and metaanalysis. BMJ (Online), 350:h444. doi: 10.1136/bmj.h444.  Kampshoff, C.S., Chin A Paw, M.J.M., Brug, J., Twisk, J.W.R., Schep, G., Nijziel, M.R., Mechelen, W. van & Buffart, L.M. (2015). Randomized controlled trial of the effects of high intensity and low-to-moderate intensity exercise on physical fitness and fatigue in cancer survivors: results of the Resistance and Endurance exercise After ChemoTherapy (REACT) study. BMC Medicine, 13:275. doi: 10.1186/s12916-015-0513-2.

Annual Report 2015 | EMGO+ | 26


5 

QUALITY AND SCIENTIFIC RELEVANCE Nauta, J., Martin-Diener, E., Martin, B.W., Mechelen, W. van & Verhagen, E.A.L.M. (2015). Injury Risk During Different Physical Activity Behaviours in Children: A Systematic Review with Bias Assessment. Sports Medicine, 45 (3), 327-336. doi: 10.1007/s40279-014-0289-0.

Number of articles in top 10% van de publications relevant to the discipline: 81 Number of articles in top 25% van de publications relevant to the discipline: 123

Affiliated members Gender Dysphoria (GD) is the feeling of incongruence between the experienced gender and the assigned sex. It has been well established that gender confirming treatment, the alignment of the physical appearance to the experienced gender, is the most successful treatment option in persons with severe gender dysphoria. 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 gender dysphoria is complex and sustained, and involves many disciplines which all cooperate within the center of expertise on gender dysphoria. The treatment is organized in a health care regime which takes more than 4 years. The center of expertise on gender dysphoria of VUmc is the only Center in the Netherlands that offers a complete package of multidisciplinary care for gender dysphoric people of all ages. Over the last years, transgender people have been exposed increasingly in the media. Transgenderism has become more known and gains more acceptance in society. At the same time more and more individuals with gender dysphoric feelings present at our treatment center. Research is organized in a multidisciplinary Gender Dysphoria Research Group. The general aim of our 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, we aim to improve and develop treatment strategies, investigate the effects of treatments, and assess quality of care. The output for 2015 realized by GD staff participating in EMGO+ is listed in appendix 19.

Annual Report 2015 | EMGO+ | 27


Sarphati Amsterdam Research for Healthy Living is a unique scientific research institute in Amsterdam that focusses on innovative multidisciplinary research beneficial to preventing lifestyle -related diseases effectively and sustainably. Its first priority is one of the most prevailing lifestyle-related diseases: i.e., overweight and obesity among children. Research will initially mainly concentrate on promoting a healthy lifestyle and preventing overweight and obesity among young people in Amsterdam. This will lay a solid foundation for combatting in the long-term lifestyle-related diseases such as overweight, diabetes and cardiovascular disease. Sarphati Amsterdam is a newly established, unique collaboration* between Amsterdammers, the city of Amsterdam, its research institutions (VU/VUMC - EMGO+, UvA, AMC, HvA) and private parties. Together they will work on solutions in the field of prevention and care and at the same time connect research, policy and practice. Amsterdam The city of Amsterdam is very suitable as a research location. There is broad social and political support for health promotion for all Amsterdam citizens, especially when it comes to ‘healthy development’. In addition, the Amsterdam research institutions are internationally acclaimed for their scientific expertise and their large international network. The presence of multinationals and SMEs in Amsterdam with their expertise in the field of nutrition, healthcare and technology provide the foundation for a solid and valuable collaboration. Core of Sarphati Amsterdam The core of Sarphati Amsterdam is a dynamic cohort: the Sarphati Cohort. The basis for this cohort is the systematic monitoring of all children in Amsterdam by means of the routine consultations with Youth Health Care (YHC). YHC monitors the health of all children aged 0 to 19 years living in Amsterdam. All these children will be included in the Sarphati Cohort. The Sarphati Cohort data will be made available for longitudinal studies. Furthermore the research infrastructure comprises ongoing cohort studies conducted by the Amsterdam research institutions. 2015/2016 The 1st of January has been the starting point of the development of the Sarphati Cohort data infrastructure and the operational structure of Sarphati Amsterdam. This concerns both internal and external factors within the organization. In the autumn of 2016 the Sarphati Cohort will be operational. More information? Please contact by email: info@sarphati.amsterdam * Triple helix collaboration: the collaboration between the (municipal) government, research institutions and companies that leads to several ‘ecosystems’. Meaning: networks and different forms of collaboration in which various stakeholders can participate. The quality of these networks and collaborations will very much determine the level of impact and innovation and subsequently the social and economic success.

Annual Report 2015 | EMGO+ | 28


InterRAI InterRAI is an international collaborative consortium to improve the quality of life of vulnerable persons through a seamless comprehensive assessment system. Our consortium strives to promote evidenceinformed clinical practice and policy decision making through the collection and interpretation of high-quality data about the characteristics and outcomes of persons served across a variety of health and social services settings. Although each instrument in the interRAI suite has been developed for a particular population, they are designed to work together to form an integrated health information system. InterRAI instruments all share a common language, that is, they refer to the same clinical concept in the same way across instruments. Using common measures enables clinicians and providers in different care settings to improve continuity of care and to integrate care/supports for each individual. Common language also empowers families, advocates, and payers to track the progress of program participants across settings. As an organization, interRAI maintains high standards for the quality of measures used in our instrument systems. Each version of a system represents the results of rigorous research and testing to establish the reliability and validity of items, outcome measures, assessment protocols, case-mix algorithms, and quality indicators. VUmc hosts the Dutch interRAI databases since 1997 which consist in about 20.000 unique persons and 80.000 observations, spread over long term care facilities, home care and general practice. All instruments collect information on daily, physical, mental, cognitive, social, medical functioning, care goals and resource use. The number of items per instrument ranges from 110 (Acute Care) to 300 (Long Term Care Facilities). VUmc participates in several EU projects that concern interRAI data. Persons interested to perform secondary data analyses can contact Dr. Hein van Hout who is fellow and national coordinator. More information can be found on www.interrai.org and www.nedrai.org.

Annual Report 2015 | EMGO+ | 29


EMGO+ Cohort Booster Project The environment is receiving growing attention in medical research with respect to its relationship with health problems and well-being of individuals. The EMGO Institute for Health and Care Research (EMGO+) has recognized the importance of environmental factors for public health. Therefore, the EMGO+ Institute initiated and funded the EMGO+ Cohort Booster Project. In this project, databases of six large-scale and on-going longitudinal studies within the EMGO+ Institute have been enriched with a variety of existing geo-data. The six cohort studies that are involved in this project are 

the Generations2-study

the New Hoorn Study

the Longitudinal Aging Study Amsterdam (LASA)

the Netherlands Longitudinal Study on Hearing (NL-SH)

the Netherlands Study on Depression and Anxiety (NESDA)

the Netherlands Twin Register (NTR)

From 1st April 2015 to 31st March 2016, a variety of existing geo-data on addresszip code-, as well as neighbourhood level from different sources were collected. Data are available for several years, depending on the database used. All collected geo-data have been documented. Examples of geo-data that have been made available for linkage with data from the cohort studies are: road-, rail-, and air traffic noise on address-level, and number of different types of facilities (e.g., health care facilities, sport facilities, educational facilities, and socio-cultural facilities) on 4-digits zip code level. For the data-linking between the collected geodata and respondents of each specific cohort study, 4-digits zip codes and 6-digits zip codes are used as identifier. The geo-data that have been linked to each cohort study are available upon request, provided that there are no additional requirements of the original source holder, and an agreement is made up with the research team of the EMGO+ Cohort Booster Project. The collaboration between the six cohort studies within the EMGO+ Cohort Booster project stimulates large-scale research studies on environmental impacts on health in the Netherlands.

Annual Report 2015 | EMGO+ | 30


MooDFOOD Multi-country cOllaborative project on the rOle of Diet, FOod-related behaviour, and Obesity in the prevention of Depression (MooDFOOD) Depression is one of the most prevalent and disabling disorders in the EU and it places a heavy burden on individuals and their families. A large proportion of the EU population is overweight which increases depression risk. Improvement of food-related behaviour and nutrient status may prevent depression, specifically for people prone to being overweight. Unravelling the different pathways that link nutritional behaviour to the development of depression and identifying potential psychological, lifestyle, and environmental mechanisms is exactly at the centre of the MooDFOOD project. MooDFOOD is one of the largest consortia investigating depression and the first to address how food intake, nutrient status, food-related behaviour and obesity are linked to the development of depression. The MooDFOOD consortium combines expertise in nutrition, consumer behaviour, psychiatry and preventive psychology. MooDFOOD employs an unique approach where high quality data from longitudinal prospective European cohort studies will be combined with new data from surveys, short-term experiments and a multi-centre long-term preventive intervention study to unravel these multifaceted links of food intake, nutrient status, food-related behaviour and obesity with depression. The obtained scientific evidence will be integrated with information from stakeholders regarding future implementation as well as information regarding demographic trends, sustainability and planned policy measures will allow the development of innovative nutritional strategies for the prevention of depression and contribute to the overall health of EU-citizens. More information can be found on www.moodfood-vu.eu.

Annual Report 2015 | EMGO+ | 31


Annual Report 2015 | EMGO+ | 32


6

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 2015, 16 students enrolled in the Master’s Program. Furthermore, 370 students attended one or more courses of EpidM, resulting in a total of 565 course registrations. 27% of these students were PhD students within EMGO+, 13% were researchers of the VU University Medical Center, and the remaining 59% 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 www.epidm.nl.

Annual Report 2015 | EMGO+ | 33


7

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.

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. After a check for completeness regarding all requirements (e.g., analysis plan, planning, personnel), the proposal is 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 that makes a final decision regarding approval of research proposals. Only after approval of the Executive Board, the research project described in the proposal will be embedded within EMGO+. In addition, approval of the EMGO+ Science Committee is required before a proposal is submitted to the Medical Ethical Committee of the VU University Medical Center. Annual Report 2015 | EMGO+ | 34


7

QUALITY CONTROL

A full list of discussed protocols in 2015 is presented in appendix 4. In total, 93 research protocols were reviewed of which 84 were approved at the end of 2015.

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 and provides personal introductions to newly appointed researchers within the institute. In 2015 the Quality Committee has audited 15 research projects. The quality officer has given 41 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. To stimulate the use of the quality handbook, it was completely restyled and transferred to a modern content management system. Special attention was given to make relevant guidelines easier to find for a researcher. The structure of the guidelines was also changed, to explicit the requirements, responsibilities and documentation. To create more awareness in the EMGO+ departments on the topic of privacy, a set of privacy indicators piloted. After minor adaptations 12 departments were asked to assign a contact person and to fill in the indicator. Results are expected in 2016. The quality officer chairing the quality committee also acts as the principal investigator of potential violations of research integrity brought to the attention of the Executive Board. The officer will suggest (and help implement) a course of action to correct such incidents. In 2015, four incidents of possible violations of privacy protection were reported to the quality officer, all of which have been handled through the appropriate channels.

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 Annual Report 2015 | EMGO+ | 35


7

QUALITY CONTROL

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 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, statistical analysis and health technology assessment. 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. We participate in the VUmc working group on Patient-Reported Outcome Measures (PROMs) and the NFU expertise network on PROMs. In 2015 the new COSMIN database on systematic reviews of measurement instruments was launched: database.cosmin.nl Four new grants were obtained in 2015 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 appropriate study outcomes and measurement instruments, 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 Annual Report 2015 | EMGO+ | 36


7

QUALITY CONTROL

short consultations via e-mail, telephone or in person to long-term participation in medical and biomedical research projects. Statisticians, research methodologists, and health economists provide the expertise and support. Health Technology Assessment Health Technology Assessment (HTA) is a multi-disciplinary field of policy-analysis that examines the medical, economic, social and ethical implications of the incremental value, diffusion and use of a medical technology in health care (www.inahta.org). Economic aspects have become more and more important when evaluating the value of new interventions in health care. Thus, most HTA studies evaluate economic aspects associated with the use of existing and implementation of new interventions in health care. The main reason for this increased focus on economic aspects is that health care costs continue to rise in the Netherlands, and other developed countries, while the resources available for health care are scarce. Therefore, policymakers need relevant information to be able to allocate such scarce resources as efficiently as possible. This type of information is typically provided by economic evaluations in which the costs and effects of an intervention are compared with usual care (i.e., cost-effectiveness). Accordingly, information on the cost-effectiveness of interventions is increasingly requested by governments, and funding organizations such as ZonMw and NWO also increasingly demand researchers to show the cost-effectiveness of their proposed intervention in comparison with usual care. Within EMGO+ Institute many trials are conducted that also include an economic evaluation. The design, conduct, analysis and interpretation of these economic evaluations are supervised by a group of experienced researchers embedded in the Department of Health Sciences of the VU University Amsterdam.

Annual Report 2015 | EMGO+ | 37


Figure 5: Some EMGO + dissertations in 2015

Annual Report 2015 | EMGO+ | 38


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 2015 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 2015 EMGO+ publications, ordered per program and by the main categories used in table 6. EMGO+ Institute

2010

2011

2012

2013

2014

2015

Refereed articles

786

851

954

1124

1209

1263

Non-refereed articles

157

17

18

11

5

13

Books and book chapters

131

82

110

102

65

77

PhD-theses

52

42

61

77

58

93

Professional publications

75

110

164

218

200

189

4

5

18

23

23

19

Total publications

1205

1107

1325

1555

1560

1654

Lifestyle, Overweight and Diabetes

2010

2011

2012

2013

2014

2015

139

218

205

259

236

239

Non-refereed articles

15

3

2

0

1

2

Books and book chapters

15

4

17

10

4

5

PhD-theses

3

9

10

20

11

15

Professional publications

9

5

15

21

21

14

Publications aimed at the general public

1

2

2

0

2

1

Publications aimed at the general public

Refereed articles

Total publications

182

241

251

310

275

276

2010

2011

2012

2013

2014

2015

270

288

321

376

419

506

Non-refereed articles

42

7

7

3

0

5

Books and book chapters

62

38

57

31

10

38

PhD-theses

29

18

30

28

10

34

Professional publications

12

44

49

47

54

63

0

0

3

11

9

8

Mental Health Refereed articles

Publications aimed at the general public Total publications

415

395

467

496

502

654

2010

2011

2012

2013

2014

2015

199

210

229

298

334

311

Non-refereed articles

76

6

8

7

4

6

Books and book chapters

47

36

32

50

35

33

PhD-theses

10

9

16

18

20

29

Professional publications

39

51

81

142

109

106

Quality of Care Refereed articles

Publications aimed at the general public Total publications

3

3

11

11

12

8

374

315

377

526

514

493

Annual Report 2015 | EMGO+ | 39


8

SCIENTIFIC OUTPUT

Musculoskeletal Health Refereed articles Non-refereed articles Books and book chapters

2010

2011

2012

2013

2014

2015

178

135

199

191

220

207

24

1

1

1

0

0

7

4

4

11

16

1

PhD-theses

10

6

5

11

17

15

Professional publications

15

10

19

8

16

6

Publications aimed at the general public Total publications

0

0

2

1

0

2

234

156

230

223

269

231

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 2015. A total of 277 EMGO+ PhD students were working on their thesis within the institute, representing ~139 research FTE (see table 3). Of them 46 PhD students were external, i.e. they were not appointed by VUmc. A total of 93 PhD theses were produced in 2015, the titles of which give a very good overview of the EMGO+ research output (see appendix 6). Figure 6 shows an increase in output (articles and dissertations) while the number of FTEs remains relatively constant.

Figure 6: FTE total research staff, number of dissertations, 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) of the University of Leiden. This CWTS analysis has a one-year lag in citations and a two-year lag in publications. Annual Report 2015 | EMGO+ | 40


8

SCIENTIFIC OUTPUT

The analysis does not include publications with only VU University authors. For the EMGO+ Institute this constitutes only 18% of our papers, as the majority of papers are jointly published 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 2934 scientific publications in Thomson Reuters Web of science core collection between 2010 and 2013. For comparisons between faculties and between institutes CWTS calculates a so-called MNCS indicator for which 1 represents world average. The 2015 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 2010 and 2013, and MNCS (based on the number of citations between 2010 and 2014), for the subject categories according to web of science in which we publish at least 50 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 8 out of the 20 categories listed.

Figure 7: CWTS analysis of the EMGO+ Institute’s publication profile 2010-2013 (only VUmc authored publications and joint VU/VUmc authored publications are included)

Annual Report 2015 | EMGO+ | 41


Annual Report 2015 | EMGO+ | 42


9

EARNING CAPACITY

As shown in table 7 and figure 8, the earning capacity of the EMGO+ Institute has increased from almost ~€21 million in 2014 to ~€25 million in 2015. This is rather remarkable in the face of 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. It attests to the high societal appreciation for our research and the grant writing craftsmanship of our researchers. The bulk of our research remains externally funded, with public organizations as the main source (‘2e en 3e geldstroom’) and ZonMw/NWO (€6,4 million) and the European Union (€5,6 million) still as the main contributors. Appendix 7 lists all grants and funding acquired by EMGO+ researchers in 2015. Very successful themes in external acquisition, reflected in the growth of the Quality of Care revenues, is the integrated care for the elderly and the quality of care for cancer patients. 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. 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 2015 | EMGO+ | 43


9

EARNING CAPACITY

EMGO+

2010

2011

2012

2013

2014

2015

RG

18.815.942 €

9.891.265 €

14.726.635 €

10.572.350 €

6.307.295 €

11.878.842

CR

9.713.825 €

7.423.260 €

6.383.789 €

15.483.945 €

12.713.226 €

11.569.503

OF

437.078 €

190.600 €

350.000 €

930.535 €

2.389.170 €

1.708.450

Total

28.966.845 €

17.505.125 €

21.460.424 €

26.986.830 €

21.409.691 €

25.156.795

EU funding €

5.595.581

LOD

2010

3.823.929 €

7.672.424 €

3.342.014 €

%

17,8%

28,4%

15,6%

22,2%

2011

2012

2013

2014

2015

RG

3.716.977 €

1.150.369 €

2.277.395 €

2.153.790 €

689.833 €

929.864

CR

2.200.517 €

1.541.115 €

1.001.199 €

5.789.680 €

287.261 €

1.520.736

OF

169.953

32.500 €

1.500 €

117.780 €

194.000 €

860.000

Total

6.087.447 €

2.723.984 €

3.280.094 €

8.061.250 €

1.171.094 €

3.310.600

MH

2010

2011

2012

2013

2014

2015

RG

7.892.491 €

5.147.627 €

2.994.078 €

2.371.326 €

2.457.118 €

5.139.763

CR

3.399.377 €

2.060.524 €

3.170.810 €

4.698.185 €

6.272.407 €

2.677.348

OF Total

€ €

QoC

1 €

158.100 €

125.000 €

108.300 €

1.338.970 €

528.000

11.291.869 €

7.366.251 €

6.289.888 €

7.177.811 €

10.068.495 €

8.345.111

2010

2011

2012

2013

2014

2015

RG

4.489.200 €

2.271.571 €

7.806.707 €

4.219.864 €

2.807.652 €

5.383.512

CR

1.796.925 €

2.765.767 €

1.846.428 €

4.287.823 €

2.202.184 €

5.866.340

OF

267.121

Total

6.553.246 €

MSH

2010

- ���

220.860 €

360.380 €

759.200 €

320.450

5.037.338 €

9.873.995 €

8.868.067 €

5.769.036 €

11.570.302

2011

2012

2013

2014

2015

RG

2.717.274 €

1.321.698 €

1.648.455 €

1.827.370 €

352.692 €

425.703

CR

2.317.006 €

1.055.854 €

365.352 €

708.257 €

3.951.374 €

1.505.079

OF Total

€ €

3 5.034.283 €

- €

2.640 €

344.075 €

2.377.552 €

2.016.447 €

2.879.702 €

97.000 4.401.066 €

-

1.930.782

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 2015 | EMGO+ | 44


10

ACADEMIC REPUTATION

EMGO+ was externally evaluated in 2010 by a European international site visit committee 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 and received the highest rating for across all domains: quality, productivity, relevance, vitality and feasibility. This external evaluation covered the 20042009 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”. In October 2016 the institute will once more be externally evaluated by an international site visit committee. 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 2015 (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).

Annual Report 2015 | EMGO+ | 45


Photo impression of the EMGO + Annual Meeting in the Rode Hoed

Annual Report 2015 | EMGO+ | 46


11

SOCIETAL RELEVANCE

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 2015 EMGO+ researchers contributed to at least 69 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. 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, 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). Our researchers were interviewed on television multiple times, and 31 interviews on national public radio were broadcasted. Interviews and articles about research projects and their results were published locally or nationally in at least 92 newspapers (online and print) and 62 magazine articles (online and print) and in at least 40 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. The EMGO+ Institute maintains a number of own websites, in part conveying general information, in part explaining the rationale and/or the results of our ongoing research and research collaborations. The list of our most important websites is given in appendix 15. 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, which provides an overview of the 2015 lectures for various non-scientific audiences. Our researchers are frequently involved in teaching programs based on the results of Annual Report 2015 | EMGO+ | 47


11

SOCIETAL RELEVANCE

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 FGB) 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. 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 2015 are listed in appendix 18. 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 2015. In these collaborative networks, practice, research, education and policy are brought together by direct collaboration between clinicians, teachers, researchers and managers.

Academic Collaborative Aim Center Child and Youth Health Improve knowledge transfer Care between health policy, research and education in child and youth health care. Providing scientific evidence for child health care practice and innovation.

Partner(s)

Healthcare Inspection (AWP Toezicht)

Build a scientific evidence-base for health care inspection activities and to provide insight in the process and effects of inspection activities on health care.

Healthcare Inspection (IGZ), IBMG, NIVEL, IQ Healthcare

Insurance Medicine

Improve the quality of work disability assessments and developing and evaluating new return-to-work strategies and tools.

National Institute for Employee Benefits (UWV), AMC, UMCG

Occupational and Environmental Health Service VU-AMD

Prevention of work-related complaints and disease, and effective return-to work intervention for those off work because of sickness. Improving work conditions, lifestyle and workers health.

VU University/VU University Medical Center, department for Occupational Health and Safety (AMD)

Municipal Health Services of Amsterdam, Hollands Noorden, Zaanstreek-Waterland, Gooi & Vechtstreek and the Child Health Care organization Kennemerland.

Annual Report 2015 | EMGO+ | 48


Occupational and Environmental Health Service KLM

Prevention of work-related complaints and disease, and effective return-to work intervention for those off work because of sickness. Improving work conditions, lifestyle and workers health.

KLM Health Services

Occupational and Environmental Health Service Tata Steel

Prevention of work-related complaints and disease, and effective return-to work intervention for those off work because of sickness. Improving work conditions, lifestyle and workers health.

Tata Steel

Network of Academic General Practices

Integrate scientific research, medical education, vocational training and innovation in general-practice care.

University Network of Organizations for Elderly care (UNO)

Anxiety Disorders Depression Bipolar disorders

1. General Practice collaboration (Huisartsencoรถperatie) Groot Zuid, Amsterdam. 2. Amsterdam Health Centers (Stichting Amsterdamse Gezondheidscentra, SAG). 3. HOED Leonard Springer, Haarlem. Build a bridge between research Amaris Zorggroep, Amstelring, and practice in long-term elderly Argos Zorggroep, Beweging 3.0, care, especially in nursing homes. Careyn, Cordaan, Evean, Hilverzorg, Quarijn, Sint Jacob, Viva Zorggroep, Vivium, Warande, Zonnehuisgroep Amstelveen, Zorgbalans, Zorggroep Noorderbreedte, Zorggroep Solis, Zorggroep IJsselVecht, Zorggroep Apeldoorn, Zorgspectrum Establish the biological basis of Psychiatry VUmc, anxiety and compulsion disorders, Policlinic Anxiety and Compulsive unipolar and bipolar depression, disorders (poli Angst- en dwangand their comorbidity with somat- stoornissen), ic disorders to develop innovative Policlinic Bipolar Disorders (Poli interventions for patients treated bipolaire stoornissen Altrecht, for these disorders. Dimence), GGZ inGeest

Care for the Intellectually Disabled

Develop academic research on developmental pathways, personalized treatment and quality of care for people with intellectual disabilities in the Institution.

s'Heerenloo Institute

Psychological Complaints

Provide evidence-based advice and support in case of sadness, anxiety, stress and other psychological symptoms.

GGZ inGeest-Prezens

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+ Institute, although the embedded PhD program started in 2013 is already starting to provide good bridgeheads into industry (see appendix 13). Annual Report 2015 | EMGO+ | 49


Strengths

      

 

Weaknesses

Inclusive in its broad extra-, trans- and intramural scope, but focused in its actual research by the thematic research programs (mass and focus). Methodological rigor and innovation in both clinical and public health evaluation (including cost-effectiveness analysis), and epidemiological research. Strong national and international collaborative networks.

Not fully developed networks with small and medium-sized enterprises (SMEs) and industry, hampering the formation of public private partnerships for research on EMGO+ research themes.

Small number of (tenured) staff members (relative to the large number of PhD students).

Low number of international staff and PhD students.

Widely respected for its promotion and control of the quality of the scientific process and scientific conduct. Internationally renowned longitudinal cohort studies (e.g., LASA, NESDA, NTR, Hoorn, Generations2, 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, UWV 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 (73% of total funding), even in the face of dwindling national research funding. Opportunities

S W O T

EMGO+ research themes figure prominently on European research agenda (Horizon 2020).

EMGO+ research themes figure prominently on the National Science Agenda (NWA).

Main research 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).

The potential of E-health and M-health applications in our field.

Growing focus on patient perspective s in health care, including patient participation, person centered medicine and patient rights, and on societal participation of people with and without disabilities.

VUmc/AMC collaboration within Amsterdam Public Health expands and strengthens the existing research themes in the LOD, MH and QoC programs and brings new programs that, amongst others, allow us to:

Create more coherence in EMGO+ research on Aging and Later Life, thereby doing justice to the societal urgency and the substantial amount of EMGO+ researchers working on this theme.

Develop Societal Participation as a major research theme within and beyond the boundaries of occupational health.

Expand our health care (services) research to Global Health care (services) research.

Create a strong program dedicated to innovation in Annual Report Methodology.

Threats

Thinning of mid-career levels, aggravated by new national laws on temporary contracts (maximum of 2, total duration of 4 years) and poor long-term career perspectives for PhDs and postdocs.

Strong dependency on external funding threatens high risk projects and true innovation.

The complex merger of VUmc and AMC and the change from being the EMGO+ Institute to Amsterdam Public Health will put pressure on existing achievements accrued in EMGO+’s long history , e.g.,

The tight and very successful VU/VUmc multidisciplinary collaboration at the Boelelaan campus needs to be reconsidered to incorporate a large “third” party.

The existing and highly praised EMGO+ quality control system will be reconsidered.

The visibility of trans- and extramural research within the UMCA will be smaller, as the focus of the seven other newly created VUmc/AMC research institutes is largely intramural, and focuses on specialized (tertiary) care.

The brand “EMGO+” will be lost before the APH brand is established.

2015 | EMGO+ | 50


Annual Report 2015 | EMGO+ | 51


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


EMGO+ Annual Report 2015