Data Linkage with Alberta's Tomorrow Project

Your daily activities, such as eating, sleeping and physical exercise, can have great impact on your health. By filling out health and lifestyle questionnaires, participants of Alberta’s Tomorrow Project (ATP), the largest population-based cohort study of cancer and chronic diseases in Alberta, provided unique information on individual lifestyle behaviors and disease risk factors. This information about personal behaviours cannot be easily obtained from other data sources, and is an important contribution to help people understand the underlying causes leading to chronic conditions like cardiovascular disease, diabetes and cancer.

The ATP cohort began in 2000 and is led by a team based in Alberta Health Services. Over 50,000 Albertans participate in this project. In 2008, ATP joined forces with other regional cohorts to create a nation-wide research platform known as the Canadian Partnership for Tomorrow’s Health (CanPATH; https://canpath.ca/). More details of ATP can be found at www.myATP.ca.

How can we make the ATP cohort data even more valuable for the study of chronic diseases? Almost all – more than 99% – of ATP participants have given consent to linking their personal behavioral and risk factor survey data to other health-related records. With the support of Alberta Health (AH), the Ministry of Health in Alberta, ACHORD has partnered with ATP to build an Alberta-based research platform for cancer and chronic disease study by linking multiple health data sources to the ATP cohort. These health datasets include AH clinical and healthcare data, Alberta Precision Laboratories (APL) diagnostic laboratory data, Alberta Cancer Registry (ACR) cancer diagnosis and treatment data and the Canadian Urban Environmental Health Research Consortium (CANUE) socio-geographic data.

By linking all these health data together with the ATP cohort, researchers in Alberta can easily access anonymous, de-identified individual level healthcare data, such as doctors’ visits, medication, diagnosis and health outcomes, along with patients’ individual lifestyles, biomarker data, socio-economic status, socio-geographic and environmental factors. ATP research using multiple data sources linked by the ACHORD can help clinicians and policy makers get a holistic view of how personal lifestyle behaviors, social and environmental factors and healthcare systems interact with each other to influence the health and wellness of Albertans. Linking and co-analyzing the ATP lifestyle and risk factor data with other health-related data has greatly enhanced the research capacity of ATP to study cancer and chronic diseases. The following is a list of publications arising from this ACHORD-ATP partnership, using the ATP cohort data linked with multiple health datasets.

1. Nonfasting remnant cholesterol and cardiovascular disease risk prediction in Albertans: a prospective cohort study. Weaver OR, Krysa JA, Ye M, Vena JE, Eurich DT, Proctor SD. CMAJ Open. 2023 Jul 25;11(4):E645-E653. doi: 10.9778/cmajo.20210318. Print 2023 Jul-Aug. PMID: 37491049

2. Impact of Comorbidity on Hospitalization and Emergency Room Visits in Adults With Diabetes: A Longitudinal Study of Alberta's Tomorrow Project. Ye M, Vena JE, Johnson JA, Shen-Tu G, Eurich DT. Can J Diabetes. 2023 Jun;47(4):359-367. doi: 10.1016/j.jcjd.2023.02.006. Epub 2023 Feb 27. PMID: 37178108

3. Non-fasting lipids and cardiovascular disease in those with and without diabetes in Alberta's Tomorrow Project: A prospective cohort study. Weaver OR, Ye M, Vena JE, Eurich DT, Proctor SD. Diabet Med. 2023 May 12:e15133. doi: 10.1111/dme.15133. Online ahead of print. PMID: 37171453

4. Anti-Hyperglycemic Medication Adherence and Health Services Utilization in People with Diabetes: A Longitudinal Study of Alberta's Tomorrow Project. Ye M, Vena JE, Johnson JA, Shen-Tu G, Eurich DT. Patient Prefer Adherence. 2022 Jun 11;16:1457-1467. doi: 10.2147/PPA.S362539. eCollection 2022. PMID: 35722195

5. Chronic disease surveillance in Alberta's tomorrow project using administrative health data. Ye M, Vena JE, Johnson JA, Shen-Tu G, Eurich DT. Int J Popul Data Sci. 2021 Oct 21;6(1):1672. doi: 10.23889/ijpds.v6i1.1672. eCollection 2021. PMID: 34734125 

6. Diet Quality and Health Service Utilization for Depression: A Prospective Investigation of Adults in Alberta’s Tomorrow Project. Marozoff S, Veugelers PJ, Dabravolskaj J, Eurich DT, Ye M, Maximova K. Nutrients. 2020 Aug 13;12(8):2437. doi: 10.3390/nu12082437. PMID: 32823652

7. Validation of drug prescription records for senior patients in Alberta’s Tomorrow Project: Assessing agreement between two population-level administrative pharmaceutical databases in Alberta, Canada. Ye M, Vena JE, Johnson JA, Xu JY, Eurich DT. Pharmacoepidemiol Drug Saf. 2019 Oct;28(10):1417-1421. doi: 10.1002/pds.4861. Epub 2019 Jul 26. PMID: 31348593

8. Systemic use of antibiotics and risk of diabetes in adults: A nested case-control study of Alberta’s Tomorrow Project. Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Diabetes Obes Metab. 2018 Apr;20(4):849-857. doi: 10.1111/dom.13163. Epub 2017 Dec 27. PMID: 29152889

9. Anthropometric changes and risk of diabetes: are there sex differences? A longitudinal study of Alberta’s Tomorrow Project. Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. BMJ Open. 2019 Jul 19;9(7):e023829. doi: 10.1136/bmjopen-2018-023829. PMID: 31326923

10. Changes in body mass index and incidence of diabetes: A longitudinal study of Alberta’s Tomorrow Project Cohort. Ye M, Robson PJ, Eurich DT, Vena JE, Xu JY, Johnson JA. Prev Med. 2018 Jan;106:157-163. doi: 10.1016/j.ypmed.2017.10.036. Epub 2017 Nov 5. PMID: 29117506

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