About The PERSIAN Cohort
The Prospective Epidemiological Research Studies in IrAN (PERSIAN) is a nationwide cohort study launched in the year 2014 in an attempt to encourage research in the fields of medicine, epidemiology, health, and nutrition. PERSIAN has empowered medical schools around the country with the necessary resources to take part in the study, in order to identify the risk factors related to the most prevalent chronic diseases in Iran, with the ultimate goal to reform the health system and enhance the health of Iranians, while contributing to the world’s medical knowledge.
Although the name PERSIAN Cohort mainly refers to the most extensive adult component, birth, youth and elderly components are also simultaneously being carried out in different parts of Iran. The PERSIAN Birth Cohort involves pregnant women and their newborn infants to investigate the relationship between genetic, environmental and social factors on human development, while the PERSIAN Youth Cohort focuses on psychiatric disorders and substance abuse. The PERSIAN Elderly Cohort, the so far smallest component, studies the aging process. (Learn more about the PERSIAN Birth, Youth and Elderly Cohorts under the Parallel Studies tab.)
Rationale for the PERSIAN Cohort
Health of populations is not static; it has a changing trend that should be continuously measured, monitored, modified, and evaluated in a cycle. Accordingly, evidence–based health policies should also be updated and tailored to the continuously changing needs and priorities of a community, and their cost-effectiveness and efficiency should be evaluated on a regular basis.
In Iran, similar to many other developing countries, there has been a shifting trend in the prevalence of diseases from communicable diseases and those passed from a mother to her child, towards non-communicable diseases, calling for action and reform in the health system. For health policies to be evidence-based, there needs to be adequate research performed in the field.
Today, many chronic diseases, such as heart disease, cancers, respiratory diseases, etc. are the leading causes of death in Iran. Although a large amount of research has been done thus far, unraveling the causes of many chronic diseases; however, much of this knowledge is based on studies in the West, and does not generally suffice to explain much of the large geographic differences in disease rates around the world, between different countries, and even within one country. Consequently, the etiology of many common chronic diseases in Iran is still poorly understood, and there is still substantial uncertainty about the impact of many common risk factors to population mortality.
Among epidemiological research methods, interventional studies and prospective cohort studies are the most credible. Cohort studies are necessary for investigating the determinants and risk factors of major diseases. Since the mid-1900s, a number of large cohort studies such as the Framingham Study, Nurses’ Health Study, the Asia- Pacific Cohort Studies Collaboration, and the Alberta Cancer Board were launched mainly in developed countries, enhancing the general medical knowledge about the distribution and causes of major diseases, disabilities, and mortality. Similar studies, however, have been rare in developing countries.
In Iran, the Gastro-Esophageal Malignancies in Northern Iran (GEMINI), was launched in the year 1996, with the aim of investigating esophageal and stomach cancers and their determinants. Today, the findings in GEMINI have gone much further than its original goals, highlighting the high and increasing prevalence of cardiovascular diseases, cancers, and injuries in North Eastern Iran. About 50% of cohort deaths are due to ischemic heart disease and cerebrovascular accidents, while 50% of people are hypertensive, and about 6% of deaths are due to accidents. The results of GEMINI have made it clear that it will be incredibly important and rewarding to launch a large scale national cohort—the PERSIAN Cohort—to investigate the contributing factors and causes of various chronic diseases in Iran, in order to plan for effective interventions for their prevention and treatment.
PERSIAN Cohort is a prospective study aiming to include 170,000 men and women throughout Iran. Originally intended to be carried out in 10 geographically distinct areas, the PERSIAN Cohort has now stretched to 17 regions of Iran, chosen based on local disease patterns, exposure to certain risk factors, population stability causes of death, local commitment and capacity. All individuals 35-70 years of age in the selected sites are recruited and those who agree to participate will be included in the study.
PERSIAN Objectives and Outcomes of Interest
The health-oriented and research-oriented objectives of the PERSIAN Cohort are divided into two categories as followed:
Research and Public Health Objectives:
Health System Research objectives:
Outcomes of Interest
Data and Specimen Collection
Questionnaires and Physical Examinations
As part of the data gathering for the PERSIAN Cohort, a comprehensive interviewer-administered electronic questionnaire consisting of 3 major sections—General, Medical and Nutrition—has been developed, encompassing many different aspects of an individual’s life, which may have an impact on their health status. In addition to the questionnaires, a physical examination is performed and pulse, blood pressure and anthropometric measurements are also recorded.
Data is gathered at each location using a pre-designed software and pooled into a Central Data Bank. Topics covered in the PERSIAN Cohort questionnaire are as followed:
Funding and Governance
The PERSIAN Cohort is governed by a Central Committee, led by Dr. Reza Malekzadeh, the Deputy of Technology and Research at the Ministry of Health and Medical Education (MOHME). In addition, principle investigators (PIs) from each university also govern their own site. While the MOHME provided the necessary funds to set the cohort infrastructure at the cohort sites, each university is responsible for their funding, with some support from the MOHME.
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