1. Epidemiology in the Hospital Setting Benjamin A. Rybicki, PhD Senior Scientist, Henry Ford Hospital

2. Henry Ford Health System AgeFemalesMalesTotal 0 - 176345866583130041 18 - 29423063918981495 30 - 39384623215070612 40 - 49519244613898062 50-59527334700099733 60-69315782963861216 70-79137731171025483 80+9943676416707 Total304177279172583349 FemalesMalesTotal Age#% of pop# # 0-17105297.6%108147.8%2134315.4% 18-2988876.4%76675.5%1655411.9% 30-3965434.7%47753.4%113188.1% 40-49107617.7%83626.0%1912313.8% 50-591440010.4%114988.3%2589818.6% 60-69111868.0%98167.1%2100215.1% 70-7978465.6%60534.4%1389910.0% 80+58554.2%39762.9%98317.1% Total7600754.7%6296145.3%138968100.0%

5. Molecular BioHuman Populations Statistics Epidemiology Molecular Biology Laboratory Mol Biologists Population Database Laboratory Prog/Data Mgrs. Epidemiology Epidemiologists Statistics Biostatisticians Interviewers Abstractors Data Entry Respiratory Research Cancer Neuro Cardiovascular Biostatistics & Research Epidemiology www.henryford.com/body.cfm?id=39207

6. BRE Organizational Structure Biostatisticians 13 Epidemiologists 16 Molecular Epid Research Lab 6 Data Management & Programming 10 Abstracting, Interviewing, RN/LPNs, MAs 36 Data Entry 2 Computer Facility 4 Secretarial 3 Grants Managers 2 Project Support 10 Administrative Manager 1 Total Staff 103

9. Benign Cohort 1990 – 2006 N=8,117* PSA test +/- 1 year of benign specimen (N=7,122) Prostate cancer diagnosis on or before 12/31/2010 Cases N=1,441 Controls N=5,681 ≥ 1 year between benign specimen and cancer diagnosis N=1,136 ≥ 1 year of follow-up after benign biopsy N=4,431 Benign tissue available for study N=931 Benign tissue available for study N=3,633 Tumor tissue available for study N=698 Aim 1 & Aim 2 Aim 3 Yes No Case-Control Matching: Age, race, and follow-up duration 800 case-control pairs 650 case-control pairs A Nested Case-Control Study using a Pathology-based Cohort

10. At Henry Ford, epidemiologists lead and co-lead research in step with the mission of the health system. Biostatisticians are often co-investigators on epidemiologist-lead research, but focus most on statistical issues across multiple projects. Epidemiologists tend to favor observational studies, but often employ methodologies developed by basic science researchers and team with clinical researchers doing intervention studies. Investigators who want to use population data to address a research question can benefit from interactions with an epidemiologist.At Henry Ford, epidemiologists lead and co-lead research in step with the mission of the health system. Biostatisticians are often co-investigators on epidemiologist-lead research, but focus most on statistical issues across multiple projects. Epidemiologists tend to favor observational studies, but often employ methodologies developed by basic science researchers and team with clinical researchers doing intervention studies. Investigators who want to use population data to address a research question can benefit from interactions with an epidemiologist. Summary