1. Unlocking the Power of NHANES

2. Agenda I.Introduction Joshua Murphy, Vice President II.Demonstration/Training Dennis Wijnker, Senior Software Architect, VP of Technology III.Question/Answer Session

3. Presenter Biography Dennis Wijnker Sr. Software Architect; VP, Technology Mr. Wijnker has more than 15 years of experience in Software Development, filling positions of technical and managerial leadership. He has extensive experience building web-based and standalone platforms, primarily in the fields of Health Care and Life Sciences. Amongst others, Mr. Wijnker has developed a web-based fully configurable Electronic Data Capture platform for managing clinical trials that is still used today by many pharmaceutical companies and Clinical Research Organizations. He was also instrumental in integrating said platform with other technologies used in clinical trials. Prior to focusing on technology, Mr. Wijnker studied Bio-Pharmaceutical Sciences at Leiden University (Leiden, The Netherlands). At Doctor Evidence, Mr. Wijnker is responsible for software and systems architecture, product management as well as quality assurance. He has been involved in development of the company’s core software platform, led development for the NHANES Query tool and is currently focusing on a comprehensive and collaborative guideline development platform.

4. Doctor Evidence Core Solutions: LMS and EVP Through an easy navigation system, users can create graphs, forest plots, and comparison reports with the click of a button. Our medically-compliant meta- analysis and pooling tools maximize the value of clinical data.  Assess Comparative Effectiveness: Evaluate competing treatments by patient profile in a side-by-side view.  Analyze Clinical Literature Gaps: Identify holes in the published clinical evidence to plan future research or publications.  Replicate and Audit Systematic Reviews: Assess the strengths and weaknesses of the body of clinical evidence.

5. Doctor Evidence Platform Literature Management System (LMS) Research Articles, Posters, Systematic Reviews, Guidelines Search Tools E-Dossiers/Regulatory Submissions Trial Design / Simulation Comparative Effectiveness & Meta Analysis Online HCP and Consumer Sites Evidence Portal (EVP) and Database Static References Doctor Evidence Solutions Dynamic Results Internal data, marketing materials Web-based Literature Repository Clinical Data Extraction

6. The National Health and Nutrition Examination Survey (NHANES) is a program of studies designed to assess the health and nutritional status of adults and children in the United States. The survey is unique in that it combines interviews and physical examinations. The NHANES interview includes demographic, socioeconomic, dietary, and health-related questions. The examination component consists of medical, dental, and physiological measurements, as well as laboratory tests administered by highly trained medical personnel. What is NHANES?

7. What Areas are Covered? Physical fitness and physical functioning Reproductive history and sexual behavior Respiratory disease (asthma, chronic bronchitis, emphysema) Sexually transmitted diseases Vision Oral health Osteoporosis Anemia Cardiovascular disease Diabetes Environmental exposures Eye diseases Hearing loss Infectious diseases Kidney disease Nutrition Obesity

8. Current Challenges No way to locate data of interest in NHANES other than browsing the web site Requires knowledge of Analytic Guidelines - each dataset may have specific analytic requirements Analysis is not possible without statistical software package and a lot of custom programming Even with a statistical software package data is hard to analyze (e.g. prescription data) Steep learning curve

9. 1 Navigate through NHANES web site to identify relevant data organized by cycle, component and dataset 2 Review and understand analytic guidelines for NHANES 3 Download and import appropriate data files for each cycle of interest 4 Append data 5 Merge data 6 Clean and Recode data 7 Program query in statistics program 8 Select correct weight(s) and/or construct weight across survey cycles 9 Apply Age Standardization 10 Calculate Population estimates 11 Get Results / Create Graphs and Tabular Data 12 Interpret results, identify missing data, go back to step 1. Current Steps to get to the Data