MR1b - Health and Development Study - S251 Cohort members
University College London (UCL) · Academic
In term In term in the September 2026 edition: the latest version runs to 21 January 2027.
- Reference
- DARS-NIC-86954-Y0R2N
- Current version
- v7.2
- Term of current version
- 18 October 2024 to 21 January 2027
- Start date
- Before 23 January 2019
- Data controller
- Sole Data Controller
- Commercial purposes
- No
- Sublicensing
- No
- Files released to date
- 63
Why the data was released
Objective for processing
The Medical Research Council National Survey of Health and Development (NSHD) is the oldest and longest running of the British birth cohort studies. From an initial maternity survey of 13,687 (82%) of all births recorded in England, Scotland and Wales during one week of March, 1946, a socially stratified sample of 5,362 singleton babies born to married parents was selected for follow-up. The NSHD study team is housed within the MRC Unit for Lifelong Health and Ageing (LHA) at University College London (UCL).
Linkages for Scotland and Wales will be performed separately to the NHS England linkage. The linkages to central NHS held data will only involve the transfer of data for patients recruited in those nations, so for example there will be no data transferred to NHS England for patients recruited in Welsh institutions.
The NSHD study team has collected unique lifetime data on body size and maturation, cognitive and physical function, socioeconomic status and diet; and has repeat adult data on diet, smoking, physical activity, blood pressure and lung function. The most intensive data collection in 2006-2010, when study members were aged 60-64 years, included measurement of cardiac structure and function, body composition and bone density.
The 24th and most recent data collection to the whole sample included a postal questionnaire in 2014 and a home visit by a trained research nurse for interview and assessment in 2015/2016. At the 24th follow-up, the target sample was 2816 study members still living in mainland Britain; this is the maximum sample used in the analyses. Of the remaining 2546 (47%) study members: 957 (18%) had already died, 620 (12%) had previously withdrawn permanently, 574 (11%) lived abroad, and 395 (7%) had remained untraceable for more than 5 years.
Where study members have become lost to follow up, the MRIS data (Cohort Event Notification Report, List Cleaning Report, Flagging Current Status Report and Cause of Death Report) being provided under this application will enable NHS England to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
The NSHD was the first study (in 1971) to have participants flagged on the NHS Central Register for mortality (ICD codes are used to code cause of death) and cancer registrations. The LHA receives notifications on an ongoing quarterly frequency.
The LHA wishes to link NSHD study members to HES data in order to improve the quality of information on hospital admissions and health outcomes for research purposes. Currently, the study obtains self-reported hospital admission data at each follow-up which are then confirmed through contact with each hospital.
The data from HES will be used to improve the identification of acute events such as those caused by cardiovascular disease (CVD). For example, the unit will assess how life course risk factor trajectories of body size, resting heart rate, blood pressure, socio-economic position (SEP) and health related behaviours, accumulate and interact to influence incidence of CVD, thus potentially identifying possibilities for earlier prevention. As the cohort is entering older age, hospital care becomes increasingly frequent and study members are thus less likely to report hospital admissions over a number of years accurately. It is therefore important to capture this information in other ways. New research within LHA on health service use is being developed which will utilise these data and investigate life course predictors of health care utilisation.
The data collected on the NSHD cohort, including that provided by NHS England, is used across five research integrated programmes with the overarching aim of identifying social and biological factors that affect lifelong health, ageing and the development of chronic disease risk.
The five programmes are:
1) Enhancing NSHD
2) Functional Trajectories and Cardiovascular Ageing
3) Physical Capability and Musculoskeletal Ageing
4) Mental Ageing
5) Wellbeing in older age
Historic HES data has now been previously added to the agreement in order for NSHD to continue their work on linking NSHD data to HES data, historic data has been requested (Admitted Patient Care: 1997/98 – latest; Outpatients: 2003/4 – latest; A&E: 2007/8 – latest). It had previously been thought that these historic data were too incomplete for research purposes. However, recent work by contemporary cohorts indicate that such data are indeed adequate for purposes such as those originally outlined for the NSHD application for HES data from 2012 onwards, i.e. improving the quality of information of hospital admissions and health outcomes, and identifying acute events. The overall objectives for NSHD have always been to investigate risk and protective factors from across the life course that influence the ageing process and this application for historic HES data is entirely in keeping with this purpose.
There are a number of reasons why the addition of historic HES data will be invaluable to meeting the research objectives. The team will use these data to identify health events which have occurred since the earliest HES data became available, thus enriching and enlarging on existing self-reported data, gathered on an intermittent basis. The frequency of hospital admissions increases with age and the cohort participants were already aged 43 years when HES data were first compiled in 1989. Increasing frequency of admissions with age, often with multiple co-morbidities, renders self–report of diagnoses and timing of events less accurate. ‘Complete’ HES data will be particularly important not only for acute cardiovascular events such as myocardial infarction and stroke, but also for many chronic conditions, for example heart failure- a major cause of morbidity and mortality in older age, but where self-reported diagnosis is known to be unreliable and where underlying causal mechanisms are poorly understand, but likely to be influenced by factors operating across the life course. Complete HES data will also improve the accuracy of the ongoing NSHD study of life course predictors of health care utilisation in older age. In addition, complete HES records will be valuable for members of the cohort who no longer actively take part in the study. For these participants who are otherwise lost to morbidity follow-up the team will have records of their major health events since early middle age, thus minimising bias.
This agreement is for university research, the lawful basis for processing data is GDPR article 6(1)(e): ‘Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller’. Also referred to as ‘Public Task’. As the research involves health data, which is included in the definition of special categories of personal data, it requires an additional condition for processing. Based on guidance, for health research this is article 9(2)(j), which details that processing is necessary for scientific and research purposes, subject to appropriate safeguards.
For this programme of research, UCL are the sole Data Controller who also process data.
A nursing agency is involved in the wider project for solely collecting data directly from consented patients through home visits. NSHD will provide the nursing agency with the contact details of the study member so they will be able to make appointments with them. NSHD will also send the information needed for the feed forward section. The data will be encrypted and password protected before being securely transferred. The nursing agency will collect the data directly from the consented patient using Computer Aided Interview (CAI). These data will have basic cleaning performed before it is sent back the NSHD. The nursing agency will not have any access to data disseminated by NHS England under this agreement.
The Unit has a 5-year Medical Research Council core funded programme of research based on the NSHD with the objective to investigate risk and protective factors from across the life course that influence the ageing process. This core funding has been in place since 1962 and is renewed every five years after scientific review.
Processing activities
The University College London (UCL) originally sent a cohort to NHS England with the patient identifiers of NHS Number, Date of Birth and Study ID, this continues to be held by NHS England. The cohort of 1,978 will not be added to for this agreement (v4).
NSHD receives data from two main sources i) collected from the study members themselves over the past 70 years and ii) from NHS England; these data are held in the NSHD-Data Repository (NSHD-DR). Study participants are flagged with NHS England. NHS England provides notifications of deaths and cancer registrations on a quarterly frequency. These data are incorporated into the NSHD-DR to enhance that dataset for research purposes. The mortality data (fact of death) are also used for administrative purposes. As well as being used to identify specific health events, linkage to HES data will allow the derivation of useful aggregate variables such as number of hospital admissions and length of time in hospital. The derived aggregate variables are then used for other research analyses by LHA scientists and may be shared with external researchers.
In scientific studies in the period that pre-dated the MREC/LREC structure, consent was assumed by participation. In this study, the period of assumed consent covers the years from birth to age 35 years (from 1946 to 1981). Ethical permission for the 1982 and 1989 studies was obtained from the local ethical committees that preceded the LRECs and were run by the teaching hospital to which the NSHD research team were then affiliated (Bristol in 1982 and UCL in 1989. In 1999, MREC approval was obtained for the data collection and its use for research purposes by the team and their collaborations (MREC98/1/121). Ethical approval for the feasibility study (MREC06/Q1407/26) and extension study (07/H1008/245) was obtained from the Central Manchester Research Ethics Committee, and additional Scottish approval (08/MRE00/12) was granted through the Scotland A Research Ethics Committee. Most recently, a favourable opinion was obtained from the London Queen Square REC (14/LO/1073) and Scotland A REC (14/SS/1009).
The legal basis for access to NHS England data for DARS-NIC-148100-6RFK9 (MR1a) is through consent. In this parallel agreement for members who are lost to follow up, DARS-NIC-86954-Y0R2N (MR1b), the legal basis is through Section 251 of the NHS Act 2006 (CAG approval ref: 15/CAG/0139).
Derived NHS England data will be linked to the NSHD-DR which stores all study member data in pseudonymised form going back to 1946. NHS England identifiable data can only be viewed by named NSHD staff and is stored separately from pseudonymised derived data. The NSHD-DR additionally holds hospital admissions data that was previously obtained directly from the hospitals or General Practitioners.
All organisations party to this agreement must comply with the Data Sharing Framework Contract requirements, including those regarding the use (and purposes of that use) by “Personnel” (as defined within the Data Sharing Framework Contract ie: employees, agents and contractors of the Data Recipient who may have access to that data).
All those with access to the data are substantive employees of University College London.
The data from NHS England will not be used for any other purpose other than that outlined in this Agreement.
There will be no onward sharing of record level data as part of this application.
Expected output
The data will be used on an ongoing basis to update study member records. The database will be updated after each data release.
The primary output of the linkages with HES, mortality and Cancer Registration data are the maintenance and enhancement of the NSHD-DR. This is in turn used to achieve multiple research outputs that benefit health and social care.
As this is a two part cohort (MR1a and MR1b) the project requires access to both data to be able to understand and make sense of the complete dataset. Although the project has been able to conduct some work on investigating the impact of birth weight on later life cancer, health inequalities and physical activity, it is not yet in a position to publish these data.
The programme ‘Enhancing NSHD’ examines many of the genomic and other epigenomic (genetic material of a cell) and metabolomics (systematic study of the unique chemical fingerprints that specific cellular processes leave behind) factors that influence the risk of many age-related diseases and quantitative traits, often in collaboration with external researchers.
The programme ‘Functional Trajectories and Cardiovascular Ageing’ examines which factors from across the life course promote good adult cardiovascular function and prevent disease onset, and which increase vulnerability to accelerated cardiovascular ageing.
The programme ‘Physical Capability and Musculoskeletal Ageing’ examines which factors from across the life course promote good adult physical capability and musculoskeletal health, and which increase vulnerability to accelerated decline in capability.
The programme ‘Mental Ageing’ examines which factors from across the life course promote cognitive capability and protect against depression and which factors increase vulnerability to cognitive decline.
The programme ‘Wellbeing in older age’ examines what social contexts and experiences in childhood and early adulthood promote wellbeing in later life and whether wellbeing protects against functional ageing.
Each of these programmes generate multiple publications in peer review journals annually and findings are further disseminated via conference presentations. A full list of publications produced to date plus details of the current priorities for each programme are published on the MRC LHA website at: http://www.nshd.mrc.ac.uk/.
Publications and presentations only use data that is aggregated with small numbers suppressed in line with the HES Analysis Guide.
This MRC Unit is committed to research on ageing – outputs arising from ONS data will be anonymised in the form of tables, graphs, peer reviewed journals, presentations and books.
These data have been used in a number of publications. A full list of publications can be found at http://www.nshd.mrc.ac.uk/findings/
Expected measurable benefits
The NSHD has informed UK health care, education and social policy for 70 years and is the oldest and longest running of the British birth cohort studies. Today, with study members in their early seventies, the NSHD offers a unique opportunity to explore the long-term biological and social processes of ageing and how ageing is affected by factors acting across the whole of life.
Work is also underway to create disease algorithms, in collaboration with colleagues from HDR-UK, which will enable direct comparisons with other cohorts.
Evidence is growing from this cohort study and others, that factors from early life (such as growth, neurodevelopment, nutrition and family socioeconomic circumstances) as well as later life (such as adult smoking, diet, exercise and socioeconomic circumstances) affect the opportunity to age well. This is of interest to policymakers, practitioners, and older people themselves.
The research using NSHD life course information will provide insights into when in the life course interventions to prevent disease (in particular CVD). This information will inform the design of future interventions which can then be tested in controlled trials.
In particular, through knowledge transfer, public engagement, publications, presentations and invited commentaries (http://www.nshd.mrc.ac.uk/findings/) the MRC LHA has contributed to a body of evidence to influence policies and support evidence based medicine. For example, recent paper in PLOS Medicine comparing lifetime trajectories of overweight and obesity across NSHD and the later born cohorts has been cited in the recent Government’s Child Obesity Strategy. Other examples highlighting the depth and breadth of this lifelong study include:
• NSHD is a member of the Dementias Platform UK, a £53 million collaboration between universities and industry established by the MRC in 2014, to transform the best dementia research into the best treatments as quickly as possible. It combines the power of multiple population studies to compare healthy people with people at all stages of dementia.
• The NSHD finding, in 2014, that more rapid rises in systolic blood pressure during midlife (even if not crossing into hypertension) were related to poorer cardiac structure (published in the European Heart Journal in 2014) has implications for treatment guidelines as it suggests that identification and treatment of people with rapidly increasing SBP, even if they are not reaching the criteria for hypertension, may be beneficial in preventing subsequent cardiovascular disease.
• The NSHD findings (published in The Lancet Diabetes & Endocrinology in 2014) suggesting that those who lost weight at any age during adulthood, even if weight was regained later, had better cardiovascular risk profiles than those who remained overweight or obese supports public health strategies that help individuals to lose weight at all ages.
• In 2014, the NSHD finding that better performance in tests of physical capability (i.e. grip strength, chair rising and standing balance) in midlife was linked to higher survival rates over 13 years of follow-up was published in the British Medical Journal. This highlighted the value of these simple objective physical tests in helping to identify those people who from at least as early as midlife onwards may require more support than others to achieve a long and healthy life.
• Subsequent work examining changes in objective measures of physical capability between ages 53 and 60-64 has highlighted that age-related decline may not be entirely inevitable and is potentially modifiable. This work has also suggested that there may be a need to monitor physical capability from at least as early as midlife onwards as opportunities to help some high risk groups may already have been missed if no action is taken until later in life.
• A 2009 report on adult life chances in relation to childhood mental health using NSHD was cited by the government in support of a case for early intervention to build mental capacity and resilience.
• The study’s findings of the continuing effect of early life growth and development on health outcomes in adulthood add to the arguments for early intervention of the kind provided by the national SureStart programme.
• The 1999 paper comparing children’s diet in 1950 with that in the 1990s (‘Food and nutrient intake of a national sample of four-year-old children in 1950: comparison with the 1990s’, Public Health Nutrition) had an impact because of its evidence that the quality and nutrient value of infant and childhood diet had declined between 1950 and 1990.
• The study’s finding (published in All our Future in 1968) of the extent and inequity of the ‘waste of talent’ – in terms of high ability children who did not continue into further or higher education – added to arguments for improving opportunities for, and expectations of, children from poorer families.
• The Home and the School (1964) had a great impact, probably because it provided the first hard evidence that parents and preschool circumstances had a significant impact on ability and attainment at age eight, and so showed that preschool development and experience formed the bedrock on which primary schooling was built.
• Press reports that followed the publication of Maternity in Great Britain (1948), which were concerned with the ‘Need for Better Care and Lower Costs’ (The Times), are likely to have influenced the arguments for improvements in the care of mothers and babies.
Benefits reported so far
The research has also enabled insights into how the socioeconomic circumstances in early and adult life affect premature mortality, risks and rates of adult multimorbidity accumulation.
The use of the linked dataset (i.e the combination of data previously collected in NSHD and NHS England data) has enabled a number of manuscripts to be drafted, presented at conferences and contribute to our understanding of life course ageing.
For example, the research has enabled insights into chronic respiratory diseases. For example, children who had a lower respiratory tract infection (LRTI), such as bronchitis or pneumonia, by the age of two were almost twice as likely to die prematurely in adulthood from respiratory diseases. Our research has shown that early respiratory health has an impact on mortality later in life and highlights the need to prevent childhood respiratory infection.
Allinson JP, Chaturvedi N, Wong A, et al., Early childhood lower respiratory tract infection and premature adult death from respiratory disease in Great Britain: a national birth cohort study. Lancet. 2023 Apr 8;401(10383):1183-1193.
We have also highlighted the need for further work into e-smoking; where vaping was shown to cause similar DNA damage to smoking, which has been linked to the future development of lung cancer in smokers.
Herzog C, Jones A, ... Wong A, et al. . Cigarette Smoking and E-cigarette Use Induce Shared DNA Methylation Changes Linked to Carcinogenesis. Cancer Res. 2024 Jun 4;84(11):1898-1914.
Other examples include:
Lau CE, Manou M, et al. NMR metabolomic modelling of age and lifespan: a multi-cohort analysis. medRxiv [Preprint]. 2023 Nov 8:2023.11.07.23298200.
Topriceanu CC, Dev E, et al. Accelerated DNA methylation age plays a role in the impact of cardiovascular risk factors on the human heart. Clin Epigenetics. 2023 Oct 18;15(1):164.
Hostettler IC, Seiffge D, Wong A, et al. APOE and Cerebral Small Vessel Disease Markers in Patients With Intracerebral Hemorrhage. Neurology. 2022 Sep 20;99(12):e1290-e1298.
Datasets on the current version
Legal basis for provision: Health and Social Care Act 2012 – s261(7)
| Dataset | Type of data | Sensitivity | Frequency | Confidential data |
|---|---|---|---|---|
| Cancer Registration Data | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| Civil Registrations of Death | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| Demographics | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| Hospital Episode Statistics Accident and Emergency (HES A and E) | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| Hospital Episode Statistics Admitted Patient Care (HES APC) | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| Hospital Episode Statistics Outpatients (HES OP) | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| MRIS - Cause of Death Report | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| MRIS - Cohort Event Notification Report | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
| MRIS - Flagging Current Status Report | Identifiable | Sensitive | One-Off | Section 251 NHS Act 2006 |
| MRIS - List Cleaning Report | Identifiable | Non-Sensitive | Ongoing | Section 251 NHS Act 2006 |
| MRIS - Members and Postings Report | Identifiable | Sensitive | Ongoing | Section 251 NHS Act 2006 |
Files released
Files released counts only files released externally by DARS. Access granted in NHS England's own systems, such as its Secure Data Environment, is not included.
Patient opt-outs were applied to all 63 files released under this agreement, across every version. About opt-outs
No files recorded as released under the current version. 63 were released under earlier versions, shown in the version history.
Version history
The register lists each renewal of this agreement as a separate row. This site has 5 versions — earlier versions existed before this site's records begin.
DARS-NIC-86954-Y0R2N-v7.2 18 October 2024 to 21 January 2027
- Title
- MR1b - Health and Development Study - S251 Cohort members
- Commercial
- No
- Sublicensing
- No
- Datasets
- 11
- Files released
- 0
Datasets: Cancer Registration Data; Civil Registrations of Death; Demographics; Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); MRIS - Cause of Death Report; MRIS - Cohort Event Notification Report; MRIS - Flagging Current Status Report; MRIS - List Cleaning Report; MRIS - Members and Postings Report
What changed from DARS-NIC-86954-Y0R2N-v6.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2024-10-18 | |
| End date | 2027-01-21 |
Objective for processing
[1 paragraph unchanged]
Linkages for Scotland and Wales will be performed separately to the NHS
Digital
England
linkage. The linkages to central NHS held data will only involve the
[8 words unchanged]
nations, so for example there will be no data transferred to NHS
Digital
England
for patients recruited in Welsh institutions.
[2 paragraphs unchanged]
Where study members have become lost to follow up, the MRIS data
[11 words unchanged]
and Cause of Death Report) being provided under this application will enable
NSHD
NHS England
to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
[3 paragraphs unchanged]
The data collected on the NSHD cohort, including that provided by NHS
Digital,
England,
is used across five research integrated programmes with the overarching aim of
[5 words unchanged]
that affect lifelong health, ageing and the development of chronic disease risk.
[10 paragraphs unchanged]
A nursing agency is involved in the wider project for solely collecting
[88 words unchanged]
nursing agency will not have any access to data disseminated by NHS
Digital
England
under this agreement.
[1 paragraph unchanged]
Processing activities
The University College London (UCL) originally sent a cohort to NHS
Digital
England
with the patient identifiers of NHS Number, Date of Birth and Study ID, this continues to be held by NHS
Digital.
England.
The cohort of 1,978 will not be added to for this agreement (v4).
NSHD receives data from two main sources i) collected from the study members themselves over the past 70 years and ii) from NHS
Digital;
England;
these data are held in the NSHD-Data Repository (NSHD-DR). Study participants are flagged with NHS
Digital.
England.
NHS
Digital
England
provides notifications of deaths and cancer registrations on a quarterly frequency. These
[68 words unchanged]
research analyses by LHA scientists and may be shared with external researchers.
[1 paragraph unchanged]
The legal basis for access to NHS
Digital
England
data for DARS-NIC-148100-6RFK9 (MR1a) is through consent. In this parallel agreement for
[13 words unchanged]
through Section 251 of the NHS Act 2006 (CAG approval ref: 15/CAG/0139).
Derived NHS
Digital
England
data will be linked to the NSHD-DR which stores all study member data in pseudonymised form going back to 1946. NHS
Digital
England
identifiable data can only be viewed by named NSHD staff and is
[12 words unchanged]
data that was previously obtained directly from the hospitals or General Practitioners.
[2 paragraphs unchanged]
The data from NHS
Digital
England
will not be used for any other purpose other than that outlined in this Agreement.
[1 paragraph unchanged]
Benefits reported
[1 paragraph unchanged]
Socioeconomic circumstances in early and adult life show persisting associations with premature mortality from 1971 to 2016, reaffirming the need to address socioeconomic factors across life to reduce inequalities in survival to older age.
The use of the linked dataset (i.e the combination of data previously collected in NSHD and NHS England data) has enabled a number of manuscripts to be drafted, presented at conferences and contribute to our understanding of life course ageing.
Socioeconomically disadvantaged individuals have both earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood socio-economic position.
For example, the research has enabled insights into chronic respiratory diseases. For example, children who had a lower respiratory tract infection (LRTI), such as bronchitis or pneumonia, by the age of two were almost twice as likely to die prematurely in adulthood from respiratory diseases. Our research has shown that early respiratory health has an impact on mortality later in life and highlights the need to prevent childhood respiratory infection.
Longitudinal birth cohort data from the NSHD, together with a range of sensitivity analyses indicate that childhood bradycardia trebles the odds of having AV conduction defects in older age, but it did not influence mortality or older age heart size and function On-going research will examine the impact of genetic risk on COPD and mortality.
Allinson JP, Chaturvedi N, Wong A, et al., Early childhood lower respiratory tract infection and premature adult death from respiratory disease in Great Britain: a national birth cohort study. Lancet. 2023 Apr 8;401(10383):1183-1193.
The use of the linked dataset (i.e the combination of data previously collected in NSHD and NHS Digital data) has enabled a number of manuscripts to be drafted, presented at conferences and contribute to our understanding of life course ageing.
We have also highlighted the need for further work into e-smoking; where vaping was shown to cause similar DNA damage to smoking, which has been linked to the future development of lung cancer in smokers.
Below are examples of publications using the NSHD data to benefit public health.
Herzog C, Jones A, ... Wong A, et al. . Cigarette Smoking and E-cigarette Use Induce Shared DNA Methylation Changes Linked to Carcinogenesis. Cancer Res. 2024 Jun 4;84(11):1898-1914.
Jou0072nal of the American Heart Association.
Other examples include:
Title: Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study. Constantin‐Cristian T, Moon JC, Hardy R, Hughes AD, and Captur G.
Lau CE, Manou M, et al. NMR metabolomic modelling of age and lifespan: a multi-cohort analysis. medRxiv [Preprint]. 2023 Nov 8:2023.11.07.23298200.
Summary: Longitudinal birth cohort data from the NSHD, together with a range of sensitivity analyses indicate that childhood bradycardia trebles the odds of having AV conduction defects in older age, but it did not influence mortality or older age heart size and function On-going research will examine the impact of genetic risk on COPD and mortality
Topriceanu CC, Dev E, et al. Accelerated DNA methylation age plays a role in the impact of cardiovascular risk factors on the human heart. Clin Epigenetics. 2023 Oct 18;15(1):164.
Published:
Hostettler IC, Seiffge D, Wong A, et al. APOE and Cerebral Small Vessel Disease Markers in Patients With Intracerebral Hemorrhage. Neurology. 2022 Sep 20;99(12):e1290-e1298.
Journal: The Lancet. Public Health
Title: Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data.
Zhu D, Chung HF, Dobson AJ, Pandeya N, Giles GG, Bruinsma F, Brunner EJ, Kuh D, Hardy R, Avis NE, Gold EB, Derby CA, Matthews KA, Cade JE, Greenwood DC, Demakakos P, Brown DE, Sievert LL, Anderson D, Hayashi K ... Mishra GD.
Summary: The findings from this meta-analysis, including NSHD data, studying associations between age at menopause and the onset and timing of cardiovascular, has important implications for public health. The doubling of cardiovascular disease risk in women below 60 years who have premature menopause indicates an urgent need to raise awareness of cardiovascular disease risk in younger women. Further work is needed to understand the mechanisms and to redesign primary and secondary prevention guidelines.
Journal: PLoS Med.
Title:Socioeconomic inequalities in prevalence and development of multimorbidity across adulthood: A longitudinal analysis of the MRC 1946 National Survey of Health and Development in the UK.
Khanolkar A, Chaturvedi N, Kuan V, Davis D, Hughes A, Richards M, Bann D, Patalay P.
Summary: This research has investigated how the socioeconomic circumstances in early and adult life affect premature mortality, risks and rates of adult multimorbidity accumulation. Socioeconomically disadvantaged individuals have earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood SEP. This calls for population-based interventions in early life and through the life course to reduce the impact of childhood and adulthood inequalities, along with better access and delivery of healthcare for the more vulnerable to help reduce the burden of multimorbidity.
Journal: J Epidemiol Community Health.
Title: Socioeconomic inequalities across life and premature mortality from 1971 to 2016: findings from three British birth cohorts born in 1946, 1958 and 1970.
Fluharty M, Hardy R, Ploubidis G, Pongiglione B, Bann D.
Summary: Using data from three comparable national British birth cohorts—born in 1946, 1958 and 1970—we investigated changes in inequalities in mortality risk across adulthood and early old age of three generations. The study found that despite declining mortality rates, inequalities in premature mortality appear to have persisted; reaffirming the need to address socioeconomic factors in both early and adult life to reduce inequalities in early-mid adulthood mortality
Unchanged: Expected output, Expected measurable benefits.
DARS-NIC-86954-Y0R2N-v6.2 25 February 2022 to 22 January 2025
- Title
- MR1b - Health and Development Study - S251 Cohort members
- Commercial
- No
- Sublicensing
- No
- Datasets
- 11
- Files released
- 0
Datasets: Cancer Registration Data; Civil Registrations of Death; Demographics; Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); MRIS - Cause of Death Report; MRIS - Cohort Event Notification Report; MRIS - Flagging Current Status Report; MRIS - List Cleaning Report; MRIS - Members and Postings Report
What changed from DARS-NIC-86954-Y0R2N-v5.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2022-02-25 | |
| End date | 2025-01-22 |
Benefits reported
Although the project is analysing the data, it is not yet in a position to publish the data.
The research has also enabled insights into how the socioeconomic circumstances in early and adult life affect premature mortality, risks and rates of adult multimorbidity accumulation.
Socioeconomic circumstances in early and adult life show persisting associations with premature mortality from 1971 to 2016, reaffirming the need to address socioeconomic factors across life to reduce inequalities in survival to older age.
Socioeconomically disadvantaged individuals have both earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood socio-economic position.
Longitudinal birth cohort data from the NSHD, together with a range of sensitivity analyses indicate that childhood bradycardia trebles the odds of having AV conduction defects in older age, but it did not influence mortality or older age heart size and function On-going research will examine the impact of genetic risk on COPD and mortality.
The use of the linked dataset (i.e the combination of data previously collected in NSHD and NHS Digital data) has enabled a number of manuscripts to be drafted, presented at conferences and contribute to our understanding of life course ageing.
Below are examples of publications using the NSHD data to benefit public health.
Jou0072nal of the American Heart Association.
Title: Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study. Constantin‐Cristian T, Moon JC, Hardy R, Hughes AD, and Captur G.
Summary: Longitudinal birth cohort data from the NSHD, together with a range of sensitivity analyses indicate that childhood bradycardia trebles the odds of having AV conduction defects in older age, but it did not influence mortality or older age heart size and function On-going research will examine the impact of genetic risk on COPD and mortality
Published:
Journal: The Lancet. Public Health
Title: Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data.
Zhu D, Chung HF, Dobson AJ, Pandeya N, Giles GG, Bruinsma F, Brunner EJ, Kuh D, Hardy R, Avis NE, Gold EB, Derby CA, Matthews KA, Cade JE, Greenwood DC, Demakakos P, Brown DE, Sievert LL, Anderson D, Hayashi K ... Mishra GD.
Summary: The findings from this meta-analysis, including NSHD data, studying associations between age at menopause and the onset and timing of cardiovascular, has important implications for public health. The doubling of cardiovascular disease risk in women below 60 years who have premature menopause indicates an urgent need to raise awareness of cardiovascular disease risk in younger women. Further work is needed to understand the mechanisms and to redesign primary and secondary prevention guidelines.
Journal: PLoS Med.
Title:Socioeconomic inequalities in prevalence and development of multimorbidity across adulthood: A longitudinal analysis of the MRC 1946 National Survey of Health and Development in the UK.
Khanolkar A, Chaturvedi N, Kuan V, Davis D, Hughes A, Richards M, Bann D, Patalay P.
Summary: This research has investigated how the socioeconomic circumstances in early and adult life affect premature mortality, risks and rates of adult multimorbidity accumulation. Socioeconomically disadvantaged individuals have earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood SEP. This calls for population-based interventions in early life and through the life course to reduce the impact of childhood and adulthood inequalities, along with better access and delivery of healthcare for the more vulnerable to help reduce the burden of multimorbidity.
Journal: J Epidemiol Community Health.
Title: Socioeconomic inequalities across life and premature mortality from 1971 to 2016: findings from three British birth cohorts born in 1946, 1958 and 1970.
Fluharty M, Hardy R, Ploubidis G, Pongiglione B, Bann D.
Summary: Using data from three comparable national British birth cohorts—born in 1946, 1958 and 1970—we investigated changes in inequalities in mortality risk across adulthood and early old age of three generations. The study found that despite declining mortality rates, inequalities in premature mortality appear to have persisted; reaffirming the need to address socioeconomic factors in both early and adult life to reduce inequalities in early-mid adulthood mortality
Unchanged: Objective for processing, Processing activities, Expected output, Expected measurable benefits.
Objective for processing
The Medical Research Council National Survey of Health and Development (NSHD) is the oldest and longest running of the British birth cohort studies. From an initial maternity survey of 13,687 (82%) of all births recorded in England, Scotland and Wales during one week of March, 1946, a socially stratified sample of 5,362 singleton babies born to married parents was selected for follow-up. The NSHD study team is housed within the MRC Unit for Lifelong Health and Ageing (LHA) at University College London (UCL).
Linkages for Scotland and Wales will be performed separately to the NHS Digital linkage. The linkages to central NHS held data will only involve the transfer of data for patients recruited in those nations, so for example there will be no data transferred to NHS Digital for patients recruited in Welsh institutions.
The NSHD study team has collected unique lifetime data on body size and maturation, cognitive and physical function, socioeconomic status and diet; and has repeat adult data on diet, smoking, physical activity, blood pressure and lung function. The most intensive data collection in 2006-2010, when study members were aged 60-64 years, included measurement of cardiac structure and function, body composition and bone density.
The 24th and most recent data collection to the whole sample included a postal questionnaire in 2014 and a home visit by a trained research nurse for interview and assessment in 2015/2016. At the 24th follow-up, the target sample was 2816 study members still living in mainland Britain; this is the maximum sample used in the analyses. Of the remaining 2546 (47%) study members: 957 (18%) had already died, 620 (12%) had previously withdrawn permanently, 574 (11%) lived abroad, and 395 (7%) had remained untraceable for more than 5 years.
Where study members have become lost to follow up, the MRIS data (Cohort Event Notification Report, List Cleaning Report, Flagging Current Status Report and Cause of Death Report) being provided under this application will enable NSHD to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
The NSHD was the first study (in 1971) to have participants flagged on the NHS Central Register for mortality (ICD codes are used to code cause of death) and cancer registrations. The LHA receives notifications on an ongoing quarterly frequency.
The LHA wishes to link NSHD study members to HES data in order to improve the quality of information on hospital admissions and health outcomes for research purposes. Currently, the study obtains self-reported hospital admission data at each follow-up which are then confirmed through contact with each hospital.
The data from HES will be used to improve the identification of acute events such as those caused by cardiovascular disease (CVD). For example, the unit will assess how life course risk factor trajectories of body size, resting heart rate, blood pressure, socio-economic position (SEP) and health related behaviours, accumulate and interact to influence incidence of CVD, thus potentially identifying possibilities for earlier prevention. As the cohort is entering older age, hospital care becomes increasingly frequent and study members are thus less likely to report hospital admissions over a number of years accurately. It is therefore important to capture this information in other ways. New research within LHA on health service use is being developed which will utilise these data and investigate life course predictors of health care utilisation.
The data collected on the NSHD cohort, including that provided by NHS Digital, is used across five research integrated programmes with the overarching aim of identifying social and biological factors that affect lifelong health, ageing and the development of chronic disease risk.
The five programmes are:
1) Enhancing NSHD
2) Functional Trajectories and Cardiovascular Ageing
3) Physical Capability and Musculoskeletal Ageing
4) Mental Ageing
5) Wellbeing in older age
Historic HES data has now been previously added to the agreement in order for NSHD to continue their work on linking NSHD data to HES data, historic data has been requested (Admitted Patient Care: 1997/98 – latest; Outpatients: 2003/4 – latest; A&E: 2007/8 – latest). It had previously been thought that these historic data were too incomplete for research purposes. However, recent work by contemporary cohorts indicate that such data are indeed adequate for purposes such as those originally outlined for the NSHD application for HES data from 2012 onwards, i.e. improving the quality of information of hospital admissions and health outcomes, and identifying acute events. The overall objectives for NSHD have always been to investigate risk and protective factors from across the life course that influence the ageing process and this application for historic HES data is entirely in keeping with this purpose.
There are a number of reasons why the addition of historic HES data will be invaluable to meeting the research objectives. The team will use these data to identify health events which have occurred since the earliest HES data became available, thus enriching and enlarging on existing self-reported data, gathered on an intermittent basis. The frequency of hospital admissions increases with age and the cohort participants were already aged 43 years when HES data were first compiled in 1989. Increasing frequency of admissions with age, often with multiple co-morbidities, renders self–report of diagnoses and timing of events less accurate. ‘Complete’ HES data will be particularly important not only for acute cardiovascular events such as myocardial infarction and stroke, but also for many chronic conditions, for example heart failure- a major cause of morbidity and mortality in older age, but where self-reported diagnosis is known to be unreliable and where underlying causal mechanisms are poorly understand, but likely to be influenced by factors operating across the life course. Complete HES data will also improve the accuracy of the ongoing NSHD study of life course predictors of health care utilisation in older age. In addition, complete HES records will be valuable for members of the cohort who no longer actively take part in the study. For these participants who are otherwise lost to morbidity follow-up the team will have records of their major health events since early middle age, thus minimising bias.
This agreement is for university research, the lawful basis for processing data is GDPR article 6(1)(e): ‘Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller’. Also referred to as ‘Public Task’. As the research involves health data, which is included in the definition of special categories of personal data, it requires an additional condition for processing. Based on guidance, for health research this is article 9(2)(j), which details that processing is necessary for scientific and research purposes, subject to appropriate safeguards.
For this programme of research, UCL are the sole Data Controller who also process data.
A nursing agency is involved in the wider project for solely collecting data directly from consented patients through home visits. NSHD will provide the nursing agency with the contact details of the study member so they will be able to make appointments with them. NSHD will also send the information needed for the feed forward section. The data will be encrypted and password protected before being securely transferred. The nursing agency will collect the data directly from the consented patient using Computer Aided Interview (CAI). These data will have basic cleaning performed before it is sent back the NSHD. The nursing agency will not have any access to data disseminated by NHS Digital under this agreement.
The Unit has a 5-year Medical Research Council core funded programme of research based on the NSHD with the objective to investigate risk and protective factors from across the life course that influence the ageing process. This core funding has been in place since 1962 and is renewed every five years after scientific review.
Expected output
The data will be used on an ongoing basis to update study member records. The database will be updated after each data release.
The primary output of the linkages with HES, mortality and Cancer Registration data are the maintenance and enhancement of the NSHD-DR. This is in turn used to achieve multiple research outputs that benefit health and social care.
As this is a two part cohort (MR1a and MR1b) the project requires access to both data to be able to understand and make sense of the complete dataset. Although the project has been able to conduct some work on investigating the impact of birth weight on later life cancer, health inequalities and physical activity, it is not yet in a position to publish these data.
The programme ‘Enhancing NSHD’ examines many of the genomic and other epigenomic (genetic material of a cell) and metabolomics (systematic study of the unique chemical fingerprints that specific cellular processes leave behind) factors that influence the risk of many age-related diseases and quantitative traits, often in collaboration with external researchers.
The programme ‘Functional Trajectories and Cardiovascular Ageing’ examines which factors from across the life course promote good adult cardiovascular function and prevent disease onset, and which increase vulnerability to accelerated cardiovascular ageing.
The programme ‘Physical Capability and Musculoskeletal Ageing’ examines which factors from across the life course promote good adult physical capability and musculoskeletal health, and which increase vulnerability to accelerated decline in capability.
The programme ‘Mental Ageing’ examines which factors from across the life course promote cognitive capability and protect against depression and which factors increase vulnerability to cognitive decline.
The programme ‘Wellbeing in older age’ examines what social contexts and experiences in childhood and early adulthood promote wellbeing in later life and whether wellbeing protects against functional ageing.
Each of these programmes generate multiple publications in peer review journals annually and findings are further disseminated via conference presentations. A full list of publications produced to date plus details of the current priorities for each programme are published on the MRC LHA website at: http://www.nshd.mrc.ac.uk/.
Publications and presentations only use data that is aggregated with small numbers suppressed in line with the HES Analysis Guide.
This MRC Unit is committed to research on ageing – outputs arising from ONS data will be anonymised in the form of tables, graphs, peer reviewed journals, presentations and books.
These data have been used in a number of publications. A full list of publications can be found at http://www.nshd.mrc.ac.uk/findings/
Benefits reported
The research has also enabled insights into how the socioeconomic circumstances in early and adult life affect premature mortality, risks and rates of adult multimorbidity accumulation.
Socioeconomic circumstances in early and adult life show persisting associations with premature mortality from 1971 to 2016, reaffirming the need to address socioeconomic factors across life to reduce inequalities in survival to older age.
Socioeconomically disadvantaged individuals have both earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood socio-economic position.
Longitudinal birth cohort data from the NSHD, together with a range of sensitivity analyses indicate that childhood bradycardia trebles the odds of having AV conduction defects in older age, but it did not influence mortality or older age heart size and function On-going research will examine the impact of genetic risk on COPD and mortality.
The use of the linked dataset (i.e the combination of data previously collected in NSHD and NHS Digital data) has enabled a number of manuscripts to be drafted, presented at conferences and contribute to our understanding of life course ageing.
Below are examples of publications using the NSHD data to benefit public health.
Jou0072nal of the American Heart Association.
Title: Childhood Bradycardia Associates With Atrioventricular Conduction Defects in Older Age: A Longitudinal Birth Cohort Study. Constantin‐Cristian T, Moon JC, Hardy R, Hughes AD, and Captur G.
Summary: Longitudinal birth cohort data from the NSHD, together with a range of sensitivity analyses indicate that childhood bradycardia trebles the odds of having AV conduction defects in older age, but it did not influence mortality or older age heart size and function On-going research will examine the impact of genetic risk on COPD and mortality
Published:
Journal: The Lancet. Public Health
Title: Age at natural menopause and risk of incident cardiovascular disease: a pooled analysis of individual patient data.
Zhu D, Chung HF, Dobson AJ, Pandeya N, Giles GG, Bruinsma F, Brunner EJ, Kuh D, Hardy R, Avis NE, Gold EB, Derby CA, Matthews KA, Cade JE, Greenwood DC, Demakakos P, Brown DE, Sievert LL, Anderson D, Hayashi K ... Mishra GD.
Summary: The findings from this meta-analysis, including NSHD data, studying associations between age at menopause and the onset and timing of cardiovascular, has important implications for public health. The doubling of cardiovascular disease risk in women below 60 years who have premature menopause indicates an urgent need to raise awareness of cardiovascular disease risk in younger women. Further work is needed to understand the mechanisms and to redesign primary and secondary prevention guidelines.
Journal: PLoS Med.
Title:Socioeconomic inequalities in prevalence and development of multimorbidity across adulthood: A longitudinal analysis of the MRC 1946 National Survey of Health and Development in the UK.
Khanolkar A, Chaturvedi N, Kuan V, Davis D, Hughes A, Richards M, Bann D, Patalay P.
Summary: This research has investigated how the socioeconomic circumstances in early and adult life affect premature mortality, risks and rates of adult multimorbidity accumulation. Socioeconomically disadvantaged individuals have earlier onset and more rapid accumulation of multimorbidity resulting in widening inequalities into old age, with independent contributions from both childhood and adulthood SEP. This calls for population-based interventions in early life and through the life course to reduce the impact of childhood and adulthood inequalities, along with better access and delivery of healthcare for the more vulnerable to help reduce the burden of multimorbidity.
Journal: J Epidemiol Community Health.
Title: Socioeconomic inequalities across life and premature mortality from 1971 to 2016: findings from three British birth cohorts born in 1946, 1958 and 1970.
Fluharty M, Hardy R, Ploubidis G, Pongiglione B, Bann D.
Summary: Using data from three comparable national British birth cohorts—born in 1946, 1958 and 1970—we investigated changes in inequalities in mortality risk across adulthood and early old age of three generations. The study found that despite declining mortality rates, inequalities in premature mortality appear to have persisted; reaffirming the need to address socioeconomic factors in both early and adult life to reduce inequalities in early-mid adulthood mortality
DARS-NIC-86954-Y0R2N-v5.2 21 May 2020 to 22 January 2022
- Title
- MR1b - Health and Development Study - S251 Cohort members
- Commercial
- No
- Sublicensing
- No
- Datasets
- 11
- Files released
- 17
Datasets: Cancer Registration Data; Civil Registrations of Death; Demographics; Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); MRIS - Cause of Death Report; MRIS - Cohort Event Notification Report; MRIS - Flagging Current Status Report; MRIS - List Cleaning Report; MRIS - Members and Postings Report
What changed from DARS-NIC-86954-Y0R2N-v4.2
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2020-05-21 |
Datasets: + Cancer Registration Data; + Civil Registrations of Death; + Demographics
Unchanged: Objective for processing, Processing activities, Expected output, Expected measurable benefits, Benefits reported.
Objective for processing
The Medical Research Council National Survey of Health and Development (NSHD) is the oldest and longest running of the British birth cohort studies. From an initial maternity survey of 13,687 (82%) of all births recorded in England, Scotland and Wales during one week of March, 1946, a socially stratified sample of 5,362 singleton babies born to married parents was selected for follow-up. The NSHD study team is housed within the MRC Unit for Lifelong Health and Ageing (LHA) at University College London (UCL).
Linkages for Scotland and Wales will be performed separately to the NHS Digital linkage. The linkages to central NHS held data will only involve the transfer of data for patients recruited in those nations, so for example there will be no data transferred to NHS Digital for patients recruited in Welsh institutions.
The NSHD study team has collected unique lifetime data on body size and maturation, cognitive and physical function, socioeconomic status and diet; and has repeat adult data on diet, smoking, physical activity, blood pressure and lung function. The most intensive data collection in 2006-2010, when study members were aged 60-64 years, included measurement of cardiac structure and function, body composition and bone density.
The 24th and most recent data collection to the whole sample included a postal questionnaire in 2014 and a home visit by a trained research nurse for interview and assessment in 2015/2016. At the 24th follow-up, the target sample was 2816 study members still living in mainland Britain; this is the maximum sample used in the analyses. Of the remaining 2546 (47%) study members: 957 (18%) had already died, 620 (12%) had previously withdrawn permanently, 574 (11%) lived abroad, and 395 (7%) had remained untraceable for more than 5 years.
Where study members have become lost to follow up, the MRIS data (Cohort Event Notification Report, List Cleaning Report, Flagging Current Status Report and Cause of Death Report) being provided under this application will enable NSHD to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
The NSHD was the first study (in 1971) to have participants flagged on the NHS Central Register for mortality (ICD codes are used to code cause of death) and cancer registrations. The LHA receives notifications on an ongoing quarterly frequency.
The LHA wishes to link NSHD study members to HES data in order to improve the quality of information on hospital admissions and health outcomes for research purposes. Currently, the study obtains self-reported hospital admission data at each follow-up which are then confirmed through contact with each hospital.
The data from HES will be used to improve the identification of acute events such as those caused by cardiovascular disease (CVD). For example, the unit will assess how life course risk factor trajectories of body size, resting heart rate, blood pressure, socio-economic position (SEP) and health related behaviours, accumulate and interact to influence incidence of CVD, thus potentially identifying possibilities for earlier prevention. As the cohort is entering older age, hospital care becomes increasingly frequent and study members are thus less likely to report hospital admissions over a number of years accurately. It is therefore important to capture this information in other ways. New research within LHA on health service use is being developed which will utilise these data and investigate life course predictors of health care utilisation.
The data collected on the NSHD cohort, including that provided by NHS Digital, is used across five research integrated programmes with the overarching aim of identifying social and biological factors that affect lifelong health, ageing and the development of chronic disease risk.
The five programmes are:
1) Enhancing NSHD
2) Functional Trajectories and Cardiovascular Ageing
3) Physical Capability and Musculoskeletal Ageing
4) Mental Ageing
5) Wellbeing in older age
Historic HES data has now been previously added to the agreement in order for NSHD to continue their work on linking NSHD data to HES data, historic data has been requested (Admitted Patient Care: 1997/98 – latest; Outpatients: 2003/4 – latest; A&E: 2007/8 – latest). It had previously been thought that these historic data were too incomplete for research purposes. However, recent work by contemporary cohorts indicate that such data are indeed adequate for purposes such as those originally outlined for the NSHD application for HES data from 2012 onwards, i.e. improving the quality of information of hospital admissions and health outcomes, and identifying acute events. The overall objectives for NSHD have always been to investigate risk and protective factors from across the life course that influence the ageing process and this application for historic HES data is entirely in keeping with this purpose.
There are a number of reasons why the addition of historic HES data will be invaluable to meeting the research objectives. The team will use these data to identify health events which have occurred since the earliest HES data became available, thus enriching and enlarging on existing self-reported data, gathered on an intermittent basis. The frequency of hospital admissions increases with age and the cohort participants were already aged 43 years when HES data were first compiled in 1989. Increasing frequency of admissions with age, often with multiple co-morbidities, renders self–report of diagnoses and timing of events less accurate. ‘Complete’ HES data will be particularly important not only for acute cardiovascular events such as myocardial infarction and stroke, but also for many chronic conditions, for example heart failure- a major cause of morbidity and mortality in older age, but where self-reported diagnosis is known to be unreliable and where underlying causal mechanisms are poorly understand, but likely to be influenced by factors operating across the life course. Complete HES data will also improve the accuracy of the ongoing NSHD study of life course predictors of health care utilisation in older age. In addition, complete HES records will be valuable for members of the cohort who no longer actively take part in the study. For these participants who are otherwise lost to morbidity follow-up the team will have records of their major health events since early middle age, thus minimising bias.
This agreement is for university research, the lawful basis for processing data is GDPR article 6(1)(e): ‘Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller’. Also referred to as ‘Public Task’. As the research involves health data, which is included in the definition of special categories of personal data, it requires an additional condition for processing. Based on guidance, for health research this is article 9(2)(j), which details that processing is necessary for scientific and research purposes, subject to appropriate safeguards.
For this programme of research, UCL are the sole Data Controller who also process data.
A nursing agency is involved in the wider project for solely collecting data directly from consented patients through home visits. NSHD will provide the nursing agency with the contact details of the study member so they will be able to make appointments with them. NSHD will also send the information needed for the feed forward section. The data will be encrypted and password protected before being securely transferred. The nursing agency will collect the data directly from the consented patient using Computer Aided Interview (CAI). These data will have basic cleaning performed before it is sent back the NSHD. The nursing agency will not have any access to data disseminated by NHS Digital under this agreement.
The Unit has a 5-year Medical Research Council core funded programme of research based on the NSHD with the objective to investigate risk and protective factors from across the life course that influence the ageing process. This core funding has been in place since 1962 and is renewed every five years after scientific review.
Expected output
The data will be used on an ongoing basis to update study member records. The database will be updated after each data release.
The primary output of the linkages with HES, mortality and Cancer Registration data are the maintenance and enhancement of the NSHD-DR. This is in turn used to achieve multiple research outputs that benefit health and social care.
As this is a two part cohort (MR1a and MR1b) the project requires access to both data to be able to understand and make sense of the complete dataset. Although the project has been able to conduct some work on investigating the impact of birth weight on later life cancer, health inequalities and physical activity, it is not yet in a position to publish these data.
The programme ‘Enhancing NSHD’ examines many of the genomic and other epigenomic (genetic material of a cell) and metabolomics (systematic study of the unique chemical fingerprints that specific cellular processes leave behind) factors that influence the risk of many age-related diseases and quantitative traits, often in collaboration with external researchers.
The programme ‘Functional Trajectories and Cardiovascular Ageing’ examines which factors from across the life course promote good adult cardiovascular function and prevent disease onset, and which increase vulnerability to accelerated cardiovascular ageing.
The programme ‘Physical Capability and Musculoskeletal Ageing’ examines which factors from across the life course promote good adult physical capability and musculoskeletal health, and which increase vulnerability to accelerated decline in capability.
The programme ‘Mental Ageing’ examines which factors from across the life course promote cognitive capability and protect against depression and which factors increase vulnerability to cognitive decline.
The programme ‘Wellbeing in older age’ examines what social contexts and experiences in childhood and early adulthood promote wellbeing in later life and whether wellbeing protects against functional ageing.
Each of these programmes generate multiple publications in peer review journals annually and findings are further disseminated via conference presentations. A full list of publications produced to date plus details of the current priorities for each programme are published on the MRC LHA website at: http://www.nshd.mrc.ac.uk/.
Publications and presentations only use data that is aggregated with small numbers suppressed in line with the HES Analysis Guide.
This MRC Unit is committed to research on ageing – outputs arising from ONS data will be anonymised in the form of tables, graphs, peer reviewed journals, presentations and books.
These data have been used in a number of publications. A full list of publications can be found at http://www.nshd.mrc.ac.uk/findings/
Benefits reported
Although the project is analysing the data, it is not yet in a position to publish the data.
DARS-NIC-86954-Y0R2N-v4.2 23 August 2019 to 22 January 2022
- Title
- MR1b - Health and Development Study - S251 Cohort members
- Commercial
- No
- Sublicensing
- No
- Datasets
- 8
- Files released
- 40
Datasets: Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); MRIS - Cause of Death Report; MRIS - Cohort Event Notification Report; MRIS - Flagging Current Status Report; MRIS - List Cleaning Report; MRIS - Members and Postings Report
What changed from DARS-NIC-86954-Y0R2N-v3.9
Text removed is struck through; text added is underlined. Unchanged paragraphs are summarised rather than repeated.
| Field | Was | Became |
|---|---|---|
| Start date | 2019-08-23 |
Objective for processing
[3 paragraphs unchanged]
The 24th and most recent data collection to the whole sample included
[49 words unchanged]
(47%) study members: 957 (18%) had already died, 620 (12%) had previously
withdrawn permanently, 574 (11%) lived abroad, and 395 (7%) had remained untraceable for more than 5 years.
withdrawn permanently, 574 (11%) lived abroad, and 395 (7%) had remained untraceable for more than 5 years.
Where study members have become lost to follow up, the MRIS data (Cohort Event Notification Report, List Cleaning Report, Flagging Current Status Report and Cause of Death Report) being provided under this application will enable NSHD to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
Where study members have become lost to follow up, the MRIS data being provided under this application will enable NSHD to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
[10 paragraphs unchanged]
Historic HES data has now been
requested
previously added to the agreement
in order for NSHD to continue their work on linking NSHD data
[109 words unchanged]
application for historic HES data is entirely in keeping with this purpose.
[5 paragraphs unchanged]
Processing activities
The University College London (UCL) originally sent a cohort to NHS Digital
[21 words unchanged]
The cohort of 1,978 will not be added to for this agreement
(v3).
(v4).
[8 paragraphs unchanged]
Unchanged: Expected output, Expected measurable benefits, Benefits reported.
Objective for processing
The Medical Research Council National Survey of Health and Development (NSHD) is the oldest and longest running of the British birth cohort studies. From an initial maternity survey of 13,687 (82%) of all births recorded in England, Scotland and Wales during one week of March, 1946, a socially stratified sample of 5,362 singleton babies born to married parents was selected for follow-up. The NSHD study team is housed within the MRC Unit for Lifelong Health and Ageing (LHA) at University College London (UCL).
Linkages for Scotland and Wales will be performed separately to the NHS Digital linkage. The linkages to central NHS held data will only involve the transfer of data for patients recruited in those nations, so for example there will be no data transferred to NHS Digital for patients recruited in Welsh institutions.
The NSHD study team has collected unique lifetime data on body size and maturation, cognitive and physical function, socioeconomic status and diet; and has repeat adult data on diet, smoking, physical activity, blood pressure and lung function. The most intensive data collection in 2006-2010, when study members were aged 60-64 years, included measurement of cardiac structure and function, body composition and bone density.
The 24th and most recent data collection to the whole sample included a postal questionnaire in 2014 and a home visit by a trained research nurse for interview and assessment in 2015/2016. At the 24th follow-up, the target sample was 2816 study members still living in mainland Britain; this is the maximum sample used in the analyses. Of the remaining 2546 (47%) study members: 957 (18%) had already died, 620 (12%) had previously withdrawn permanently, 574 (11%) lived abroad, and 395 (7%) had remained untraceable for more than 5 years.
Where study members have become lost to follow up, the MRIS data (Cohort Event Notification Report, List Cleaning Report, Flagging Current Status Report and Cause of Death Report) being provided under this application will enable NSHD to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
The NSHD was the first study (in 1971) to have participants flagged on the NHS Central Register for mortality (ICD codes are used to code cause of death) and cancer registrations. The LHA receives notifications on an ongoing quarterly frequency.
The LHA wishes to link NSHD study members to HES data in order to improve the quality of information on hospital admissions and health outcomes for research purposes. Currently, the study obtains self-reported hospital admission data at each follow-up which are then confirmed through contact with each hospital.
The data from HES will be used to improve the identification of acute events such as those caused by cardiovascular disease (CVD). For example, the unit will assess how life course risk factor trajectories of body size, resting heart rate, blood pressure, socio-economic position (SEP) and health related behaviours, accumulate and interact to influence incidence of CVD, thus potentially identifying possibilities for earlier prevention. As the cohort is entering older age, hospital care becomes increasingly frequent and study members are thus less likely to report hospital admissions over a number of years accurately. It is therefore important to capture this information in other ways. New research within LHA on health service use is being developed which will utilise these data and investigate life course predictors of health care utilisation.
The data collected on the NSHD cohort, including that provided by NHS Digital, is used across five research integrated programmes with the overarching aim of identifying social and biological factors that affect lifelong health, ageing and the development of chronic disease risk.
The five programmes are:
1) Enhancing NSHD
2) Functional Trajectories and Cardiovascular Ageing
3) Physical Capability and Musculoskeletal Ageing
4) Mental Ageing
5) Wellbeing in older age
Historic HES data has now been previously added to the agreement in order for NSHD to continue their work on linking NSHD data to HES data, historic data has been requested (Admitted Patient Care: 1997/98 – latest; Outpatients: 2003/4 – latest; A&E: 2007/8 – latest). It had previously been thought that these historic data were too incomplete for research purposes. However, recent work by contemporary cohorts indicate that such data are indeed adequate for purposes such as those originally outlined for the NSHD application for HES data from 2012 onwards, i.e. improving the quality of information of hospital admissions and health outcomes, and identifying acute events. The overall objectives for NSHD have always been to investigate risk and protective factors from across the life course that influence the ageing process and this application for historic HES data is entirely in keeping with this purpose.
There are a number of reasons why the addition of historic HES data will be invaluable to meeting the research objectives. The team will use these data to identify health events which have occurred since the earliest HES data became available, thus enriching and enlarging on existing self-reported data, gathered on an intermittent basis. The frequency of hospital admissions increases with age and the cohort participants were already aged 43 years when HES data were first compiled in 1989. Increasing frequency of admissions with age, often with multiple co-morbidities, renders self–report of diagnoses and timing of events less accurate. ‘Complete’ HES data will be particularly important not only for acute cardiovascular events such as myocardial infarction and stroke, but also for many chronic conditions, for example heart failure- a major cause of morbidity and mortality in older age, but where self-reported diagnosis is known to be unreliable and where underlying causal mechanisms are poorly understand, but likely to be influenced by factors operating across the life course. Complete HES data will also improve the accuracy of the ongoing NSHD study of life course predictors of health care utilisation in older age. In addition, complete HES records will be valuable for members of the cohort who no longer actively take part in the study. For these participants who are otherwise lost to morbidity follow-up the team will have records of their major health events since early middle age, thus minimising bias.
This agreement is for university research, the lawful basis for processing data is GDPR article 6(1)(e): ‘Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller’. Also referred to as ‘Public Task’. As the research involves health data, which is included in the definition of special categories of personal data, it requires an additional condition for processing. Based on guidance, for health research this is article 9(2)(j), which details that processing is necessary for scientific and research purposes, subject to appropriate safeguards.
For this programme of research, UCL are the sole Data Controller who also process data.
A nursing agency is involved in the wider project for solely collecting data directly from consented patients through home visits. NSHD will provide the nursing agency with the contact details of the study member so they will be able to make appointments with them. NSHD will also send the information needed for the feed forward section. The data will be encrypted and password protected before being securely transferred. The nursing agency will collect the data directly from the consented patient using Computer Aided Interview (CAI). These data will have basic cleaning performed before it is sent back the NSHD. The nursing agency will not have any access to data disseminated by NHS Digital under this agreement.
The Unit has a 5-year Medical Research Council core funded programme of research based on the NSHD with the objective to investigate risk and protective factors from across the life course that influence the ageing process. This core funding has been in place since 1962 and is renewed every five years after scientific review.
Expected output
The data will be used on an ongoing basis to update study member records. The database will be updated after each data release.
The primary output of the linkages with HES, mortality and Cancer Registration data are the maintenance and enhancement of the NSHD-DR. This is in turn used to achieve multiple research outputs that benefit health and social care.
As this is a two part cohort (MR1a and MR1b) the project requires access to both data to be able to understand and make sense of the complete dataset. Although the project has been able to conduct some work on investigating the impact of birth weight on later life cancer, health inequalities and physical activity, it is not yet in a position to publish these data.
The programme ‘Enhancing NSHD’ examines many of the genomic and other epigenomic (genetic material of a cell) and metabolomics (systematic study of the unique chemical fingerprints that specific cellular processes leave behind) factors that influence the risk of many age-related diseases and quantitative traits, often in collaboration with external researchers.
The programme ‘Functional Trajectories and Cardiovascular Ageing’ examines which factors from across the life course promote good adult cardiovascular function and prevent disease onset, and which increase vulnerability to accelerated cardiovascular ageing.
The programme ‘Physical Capability and Musculoskeletal Ageing’ examines which factors from across the life course promote good adult physical capability and musculoskeletal health, and which increase vulnerability to accelerated decline in capability.
The programme ‘Mental Ageing’ examines which factors from across the life course promote cognitive capability and protect against depression and which factors increase vulnerability to cognitive decline.
The programme ‘Wellbeing in older age’ examines what social contexts and experiences in childhood and early adulthood promote wellbeing in later life and whether wellbeing protects against functional ageing.
Each of these programmes generate multiple publications in peer review journals annually and findings are further disseminated via conference presentations. A full list of publications produced to date plus details of the current priorities for each programme are published on the MRC LHA website at: http://www.nshd.mrc.ac.uk/.
Publications and presentations only use data that is aggregated with small numbers suppressed in line with the HES Analysis Guide.
This MRC Unit is committed to research on ageing – outputs arising from ONS data will be anonymised in the form of tables, graphs, peer reviewed journals, presentations and books.
These data have been used in a number of publications. A full list of publications can be found at http://www.nshd.mrc.ac.uk/findings/
Benefits reported
Although the project is analysing the data, it is not yet in a position to publish the data.
DARS-NIC-86954-Y0R2N-v3.9 23 January 2019 to 22 January 2022
- Title
- MR1b - Health and Development Study - S251 Cohort members
- Commercial
- No
- Sublicensing
- No
- Datasets
- 8
- Files released
- 6
Datasets: Hospital Episode Statistics Accident and Emergency (HES A and E); Hospital Episode Statistics Admitted Patient Care (HES APC); Hospital Episode Statistics Outpatients (HES OP); MRIS - Cause of Death Report; MRIS - Cohort Event Notification Report; MRIS - Flagging Current Status Report; MRIS - List Cleaning Report; MRIS - Members and Postings Report
Objective for processing
The Medical Research Council National Survey of Health and Development (NSHD) is the oldest and longest running of the British birth cohort studies. From an initial maternity survey of 13,687 (82%) of all births recorded in England, Scotland and Wales during one week of March, 1946, a socially stratified sample of 5,362 singleton babies born to married parents was selected for follow-up. The NSHD study team is housed within the MRC Unit for Lifelong Health and Ageing (LHA) at University College London (UCL).
Linkages for Scotland and Wales will be performed separately to the NHS Digital linkage. The linkages to central NHS held data will only involve the transfer of data for patients recruited in those nations, so for example there will be no data transferred to NHS Digital for patients recruited in Welsh institutions.
The NSHD study team has collected unique lifetime data on body size and maturation, cognitive and physical function, socioeconomic status and diet; and has repeat adult data on diet, smoking, physical activity, blood pressure and lung function. The most intensive data collection in 2006-2010, when study members were aged 60-64 years, included measurement of cardiac structure and function, body composition and bone density.
The 24th and most recent data collection to the whole sample included a postal questionnaire in 2014 and a home visit by a trained research nurse for interview and assessment in 2015/2016. At the 24th follow-up, the target sample was 2816 study members still living in mainland Britain; this is the maximum sample used in the analyses. Of the remaining 2546 (47%) study members: 957 (18%) had already died, 620 (12%) had previously
withdrawn permanently, 574 (11%) lived abroad, and 395 (7%) had remained untraceable for more than 5 years.
Where study members have become lost to follow up, the MRIS data being provided under this application will enable NSHD to seek to re-contact those study members and invite them to continue participating in the study, i.e. to re-consent these participants.
The NSHD was the first study (in 1971) to have participants flagged on the NHS Central Register for mortality (ICD codes are used to code cause of death) and cancer registrations. The LHA receives notifications on an ongoing quarterly frequency.
The LHA wishes to link NSHD study members to HES data in order to improve the quality of information on hospital admissions and health outcomes for research purposes. Currently, the study obtains self-reported hospital admission data at each follow-up which are then confirmed through contact with each hospital.
The data from HES will be used to improve the identification of acute events such as those caused by cardiovascular disease (CVD). For example, the unit will assess how life course risk factor trajectories of body size, resting heart rate, blood pressure, socio-economic position (SEP) and health related behaviours, accumulate and interact to influence incidence of CVD, thus potentially identifying possibilities for earlier prevention. As the cohort is entering older age, hospital care becomes increasingly frequent and study members are thus less likely to report hospital admissions over a number of years accurately. It is therefore important to capture this information in other ways. New research within LHA on health service use is being developed which will utilise these data and investigate life course predictors of health care utilisation.
The data collected on the NSHD cohort, including that provided by NHS Digital, is used across five research integrated programmes with the overarching aim of identifying social and biological factors that affect lifelong health, ageing and the development of chronic disease risk.
The five programmes are:
1) Enhancing NSHD
2) Functional Trajectories and Cardiovascular Ageing
3) Physical Capability and Musculoskeletal Ageing
4) Mental Ageing
5) Wellbeing in older age
Historic HES data has now been requested in order for NSHD to continue their work on linking NSHD data to HES data, historic data has been requested (Admitted Patient Care: 1997/98 – latest; Outpatients: 2003/4 – latest; A&E: 2007/8 – latest). It had previously been thought that these historic data were too incomplete for research purposes. However, recent work by contemporary cohorts indicate that such data are indeed adequate for purposes such as those originally outlined for the NSHD application for HES data from 2012 onwards, i.e. improving the quality of information of hospital admissions and health outcomes, and identifying acute events. The overall objectives for NSHD have always been to investigate risk and protective factors from across the life course that influence the ageing process and this application for historic HES data is entirely in keeping with this purpose.
There are a number of reasons why the addition of historic HES data will be invaluable to meeting the research objectives. The team will use these data to identify health events which have occurred since the earliest HES data became available, thus enriching and enlarging on existing self-reported data, gathered on an intermittent basis. The frequency of hospital admissions increases with age and the cohort participants were already aged 43 years when HES data were first compiled in 1989. Increasing frequency of admissions with age, often with multiple co-morbidities, renders self–report of diagnoses and timing of events less accurate. ‘Complete’ HES data will be particularly important not only for acute cardiovascular events such as myocardial infarction and stroke, but also for many chronic conditions, for example heart failure- a major cause of morbidity and mortality in older age, but where self-reported diagnosis is known to be unreliable and where underlying causal mechanisms are poorly understand, but likely to be influenced by factors operating across the life course. Complete HES data will also improve the accuracy of the ongoing NSHD study of life course predictors of health care utilisation in older age. In addition, complete HES records will be valuable for members of the cohort who no longer actively take part in the study. For these participants who are otherwise lost to morbidity follow-up the team will have records of their major health events since early middle age, thus minimising bias.
This agreement is for university research, the lawful basis for processing data is GDPR article 6(1)(e): ‘Processing is necessary for the performance of a task carried out in the public interest or in the exercise of official authority vested in the controller’. Also referred to as ‘Public Task’. As the research involves health data, which is included in the definition of special categories of personal data, it requires an additional condition for processing. Based on guidance, for health research this is article 9(2)(j), which details that processing is necessary for scientific and research purposes, subject to appropriate safeguards.
For this programme of research, UCL are the sole Data Controller who also process data.
A nursing agency is involved in the wider project for solely collecting data directly from consented patients through home visits. NSHD will provide the nursing agency with the contact details of the study member so they will be able to make appointments with them. NSHD will also send the information needed for the feed forward section. The data will be encrypted and password protected before being securely transferred. The nursing agency will collect the data directly from the consented patient using Computer Aided Interview (CAI). These data will have basic cleaning performed before it is sent back the NSHD. The nursing agency will not have any access to data disseminated by NHS Digital under this agreement.
The Unit has a 5-year Medical Research Council core funded programme of research based on the NSHD with the objective to investigate risk and protective factors from across the life course that influence the ageing process. This core funding has been in place since 1962 and is renewed every five years after scientific review.
Expected output
The data will be used on an ongoing basis to update study member records. The database will be updated after each data release.
The primary output of the linkages with HES, mortality and Cancer Registration data are the maintenance and enhancement of the NSHD-DR. This is in turn used to achieve multiple research outputs that benefit health and social care.
As this is a two part cohort (MR1a and MR1b) the project requires access to both data to be able to understand and make sense of the complete dataset. Although the project has been able to conduct some work on investigating the impact of birth weight on later life cancer, health inequalities and physical activity, it is not yet in a position to publish these data.
The programme ‘Enhancing NSHD’ examines many of the genomic and other epigenomic (genetic material of a cell) and metabolomics (systematic study of the unique chemical fingerprints that specific cellular processes leave behind) factors that influence the risk of many age-related diseases and quantitative traits, often in collaboration with external researchers.
The programme ‘Functional Trajectories and Cardiovascular Ageing’ examines which factors from across the life course promote good adult cardiovascular function and prevent disease onset, and which increase vulnerability to accelerated cardiovascular ageing.
The programme ‘Physical Capability and Musculoskeletal Ageing’ examines which factors from across the life course promote good adult physical capability and musculoskeletal health, and which increase vulnerability to accelerated decline in capability.
The programme ‘Mental Ageing’ examines which factors from across the life course promote cognitive capability and protect against depression and which factors increase vulnerability to cognitive decline.
The programme ‘Wellbeing in older age’ examines what social contexts and experiences in childhood and early adulthood promote wellbeing in later life and whether wellbeing protects against functional ageing.
Each of these programmes generate multiple publications in peer review journals annually and findings are further disseminated via conference presentations. A full list of publications produced to date plus details of the current priorities for each programme are published on the MRC LHA website at: http://www.nshd.mrc.ac.uk/.
Publications and presentations only use data that is aggregated with small numbers suppressed in line with the HES Analysis Guide.
This MRC Unit is committed to research on ageing – outputs arising from ONS data will be anonymised in the form of tables, graphs, peer reviewed journals, presentations and books.
These data have been used in a number of publications. A full list of publications can be found at http://www.nshd.mrc.ac.uk/findings/
Benefits reported
Although the project is analysing the data, it is not yet in a position to publish the data.
Register history
When this agreement appeared in, or was edited in, each monthly edition of the register. Built by comparing every edition this site holds, the earliest of which is July 2021.
-
July 2021 —
already listed in the earliest edition this site holds, so it may be older. 3 versions: DARS-NIC-86954-Y0R2N-v3.9, DARS-NIC-86954-Y0R2N-v4.2, DARS-NIC-86954-Y0R2N-v5.2
-
March 2022
1 version added: DARS-NIC-86954-Y0R2N-v6.2
-
November 2024
1 version added: DARS-NIC-86954-Y0R2N-v7.2
Cite this page
NHS England (2026) Data Uses Register, September 2026 edition, agreement DARS-NIC-86954-Y0R2N, “MR1b - Health and Development Study - S251 Cohort members”. Read via NHS Data Access Explorer (unofficial), https://healthdatauses.uk/agreements/dars-nic-86954-y0r2n/ (accessed [date]).
This address stays the same, but the page is rebuilt with each monthly edition, so the citation names the edition it shows. Every edition's data is kept in the facts store.
Source: datausesregister_september2026.xlsx, September 2026 edition of the NHS England Data Uses Register. Search that workbook for DARS-NIC-86954-Y0R2N to see the original rows.