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Frequently Asked Questions (see below)

General Questions

1. I am an EPIC participant - will I be hearing from EPIC again soon?

The Fifth Health Check (5HC) began in September 2016 and is set to run until the end 2018. During this time we will be contacting our participants and asking them whether they would be willing to attend this latest phase. Initially we will be contacting those participants who were not invited to a 4HC.

2. I am an EPIC participant but I have not heard from EPIC for a number of years.

The length of the health checks carried out during previous phases of EPIC has varied depending on the tests included and the ability of individuals completing the tasks asked of them. We aim to invite the maximum number of participants to each health check phase within the timeframe allowed, but unfortunately this may mean that we don't always get around to inviting every participant to all health checks. In these circumstances, we plan the invitations for the next health check very carefully so that those participants we may have missed at the previous phase are invited first. It may also be that we no longer have current contact information for you. If you are concerned that this may be the case, please contact us on our freephone number 0800 616911 to check your status and update your information.

3. How does EPIC follow-up on participants?

The great value of the EPIC-Norfolk study is in understanding what happens to the health of participants over many years as they age and to get as complete a picutre as possible of health in the community. Aside from health checks and questionnaires, we do this by ongoing record linkage to general and hospital medical records and disease registries to get a picture of patterns of health and disease over the years. Thus, even if participants no longer attend future health examinations or complete questionnaires, their earlier contributions continue to be of benefit.

4. I made the decision to 'opt-out' of providing data to third parties via my GP practice. Will this affect the information received by EPIC?

You have the right to request that your data is not used beyond your own care and treatment. If you have indicated to your GP that you do not want your data to be used by third parties but do not wish this decision to affect the updates EPIC receives regarding your health information, then please contact us. This will ensure that you will continue to contribute to the study, even if you are no longer attending the health examinations. With your permission, we can make sure that the information you have given to us over the years can still be used.

5. I don't remember ever being asked about family history and patterns of disease and morbidity - isn't this as relevant as lifestyle, etc?

Answer coming soon.

6. I am an EPIC participant but I have moved out of the Norfolk area. Can I still participate?

You are very welcome to complete questionnaires from your new address, just let us know your new contact details. Alternatively, if you have not moved too far, you are also very welcome to come for a health check if you are willing to make the trip to Norwich.

7. I am unable to attend the 5HC, but can I still take part in the EPIC study?

We are extremely grateful for your participation in the study. If you are unable to attend the health check at this particular time, but can complete the questionnaires, then this information is still very useful to us.

8. I now have an illness or health concerns, can I still continue to take part in EPIC?

Yes. Any information with regards to your health is extremely important to the study, even if you are unable to attend a health check, the information we are provided with on questionnaires is still very important.

9. Am I too old to participate?

You are never too old! There is no upper age limit to participate in any part of the EPIC study. We wish to follow-up our participants for as long as possible and it is an important part of our research that we are able to collect information as people age.

10. I withdrew from EPIC at some point in the past but I am now interested in participating again, can I?

Yes indeed. Let us know and we will be happy to re-enrol you, making you eligible for the Fifth Health Check (5HC) and any other EPIC related activities moving forward.

11. I am unable/ do not want to attend health checks and fill in Questionnaires anymore. How do I stop letters being sent to me from EPIC?

Ring us on the freephone number and we will take your name off the mailing list. Your participation in EPIC is completely voluntary and you can stop attending health checks or completing questionnaires at any point in time. Once your name is removed from the mailing list you won't hear from us at all. Deciding not take part in EPIC-Norfolk does not affect the treatment you receive as part of the routine care provided by your GP.

12. What results have EPIC come up with over the years?

For general information on results see our Summary Findings. We have published many papers over the years, some of which have made headline news (see EPIC in the news.) For more details click on all our published results, see Publications.

13. What does the future hold for EPIC?

EPIC is one of the most important research studies looking at health and lifestyle. We have expanded the study to include a wide range of other conditions that affect so many of us. The longer we follow people the more information we can gather on how our diet, lifestyle and experiences affect health. We can only do this with your continued participation and for that we are very grateful.

14. Will it be possible for my children and grandchildren to be involved in EPIC in the future?

There are many scientific benefits of studying the offspring of our original EPIC participants. During the 4HC we asked participants whether, in principle, they would be willing to pass on an invitation to take part in the study to other members of their family and the responses will be considered as part of future research planning.

15. I have never been involved before, can I still sign up for EPIC now?

Unfortunately, not. EPIC is a long-term study where we follow-up on our original participants who consented at baseline (1993-1997). This allows us to gather data from the same people at multiple time points, over many years.

There may be other research which you may be interested in and there are different ways to obtain further information:

(a) Suggest a research question to the National Institute of Health

Click here (National Institute of Health website)

(b) See what studies are going on in the UK:

Click here for National Institute for Health Research 'People in Research' and to find out about opportunities for public involvement in NHS, public health and social care research

Click here for National Institute for Health Research 'UK Clinical Trials Gateway'

Questions about the Fifth Health Check (5HC)

1. How is the fifth health check different from previous health checks?

The aim of this phase of EPIC-Norfolk (5HC) is to investigate measures to understand how health changes as individuals age, and further clarify the factors that influence the ageing process and risk of disease. We will be looking at cognitive function (covering a range of mental abilities not just memory), the levels and patterns of physical activity undertaken by participants and relating this to change in function and body composition as we age. There is evidence that lifestyle factors (such as diet, smoking and exercise) are associated with the risk of a number of the common conditions linked to ageing e.g. diabetes, heart disease and dementia. The EPIC-Norfolk study has collected over twenty years of lifestyle, biological and genetic information and is well placed to identify not only factors associated with decline but also those associated with the maintenance of health and functional ability in older age.

2. Why do we have to come to Norwich, is there a clinic near me?

Previously, EPIC staff either came to your local GP practice, or set up a special clinic in your local area. Due to the complex equipment we are now using, we are unable to set up in different clinics around the county. We now have an established central location in Norwich with a fully equipped clinic and a team of researchers. If you would like to attend a health check appointment but transport is a problem, then please telephone the clinic on 01603-776812 and we may be able to provide a taxi or minibus pickup.

3. Are there any possible risks associated with the DEXA body compositional scan, undertaken as part of the Fifth Health Check?

The DEXA scanner is an x-ray procedure. The x-ray exposure from this equipment is very small indeed, amounting to approximately 8 hours natural exposure to background radiation. For reference, a single chest X-ray amounts to about 3 day's background radiation. However, if there is a possibility that you may be pregnant, we will be unable to carry out the DEXA measurement. Please telephone the unit on 01603 776812 for advice if you suspect that you may be pregnant before your appointment. We also need to be informed if you have received any exposure to X-rays in the 4 weeks leading up to your appointment, in particular an x-ray where you may have been asked to swallow barium, or a nuclear scan where a contrast media was used to highlight certain organs.

4. Will I go into a tunnel for this scan?

No, you will not be required to go into a tunnel. The scan requires you to lie on a bed and an arm passes over the top of you. It will be carried out in a bright, airy room and the operator will remain with you throughout.

5. What tests are being carried out as part of the Fifth Health Check?

Please see Fifth Health Check page

Click here (EPIC Norfolk Fifth Health Check) available from the EPIC Home page for further information on the tests included in this phase.

6. My partner or friend is a participant but was not approached when I was. Why?

We approach participants based on the GP surgery where they are registered. It may be that your partner belongs to a different surgery to yourself, or as we send out approaches in alphabetical order, they may have a different surname to yourself. If you have received an invitation to the Fifth Health Check and you would like to come on the same day as another EPIC participant living at the same address (or nearby), please call us on our freephone number and we will send an invitation pack to that person and can then arrange an appointment at the same time. You can also write this on your participation form and we will note it at our end.

7. What if the set clinic times do not suit me?

That should not be a problem. You will be sent a participation form where there will be space to indicate the best times for an appointment to suit you. The clinic opening hours are distributed to accommodate most requests and you will be able to discuss your preferences with the study team when they telephone to make your appointment.

8. What do I need to do on the day of my appointment?

Please eat and drink as normal. Hot and cold drinks will also be offered during your appointment.

If you usually wear a hearing aid or contact lenses please wear them as normal on the day.

If you usually wear spectacles please ensure that you bring these with you on the day (including thoses used for computer use).

Please also bring a list of your medications (the docket for repeat prescriptions would be very useful). Medications are either those prescribed by your GP, or supplements you may have bought over the counter at the chemist or a health food store. Details of the brand of medication, the dose, and the frequency that you take it would be most useful.

It would be helpful if ladies are able to wear their hair loose, or are able to remove any hair ornaments to aid the accuracy of the height measurement without disturbing your hair.

To carry out a DEXA scan we must ensure that you are free from all metal as this affects the results obtained, so if you are able to wear or bring suitable clothing which is free from metal it would be very helpful. However, please don't worry if you are unable to find anything suitable at home as we have garments that you are able to change into at the unit. Ladies - please don't forget that most bra fasteners and underwiring are metal, therefore you will be asked to remove these prior to the scan.

9. Where is the EPIC Clinic in Norwich situated?

The Clinic is based at the Norwich Community Hospital (formerly the West Norwich Hospital). Entry to the site is via entrance A - signposted main car park. The unit is a green porta cabin with a brick front in the main car park.

10. Is there any parking at the clinic?

There is parking available on-site. You will be sent a car-parking voucher to display in your windscreen with your appointment pack. You will also be asked to provide the clinic with your car registration number when booking your appointment and this ensures that you can park free of charge for the duration of your health check.

11. Does the clinic have disabled access?

Yes. We do have a ramp outside the clinic, but please do call the clinic to discuss your individual needs if you have any concerns. In particular, if you have very limited mobility which may affect your ability to transfer from one room to another.

12. What should I expect at the health appointment check?

There may be other participants within the unit at the same time as you but you will be taken through the entire appointment by the same researcher. The appointment structure can vary according to the participant and researcher, but each element will be explained fully before proceeding.

13. Will I have to use a computer for any of the tests at the health check?

Yes, some of the tasks performed at the appointment will be displayed on a computer. Each of the tasks will be thoroughly explained and demonstrated by the researcher before starting and you don't have to know anything at all about computers to be able to complete these tasks. As a computer is used, it may be beneficial to bring with you the glasses that you would normally wear when viewing a computer screen should these be different from the glasses you wear for reading or distance.

14. What results are available after I've had a health check?

Your results are not available on the day of your appointment as they are not released until all quality control checks have been carried out. Approximately six weeks after your appointment you will be sent a copy of your body composition (DEXA results). This copy will show your regional fat distribution, fat mass and overall fat percentage, and your average blood pressure result calculated from the two measurements taken at your appointment. You will also receive a copy of your physical activity results (step count) relating to the seven days you were wearing an activity monitor. The report we send directly to you will not contain your bone mineral density results (BMD) as these, along with your blood pressure results, will be sent directly to your GP.

15. Why can't the participants be notified of the bone density (BMD) results from the DEXA scan?

The DEXA scan carried out during your EPIC health check is a total body DEXA scan and this result alone is not routinely used to diagnose low bone density (osteoporosis) in an individual. We provide the result to your GP as they have access to additional health-related information contained in your medical records and can assess whether there is a clinical justification to refer you for a clinical diagnostic scan of the spine and hip.

16. Why can't I have the results of all of the tests carried out at the health check?

In addition to the explanation above regarding bone density results, many of the tests we carry out are research tools only and are not considered as clinical diagnostic tests. We are not able to provide the results of these particular tests because they do not currently have a defined medical meaning e.g. cognition and memory test results.

17. Why doesn't EPIC carry out a hearing test as part of the Fifth Health Check?

We acknowledge that this would be a useful test, but unfortunately the conditions within the clinic are unsuitable at the present time to guarantee accurate testing. In addition to this, we have to decide on a research strategy at each phase of the study and hearing is not included in this phase. However, it may well be included in future phases.