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Beneficial effects of ADHD medication in children and adolescents
Nikolaj Vang Nielsen
This project aims to investigate potential beneficial effects of ADHD medication in children and adolescents in Denmark. The use of ADHD medication has increased substantially in recent decades. Yet evidence on treatment effects comes mainly from short-term randomized trials, while real-world data on daily functioning and school outcomes remain limited.
Using nationwide health and education registers, we will conduct three studies evaluating the impact of ADHD medication in children and adolescents on 1) national test scores and grade point averages, 2) school well-being and school absence, and 3) ADHD symptom severity. For the third study, we will first develop and validate a natural language processing model to extract parent- and teacher-reported ADHD Rating Scale scores from electronic medical records. We will then use these data to assess whether initiating ADHD medication improves symptom severity.
The project will provide real-world evidence on the potential benefits of ADHD medication. This knowledge will support clinicians and families in deciding whether to initiate ADHD medication and inform future treatment guidelines for children and adolescents with ADHD.
Main supervisor: Anton Pottegård
PFAS Exposure in Utero and Childhood: Effects on Pubertal Timing and Gender-Specific Brain Development
Rasmus Rugård Mikkelsen
Per- and polyfluoroalkyl substances (PFAS) are persistent environmental contaminants found in many consumer products. PFAS accumulate in the food chain, cross the placenta, and are excreted in breast milk, potentially affecting development during vulnerable life stages. Experimental studies suggest that PFAS may disrupt endocrine and neurodevelopmental processes, but the long-term effects of prenatal and childhood exposure on child development remain incompletely understood.
This PhD project investigates sex-specific associations between PFAS exposure and pubertal and neurobehavioral development in children aged 9-12 years. Using longitudinal data from the Odense Child Cohort, the study examines both legacy and emerging PFAS measured repeatedly from pregnancy through childhood, providing a unique opportunity to evaluate exposure across multiple developmental stages. The project focuses on two key developmental domains. First, it examines associationsbetween PFAS exposure and pubertal development, including the timing of pubertal onset and reproductive hormone concentrations during early adolescence. Second, it investigates neurobehavioral development in children aged 9–12 years through validated assessments of cognitive, social, and behavioral functioning. The findings will improve understanding of how PFAS exposure may affect child development and provide evidence to inform future public health recommendations and regulatory decision-making.
Main supervisor: Tina Kold Jensen
Per- and polyfluoroalkyl substances (PFAS) and the risk of cardiovascular disease in adults
Emily Cantio
This PhD project aims to examine whether exposure to per- and polyfluoroalkyl substances (PFAS) increases the risk of cardiovascular disease in adults. PFAS are a group of persistent synthetic chemicals widely used in industrial processes and consumer products. Due to their extensive use and resistance to degradation, PFAS are now found worldwide in the environment and can be detected in the blood of most individuals.
Several studies have reported associations between PFAS exposure and elevated cholesterol and lipid levels, suggesting that PFAS may interfere with lipid metabolism. As dyslipidemia is a well-established risk factor for cardiovascular disease, these findings have raised concerns that PFAS exposure may contribute to the development of cardiovascular disease. However, despite growing evidence regarding PFAS and lipid disturbances, studies directly investigating cardiovascular disease outcomes have produced inconsistent results.
Using longitudinal data from the Copenhagen City Heart Study, including repeated PFAS measurements linked with Danish health registry data, this project will investigate whether PFAS exposure increases the risk of cardiovascular disease and whether this potential effect is mediated through changes in blood cholesterol levels. The project will also explore whether reductions in PFAS exposure over time are associated with a lower risk of cardiovascular disease. The findings will contribute to a better understanding of the long-term cardiovascular health effects of PFAS exposure and the mechanisms underlying these associations.
Main supervisor: Lars Christian Lund
Artificial Intelligence to Strengthen Transparency and Reproducibility in Real-World Evidence Generation
Fatemehsadat Ghanadi Ladani
This PhD project focuses on improving transparency and reproducibility in pharmacoepidemiological research through the development and evaluation of machine-learning-based methods. Pharmacoepidemiological studies using routinely collected healthcare data are essential for assessing the safety and effectiveness of medicines in real-world settings, but they often involve complex design choices, data-processing steps, and analytical workflows that can be difficult to document, reproduce, and validate.
The project will explore how large language models and other machine-learning methods can support key stages of the research process, including protocol development, study design, code validation, and the generation of synthetic longitudinal registry data. A central aim is to develop AI-assisted tools that can help researchers produce clearer study protocols, identify inconsistencies between protocols and analysis code, and strengthen quality control in common data model-based workflows such as EpiCore.
By combining expertise in artificial intelligence, medical data science, and pharmacoepidemiology, the project aims to contribute practical methods and reusable tools that support more reliable, transparent, and reproducible medicine safety research.
Main supervisor: Anton Pottegård
High-throughput screening to identify drugs associated with severe acute liver injury and decompensated cirrhosis: A new approach to hepatic drug safety
Arjun Sarathi
Drug-induced liver injury (DILI) is one of the leading causes of acute liver failure and is a common reason for drug withdrawal from the market. Discovering DILIs can be challenging due to its liability to be confused with other causes of liver dysfunction. DILIs are currently mainly identified through solicited case reporting from vigilant clinicians, so-called spontaneous reporting. This approach, however, has important limitations, among others a severe and highly variable underreporting, its dependency on individual clinicians’ suspicions, a susceptibility to media influence, that it cannot appraise the problem’s magnitude, and its inability to disprove suspected adverse effects. Consequently, some adverse drug effects are discovered with significant latency. We propose an innovative system to analyze two large real-world data sources with the aim of identifying unknown DILI associations, free from the limitations mentioned above.
We hypothesize that a systematic screening of real-world data, i.e. patient health and care delivery information collected outside research settings, analyzed with epidemiological methods and screening all marketed drugs may help identify new DILI associations. We will screen in Danish health care data sources and validate our findings in the US Veteran’s Affairs database.
Main supervisor : Jesper Hallas
Long-term Safety of ADHD Medication in Children and Adolescents
Sofie Sonne Westergaard Pedersen
This project aims to generate evidence on the long-term safety of ADHD medications in children and adolescents. Although the use of ADHD medication has increased substantially in recent decades, knowledge about the long-term risks associated with treatment remains limited. The project will investigate whether ADHD medications are associated with serious adverse outcomes, including cardiovascular events, substance use disorders, psychosis, and impaired growth and pubertal development.
Using nationwide registry data from Denmark and Norway, the project will establish large population-based cohorts of children and young people with ADHD and compare long-term outcomes among individuals who initiate ADHD medication treatment and those who do not. The project will further examine whether risks vary according to age, sex, treatment duration, cumulative dose, and medication type.
The project seeks to provide critical evidence on the long-term safety of ADHD medications to support clinical decision-making, patient counselling, and future treatment guidelines for children and adolescents with ADHD.
Main supervisor: Anton Pottegård
Reducing low-value care for patients: A registry-based evaluation of Choosing Wisely Denmark
Emma Simonsen
This PhD project aims to evaluate how Choosing Wisely Denmark (Vælg Klogt) recommendations, aimed at reducing unnecessary tests and treatments, are implemented in clinical practice. A substantial proportion of healthcare activity consists of so-called low-value care, i.e., tests and treatments with limited benefit to patients. Despite increasing international focus on reducing low-value care, there is limited evidence on how such recommendations translate into real-world clinical practice.
Using nationwide Danish health registries, the project comprises three studies: 1) evaluating changes in the use of selected tests, treatments, and consultations following Vælg Klogt recommendations, 2) investigating variation in implementation across regions and municipalities, and 3) examining potential unintended consequences of the recommendations. The project will provide new insights into how de-implementation initiatives work in practice and support more patient-centered use of healthcare resources, ensuring that patients receive care that benefits them most.
Main supervisor: Anton Pottegård
Cancer risk following assisted reproductive technology
Katrine Mose Hansen
This project aims to investigate whether assisted reproductive technology (ART) is associated with an increased risk of cancer in women undergoing treatment and in children conceived through ART. ART is increasingly used worldwide and represents one of the most hormonally intensive medical interventions, raising concerns about potential long-term health effects.
Using nationwide registry data from Denmark and Norway, the project will examine cancer risk in both women and children in relation to ART exposure, including potential variation by treatment characteristics, cumulative exposure, and underlying indication for treatment.
The findings will provide robust, population-based evidence to support clinical counseling, inform public health policy, and contribute to international safety evaluations of ART.
Main supervisor: Anton Pottegård
Data-Driven Insights into Psychotropic Medication Use
Heidi Elkjær Sonne
This PhD project aims to generate knowledge on the use of psychotropic medications in vulnerable populations and to inform evidence-based healthcare policy. The research comprises three studies which aim to: 1) Investigate prescribing patterns and geographic variation in antipsychotic use among older individuals, including those with dementia, 2) Evaluate the impact of a national multifaceted intervention on the prescribing of antipsychotic medications in older populations, using interrupted time series analysis, and 3) Describe trends in psychiatric diagnoses and psychotropic medication use among children and adolescents, using Danish health registers.
The project seeks to provide critical evidence on prescribing practices and policy interventions, and to develop interactive digital tools that enhance accessibility and usability of findings for clinicians and decision-makers. These insights will contribute to more efficient healthcare resource allocation and improved treatment quality in populations where current evidence is limited.
Main supervisor: Anton Pottegård
Elucidating the elusive molecular mechanism of chemotherapy-induced peripheral neuropathy
Alexander Wind
The objective of this PhD project is to help better understand the molecular mechanism of Chemotherapy-induced peripheral neuropathy (CIPN). We are utilizing human induced pluripotent stem cell-derived sensory neurons that are being treated with paclitaxel and vincristine to induce CIPN. With this cell model, we are using a high throughput screen of a library of drugs to identify substances that may modulate paclitaxel- or vincristine-induced neurotoxicity. In a next step, we will conduct mechanistic follow-up studies to better understand the underlying mechanisms of CIPN and the exacerbation or alleviation by the screening hits.
Main supervisor: Tore B. Stage
Use of psychotropic medication in pregnancy and gastrointestinal disorders in children
Karoline Mathilde Lundgaard
This project aims to study the consequences of psychotropic drug use during pregnancy on the risk and severity of gastrointestinal disorders in children. Using nationwide health registers, the project will consist of three studies: study 1 will describe the incidence of gastrointestinal disorders over time and characterizing diagnosed children, study 2 and 3 will investigate how exposure to psychotropic medication in utero is associated with gastrointestinal disorders and if exposure affect severity of the gastrointestinal disorders. The findings will provide evidence to support the optimal use of psychotropic medication during pregnancy and potentially reduce the incidence of gastrointestinal disorders in children.
Main supervisor: Mette Bliddal
The psychiatric burden of children and adolescents in Scandinavia – a sex and time trend perspective
Maria Højgaard Stoltz-Andersen
This project aims to outline detailed psychotropic drug utilization patterns among children and adolescents in Denmark, Norway, and Sweden during the past decade, leveraging data from the Scandinavian healthcare registers. Historically, there is a variation in psychotropic treatment between boys and girls that is beyond what can be justified by sex-specific variation in disorder symptom presentation. Furthermore, there are unexplained national variations in psychotropic drug use among Scandinavian children and adolescents. This project will help to fill this important gap in knowledge by seeking to explain counterintuitive variation in treatment of psychiatric disorders between both sexes and Scandinavians populations. Specifically, we will 1) determine sex-specific incidence and prevalence rates of psychotropic drug use, 2) compare treatment patterns, including treatment duration, treatment latency, and treatment changes for boys and girls, and 3) characterize boys and girls using psychotropic drugs regarding socioeconomic factors, and somatic and psychiatric morbidity. The three studies will detect potential differences that imply non-rational use of psychotropic drugs and inequality in mental health care between sexes and populations. Hence, our results will guide the development of optimized clinical treatment guidelines based on actual utilization patterns in Scandinavia.
Main supervisor: Rikke Thaarup Wesselhøft
Sustainable Healthcare: Task shifting, Resource Allocation, and Home Healthcare
Anders Christer Larsen
This project aims to generate knowledge to enhance the use of resources in healthcare and ensure safe and high-quality care. The research comprises three studies which aim to: 1) Investigate success factors for task shifting in the implementation of clinical pharmacy services in hospitals, using mixed methods, 2) Investigate task shifting and the transfer of medical responsibility during the transition of patients from hospitals to temporary care, using mixed methods, 3) Investigate and describe the characteristics of people receiving home healthcare services, using Danish registry data.
The project seeks to enhance the use of competencies and resources among different healthcare professionals and provide a critical overview of a large and growing population of people on which there is currently limited information. These insights will inform and help efficient resources allocation and decision-making within the healthcare system.
Main supervisor: Anton Pottegård
PFAS exposure levels in 1500 young Danes and association between prenatal PFAS exposure and serum lipides and cardiovascular risk markers in children
Christina Raun-Petersen
Perfluoroalkyl substances (PFAS) are highly persistent chemicals widely used in consumer products. PFAS are detectable in the environment and humans worldwide. The current levels of PFAS concentrations in the general Danish population are unknown, both hindering clinical guidance for highly exposed groups as well as the authorities’ ability to evaluate the impact of regulations. PFAS exposure has been associated with increased serum cholesterol which is causally linked to cardiovascular disease and potentially poses a major impact on human health. This study aims to establish PFAS exposure in 1500 18-28-year-old Danes from the general population. Additionally, the study seeks to investigate the association between prenatal exposure to PFAS and serum lipides as well as cardiovascular risk markers in children in the Odense Child Cohort. Reducing risk factors before the onset of clinical cardiovascular disease could offer major public health benefits and guide PFAS regulation.
Main supervisor: Tina Kold Jensen
Detection of unknown beneficial cumulative drug effects
Julie Rudbech Krumborg
This project aims to identify potential targets for drug repurposing. We will conduct a large screening study on real-world data on all prescriptions and diagnoses in the Danish registers employing a modified case-crossover and a nested case-control design. This project will focus on cumulative beneficial effects of drugs that have not yet been described in the literature. A cumulative effect refers to an effect that requires repeated exposure to the drug to manifest and it does not necesarily debut concurrent with use of the drug. Consequently, cumulative effects are challenging to discover using traditional methods, and beneficial cumulative effects are even more obscure.
We expect the study to result in a numerous associations. The strongest associations with highest potential public health impact will be prioritised in further validation studies.
Main supervisor: Jesper Hallas
Morbidity, mortality, and medication use among frail older people in care homes and temporary stays in Denmark
Hanin Harbi
This PhD project aims to promote a better and safer use of drugs among frail older people in care homes and temporary stays, with a particular focus on glucose-lowering drugs. The project consists of four studies, which will examine the 1) characteristics, care trajectories, and medication use of patients in temporary stays in Denmark, 2) morbidity and mortality among care home residents in Denmark, 3) use of glucose-lowering drugs in Danish care homes, and 4) use and safety of sodium-glucose co-transporter 2 inhibitors (SGLT-2is) among older people with type 2 diabetes in British Columbia, Canada. The project is based on a manually collected cohort of 11,424 patients in temporary stays in Denmark and a national cohort of all Danes admitted to care homes in Denmark from 2015 onwards and uses data from several Danish health registries. By contributing to a better understanding of the morbidity, mortality, and medication use among frail older people in care homes and temporary stays, the project seeks to optimize the treatment and care of these patients, thereby improving their safety and quality of life.
Main supervisor: Anton Pottegård
Medication use among nursing home residents
Emma Bjørk Olsen
This project aims to study medication use among Danish nursing home residents, leveraging newly available data from the Danish Health Data Authority. The research comprises four studies: 1) assessing the value of using information recorded in the Danish National Prescription Register to evaluate drug use among nursing home residents, 2) analyzing the utilization of pain medication at nursing homes, 3) examining the distribution of types of prescribers at nursing homes, and 4) evaluating the effect of designated nursing home physicians on residents' overall medication burden and prevalence of polypharmacy.
The project seeks to promote rational medication use, care, and safety for older persons living in Danish nursing homes by providing insights into the medication burden and developing interventions and strategies for systematic monitoring and evaluation.
Main supervisor: Anton Pottegård