Frederik Emil Juul

Lecturer - Department of Health Management and Health Economics

Norwegian version of this page

Email f.e.juul@medisin.uio.no

Username

Visiting address Gaustad sykehus Bygg 20 Sognsvannsveien 21 0372 Oslo

Postal address Postboks 1089 Blindern 0317 Oslo

Press photo Download business card

Frederik Emil Juul is a postdoctoral researcher at the Clinical Effectiveness research group and a lecturer in KLoK. His main research project, the COLONIZE trial, investigate whether fecal microbiota transplantation can be used as a treatment for primary infections with the bacterium Clostridioides difficile.

Academic interests

Microbiota and microbiota therapy
Clostridioides difficile
Epidemiology
Antibiotic use and -resistance

I have both a medical degree, ph.d. and research experience from the University of Oslo and Oslo University Hospital. During my medical study I did the complementary Medical Student Research Program and did research in colorectal cancer gene expression. This made me familiar with basal, experimental research, including cell culture, gene expression analysis and statistics.

My clinical experience is mainly from Bærum, Hamar and Sanderud hospitals in Norway. As an intern at Hamar hospital I worked at both the medical and surgery wards at the hospital, which includes departments in gastroenterology and gastric surgery. The final part of my Norwegian internship was at Skjåk medical centre in the small, rural mountain village of Bismo. I currently work as a doctor in specialication (internal medicine) at Bærum hospital.

I started as a Ph.d. research fellow in the Clinical Effectiveness Research group in September 2017 and defended med thesis in 2023. My main project is the COLONIZE trial, where we investigate if fecal microbiota transplantation can be used as treatment in primary Clostridioides difficile infections. This novel treatment strategy can potentially alleviate the use of conventional antibiotics in a time with increasing antibiotic resistance. I am also involved in the Clinical Effectiveness Research group’s projects in cancer epidemiology.

Work experience

2024 -	Postdoctoral researcher at the Clinical Effectiveness research group, University of Oslo
2023 -	MD in specialization in internal medicine, Bærum hospital
2020 -	Lecturer, University of Oslo.
2017 - 2023	Ph.d. research fellow and researcher position at the Clinical Effectiveness Research Group, Oslo University Hospital.
2014 - 2020	Physician (on-call). Innlandet Hospital Sanderud.
2017	Physician in district internship at Skjåk Medical Centre.
2016 - 2017	Physician in hospital internship at Hamar Hospital.
2015	Medical student with MD licence, Hamar hospital.
2014	Medical student with MD licence, Sanderud Psychiatric Hospital.

Other experience

2016 -	Lecturer at evening courses by the Student tuitition in Medicine (SUM) - a student-driven organization at the Faculty of Medicine, University of Oslo.
2014 - 2023	Writer to a "Doctor's life" in The Journal of the Norwegian Medical Association.
2014 - 2016	Chief editor of Æsculap - The Magazine for Norwegian Medical Students.
2013 - 2014	Course organizer of pharmacology courses by The Norwegian Medical Student Organization in Oslo.
2013	Scientific and IT Board representative at Frampeik - The Medical student's Research Conference in Norway.

Awards

2018: My abstract presentation at Digestive Disease Week 2018 (Washington D.C., U.S.) was awarded certificate of recognition as an early career investigator

Education

2022 - 2024	University pedagogy basics course, University of Oslo
2017 - 2023	PhD, University of Oslo
2013 - 2015	Medical Student Research Program, University of Oslo
2009 - 2016	Medical Doctor, University of Oslo
2012 - 2015	Student at the Medical Student Research Program, University of Oslo

Juul, Frederik Emil; Cross, Amanda J.; Schoen, Robert E.; Senore, Carlo; Pinsky, Paul F. & Miller, Eric A. [Show all 17 contributors for this article] (2024). Effectiveness of Colonoscopy Screening vs Sigmoidoscopy Screening in Colorectal Cancer. JAMA Network Open. ISSN 2574-3805. 7(2). doi: 10.1001/jamanetworkopen.2024.0007. Show summary
Importance: Randomized clinical screening trials have shown that sigmoidoscopy screening reduces colorectal cancer (CRC) incidence and mortality. Colonoscopy has largely replaced sigmoidoscopy for CRC screening, but long-term results from randomized trials on colonoscopy screening are still lacking. Objective: To estimate the additional screening benefit of colonoscopy compared with sigmoidoscopy. Design, setting, and participants: This comparative effectiveness simulation study pooled data on 358 204 men and women randomly assigned to sigmoidoscopy screening or usual care in 4 randomized sigmoidoscopy screening trials conducted in Norway, Italy, the US, and UK with inclusion periods in the years 1993 to 2001. The primary analysis of the study was conducted from January 19 to December 30, 2021. Intervention: Invitation to endoscopic screening. Main outcomes and measures: Primary outcomes were CRC incidence and mortality. Using pooled 15-year follow-up data, colonoscopy screening effectiveness was estimated assuming that the efficacy of colonoscopy in the proximal colon was similar to that observed in the distal colon in the sigmoidoscopy screening trials. The simulation model was validated using data from Norwegian participants in a colonoscopy screening trial. Results: This analysis included 358 204 individuals (181 971 women [51%]) aged 55 to 64 years at inclusion with a median follow-up time ranging from 15 to 17 years. Compared with usual care, colonoscopy prevented an estimated 50 (95% CI, 42-58) CRC cases per 100 000 person-years, corresponding to 30% incidence reduction (rate ratio, 0.70 [95% CI, 0.66-0.75]), and prevented an estimated 15 (95% CI, 11-19) CRC deaths per 100 000 person-years, corresponding to 32% mortality reduction (rate ratio, 0.68 [95% CI, 0.61-0.76]). The additional benefit of colonoscopy screening compared with sigmoidoscopy was 12 (95% CI, 10-14) fewer CRC cases and 4 (95% CI, 3-5) fewer CRC deaths per 100 000 person-years, corresponding to percentage point reductions of 6.9 (95% CI, 6.0-7.9) for CRC incidence and 7.6 (95% CI, 5.7-9.6) for CRC mortality. The number needed to switch from sigmoidoscopy to colonoscopy screening was 560 (95% CI, 486-661) to prevent 1 CRC case and 1611 (95% CI, 1275-2188) to prevent 1 CRC death. Conclusions and relevance: The findings of this comparative effectiveness study assessing long-term follow-up after CRC screening suggest that there was an additional preventive effect on CRC incidence and mortality associated with colonoscopy screening compared with sigmoidoscopy screening, but the additional preventive effect was less than what was achieved by introducing sigmoidoscopy screening where no screening existed. The results probably represent the upper limit of what may be achieved with colonoscopy screening compared with sigmoidoscopy screening.
Skjevling, Linn; Hanssen, Hege Marie; Valle, Per Christian; Goll, Rasmus; Juul, Frederik Emil & Arlov, Øystein [Show all 7 contributors for this article] (2023). Colonic distribution of FMT by different enema procedures compared to colonoscopy – proof of concept study using contrast fluid. BMC Gastroenterology. ISSN 1471-230X. 23. doi: 10.1186/s12876-023-02979-x. Full text in Research Archive
Juul, Frederik Emil; Garborg, Kjetil Kjeldstad; Nesbakken, Philip Eugen; Løberg, Magnus; Wieszczy, Paulina & Cubiella, Joaquín [Show all 19 contributors for this article] (2022). Rates of repeated colonoscopies to clean the colon from low-risk and high-risk adenomas: Results from the EPoS trials. Gut. ISSN 0017-5749. doi: 10.1136/gutjnl-2022-327696. Full text in Research Archive Show summary
Objective High-quality colonoscopy (adequate bowel preparation, whole-colon visualisation and removal of all neoplastic polyps) is a prerequisite to start polyp surveillance, and is ideally achieved in one colonoscopy. In a large multinational polyp surveillance trial, we aimed to investigate clinical practice variation in number of colonoscopies needed to enrol patients with low-risk and high-risk adenomas in polyp surveillance. Design We retrieved data of all patients with low-risk adenomas (one or two tubular adenomas <10 mm with low-grade dysplasia) and high-risk adenomas (3–10 adenomas, ≥1 adenoma ≥10 mm, high-grade dysplasia or villous components) in the European Polyp Surveillance trials fulfilling certain logistic and methodologic criteria. We analysed variations in number of colonoscopies needed to achieve high-quality colonoscopy and enter polyp surveillance by endoscopy centre, and by endoscopists who enrolled ≥30 patients. Results The study comprised 15 581 patients from 38 endoscopy centres in five European countries; 6794 patients had low-risk and 8787 had high-risk adenomas. 961 patients (6.2%, 95% CI 5.8% to 6.6%) underwent two or more colonoscopies before surveillance began; 101 (1.5%, 95% CI 1.2% to 1.8%) in the low-risk group and 860 (9.8%, 95% CI 9.2% to 10.4%) in the high-risk group. Main reasons were poor bowel preparation (21.3%) or incomplete colonoscopy/polypectomy (14.4%) or planned second procedure (27.8%). Need of repeat colonoscopy varied between study centres ranging from 0% to 11.8% in low-risk adenoma patients and from 0% to 63.9% in high-risk adenoma patients. On the second colonoscopy, the two most common reasons for a repeat (third) colonoscopy were piecemeal resection (26.5%) and unspecified reason (23.9%). Conclusion There is considerable practice variation in the number of colonoscopies performed to achieve complete polyp removal, indicating need for targeted quality improvement to reduce patient burden. Trial registration number NCT02319928.
Juul, Frederik Emil; Cross, Amanda J.; Schoen, Robert E.; Senore, Carlo; Pinsky, Paul & Miller, Eric [Show all 17 contributors for this article] (2022). 15-Year Benefits of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality : A Pooled Analysis of Randomized Trials. Annals of Internal Medicine. ISSN 0003-4819. 175(11), p. 1525–1533. doi: 10.7326/M22-0835. Show summary
Background: The effectiveness of screening for colorectal cancer (CRC) by sex and age in randomized trials is uncertain. Objective: To evaluate the 15-year effect of sigmoidoscopy screening on CRC incidence and mortality. Design: Pooled analysis of 4 large-scale randomized trials of sigmoidoscopy screening. Setting: Norway, the United States, the United Kingdom, and Italy. Participants: Women and men aged 55 to 64 years at enrollment. Intervention: Sigmoidoscopy screening. Measurements: Primary end points were cumulative incidence rate ratio (IRR) and mortality rate ratio (MRR) and rate differences after 15 years of follow-up comparing screening versus usual care in intention-to-treat analyses. Stratified analyses were done by sex, cancer site, and age at screening. Results: Analyses comprised 274 952 persons (50.7% women), 137 493 in the screening and 137 459 in the usual care group. Screening attendance was 58% to 84%. After 15 years, the rate difference for CRC incidence was 0.51 cases (95% CI, 0.40 to 0.63 cases) per 100 persons and the IRR was 0.79 (CI, 0.75 to 0.83). The rate difference for CRC mortality was 0.13 deaths (CI, 0.07 to 0.19 deaths) per 100 persons, and the MRR was 0.80 (CI, 0.72 to 0.88). Women had less benefit from screening than men for CRC incidence (IRR for women, 0.84 [CI, 0.77 to 0.91]; IRR for men, 0.75 [CI, 0.70 to 0.81]; P = 0.032 for difference) and mortality (MRR for women, 0.91 [CI, 0.77 to 1.17]; MRR for men, 0.73 [CI, 0.64 to 0.83]; P = 0.025 for difference). There was no statistically significant difference in screening effect between persons aged 55 to 59 years and those aged 60 to 64 years. Limitation: Data from the U.K. trial were less granular because of privacy regulations. Conclusion: This pooled analysis of all large randomized trials of sigmoidoscopy screening demonstrates a significant and sustained effect of sigmoidoscopy on CRC incidence and mortality for 15 years.
Jodal, Henriette C.; Juul, Frederik Emil; Barua, Ishita; Bretthauer, Michael; Kalager, Mette & Løberg, Magnus [Show all 7 contributors for this article] (2022). Emergency hospital admissions, prognosis, and population mortality in Norway during the first wave of the Covid-19 epidemic. Scandinavian Journal of Public Health. ISSN 1403-4948. 50(6), p. 795–802. doi: 10.1177/14034948221082959. Full text in Research Archive
Helsingen, Lise Mørkved; Løberg, Magnus; Refsum, Erle; Gjøstein, Dagrun Kyte; Wieszczy, Paulina & Olsvik, Ørjan [Show all 16 contributors for this article] (2021). Covid-19 transmission in fitness centers in Norway - a randomized trial. BMC Public Health. ISSN 1471-2458. 21, p. 1–9. doi: 10.1186/s12889-021-12073-0. Full text in Research Archive
Juul, Frederik E.; Jodal, Henriette C.; Barua, Ishita; Refsum, Erle; Olsvik, Ørjan & Helsingen, Lise Mørkved [Show all 10 contributors for this article] (2021). Mortality in Norway and Sweden during the COVID-19 pandemic. Scandinavian Journal of Public Health. ISSN 1403-4948. p. 1–8. doi: 10.1177/14034948211047137. Full text in Research Archive
Juul, Frederik Emil (2020). Legen som pasient. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 140(6), p. 1–2. doi: 10.4045/tidsskr.20.0135.
Juul, Frederik Emil; Garborg, Kjetil Kjeldstad; Bretthauer, Michael; Skudal, Hilde Kristin; Oines, Mari N. & Wiig, Håvard [Show all 16 contributors for this article] (2018). Fecal microbiota transplantation for primary Clostridium difficile infection. New England Journal of Medicine. ISSN 0028-4793. 378(26), p. 2535–2537. doi: 10.1056/NEJMc1803103. Full text in Research Archive

View all works in Cristin

Juul, Frederik Emil; Cross, Amanda J.; Pinsky, Paul; Senore, Carlo & Løberg, Magnus (2023). 15-Year Benefits of Sigmoidoscopy Screening on Colorectal Cancer Incidence and Mortality. Annals of Internal Medicine. ISSN 0003-4819. 176(6). doi: 10.7326/L23-0025.
Juul, Frederik Emil; Hov, Johannes Espolin Roksund; Trøseid, Marius; Johnsen, Peter Holger & Valeur, Jørgen (2023). Tarmflora og tarmsykdom – en edruelig formaning. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 143(10), p. 849–850. doi: 10.4045/tidsskr.23.0121.
Juul, Frederik Emil (2022). «Forskning viser at …». Tidsskrift for Den norske legeforening. ISSN 0029-2001. 142(17). doi: 10.4045/tidsskr.22.0649.
Juul, Frederik Emil (2022). Sommerlegen. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 142(10). doi: 10.4045/tidsskr.22.0371.
Bråten Løvald, Kaja & Juul, Frederik Emil (2022). #26 - Frederik Emil Juul om tarmflorabehandling. [Radio]. @medisinstudentsnap. Show summary
Medisinstudentsnap intervjuer de råeste legene i landet om spennende medisinske tema, lærerike pasienthistorier og sjelsettene opplevelser fra karrieren. Følg oss på Instagram @medisinstudentsnap for quiz og annen medisinsk moro. Dagens gjest er Frederik Emil Juul, doktorgradsstipendiat ved Oslo universitetssykehus i forskningsgruppen Klinisk effektforskning. Stipendiatprosjektet er den kliniske studien COLONIZE, hvor de undersøker om tarmflorabehandling kan brukes som behandling av primærinfeksjoner med bakterien Clostridioides difficile. I tillegg snakker vi om hverdagen som forsker, kunnskapshåndtering, IBS og mye mer! Som alltid får du også noen gode studietips og helseråd mot slutten av episoden. Enjoy! Følg oss på Instagram @medisinstudentsnap
Juul, Frederik Emil (2022). Skiftarbeid. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 142(3), p. 1–3. doi: 10.4045/tidsskr.22.0007.
Juul, Frederik Emil (2021). Filmlegen. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.21.0061.
Juul, Frederik Emil (2021). Pasient, du lyver! Tidsskrift for Den norske legeforening. ISSN 0029-2001. 141(12). doi: 10.4045/tidsskr.21.0555.
Juul, Frederik Emil (2020). Digitale forelesninger. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.20.0638.
Juul, Frederik Emil & Stensrud, Mats Julius (2020). En morbid innhøsting. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.20.0648.
Juul, Frederik Emil & Johnsen, Peter Holger (2020). Norge i forskningsfronten på avføringsbehandling. LVSinfo.
Juul, Frederik Emil (2019). Pasientutvalg representative for virkelig, klinisk praksis : . Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(9). doi: 10.4045/tidsskr.19.0328.
Juul, Frederik Emil (2019). Legene uten pasienter. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.19.0501.
Juul, Frederik Emil & Valeur, Jørgen (2019). Tilsvar til Frøland SS. Fekaltransplantasjon og mikrobiom. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(11), p. 1020–1020.
Juul, Frederik Emil & Valeur, Jørgen (2019). Tarmflorabehandling. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(9), p. 859–859. doi: 10.4045/tidsskr.19.0058.
Juul, Frederik Emil (2019). Byråkratiet i medisinske studier. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(5), p. 1–2. doi: 10.4045/tidsskr.19.0067.
Juul, Frederik Emil & Valeur, Jørgen (2019). Snille bakterier finnes ikke. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 139(6), p. 504–505. doi: 10.4045/tidsskr.19.0134.
Juul, Frederik Emil (2019). Man må like mennesker. Turleder'n. ISSN 0805-1461. 36(1), p. 14–15.
Juul, Frederik Emil; Skudal, Hilde Kristin; Øines, Mari Nanna; Wiig, Håvard; Rose, Øystein & Seip, Birgitte Karen Berggreen [Show all 14 contributors for this article] (2018). Fecal microbiota transplant in primary Clostridium difficile infection - a proof-of-concept trial.
Juul, Frederik Emil (2018). Blind nysgjerrighet. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 138(12). doi: 10.4045/tidsskr.18.0419.
Juul, Frederik Emil; Garborg, Kjetil Kjeldstad; Bretthauer, Michael; Kalager, Mette; Midtvedt, Tore & Furholm, Siv [Show all 17 contributors for this article] (2018). Fecal microbiota transplantation versus antibiotics for primary Clostridium difficile infection - a multicenter, randomized proof-of-concept trial.
Juul, Frederik Emil (2018). Lykkelig ensom. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.17.1076.
Juul, Frederik Emil (2017). Er unge leger overbehandlere? Tidsskriftet sykepleien. ISSN 0806-7511.
Juul, Frederik Emil (2017). Farlig journaltranskripsjon. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.17.0027.
Juul, Frederik Emil (2017). Unike uniformer. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.17.0239.
Juul, Frederik Emil (2016). Indremedisinsk bredde i lommeformat. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.16.0061.
Juul, Frederik Emil (2016). Blant de store veikryssene. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.16.0370.
Juul, Frederik Emil (2016). Å være en spirrevipp. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.16.0701.
Juul, Frederik Emil (2016). Å se seg selv i pasienten. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.16.0979.
Juul, Frederik Emil (2016). Like leger lunsjer best? Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.16.0098.
Juul, Frederik Emil (2016). Re: Magnesiummangel og protonpumpehemmere. Tidsskrift for Den norske legeforening. ISSN 0029-2001. 136(20), p. 1703–1703. doi: 10.4045/tidsskr.16.0867.
Blomkvist, Andreas Wahl; Juul, Frederik Emil & Schei, Edvin (2016). Å kommunisere som en helbreder. Dagens medisin. ISSN 1501-4290.
Juul, Frederik Emil (2015). En ambivalent student. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.15.1085.
Juul, Frederik Emil (2015). Husker du hvordan det var? Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.15.0098.
Juul, Frederik Emil (2015). En hyllest til bøkene. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.15.0635.
Juul, Frederik Emil; Samuelsen, Jens-Øyvind & Stensrud, Mats Julius (2015). Sportslig språkforvirring. Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.15.0564.
Juul, Frederik Emil (2014). Hva liker du å gjøre? Tidsskrift for Den norske legeforening. ISSN 0029-2001. doi: 10.4045/tidsskr.14.0866.
Myren, Sverre & Juul, Frederik Emil (2014). Turnuslege. [Business/trade/industry journal]. Æsculap.

View all works in Cristin

Published Feb. 28, 2018 1:51 PM - Last modified June 27, 2024 1:34 PM

Projects

Research groups

Clinical Effectiveness Research