1
|
Rhee CK, Choi JY, Park YB, Yoo KH. Clinical Characteristics and Frequency of Chronic Obstructive Pulmonary Disease Exacerbations in Korean Patients: Findings From the KOCOSS Cohort 2012-2021. J Korean Med Sci 2024; 39:e164. [PMID: 38769923 PMCID: PMC11106559 DOI: 10.3346/jkms.2024.39.e164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2023] [Accepted: 04/24/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) exert a substantial burden on patients and healthcare systems; however, data related to the frequency of AECOPD in the Korean population are limited. Therefore, this study aimed to describe the frequency of severe, and moderate or severe AECOPD, as well as clinical and demographic characteristics of patients with chronic obstructive pulmonary disease (COPD) in South Korea. METHODS Data from patients aged > 40 years with post-bronchodilator forced expiratory volume in 1 second (FEV1)/forced vital capacity ≤ 70% of the normal predicted value from the Korea COPD Subgroup Study database were analyzed (April 2012 to 2021). The protocol was based on the EXAcerbations of COPD and their OutcomeS International study. Data were collected retrospectively for year 0 (0-12 months before study enrollment) based on patient recall, and prospectively during years 1, 2, and 3 (0-12, 13-24, and 25-36 months after study enrollment, respectively). The data were summarized using descriptive statistics. RESULTS Data from 3,477 Korean patients (mean age, 68.5 years) with COPD were analyzed. Overall, most patients were male (92.3%), former or current smokers (90.8%), had a modified Medical Research Council dyspnea scale score ≥ 1 (83.3%), and had moderate airflow limitation (54.4%). The mean body mass index (BMI) of the study population was 23.1 kg/m², and 27.6% were obese or overweight. Hypertension was the most common comorbidity (37.6%). The mean blood eosinophil count was 226.8 cells/μL, with 21.9% of patients having ≥ 300 cells/μL. A clinically insignificant change in FEV1 (+1.4%) was observed a year after enrollment. Overall, patients experienced a mean of 0.2 severe annual AECOPD and approximately 1.1 mean moderate or severe AECOPD. Notably, the rates of severe AECOPD remained generally consistent over time. Compared with patients with no exacerbations, patients who experienced severe exacerbations had a lower mean BMI (21.7 vs. 23.1 kg/m²; P < 0.001) and lower lung function parameters (all P values < 0.001), but reported high rates of depression (25.5% vs. 15.1%; P = 0.044) and anxiety (37.3% vs. 16.7%; P < 0.001) as a comorbidity. CONCLUSION Findings from this Korean cohort of patients with COPD indicated a high exacerbation burden, which may be attributable to the unique characteristics of the study population and suboptimal disease management. This highlights the need to align clinical practices with the latest treatment recommendations to alleviate AECOPD burden in Korea. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT05750810.
Collapse
Affiliation(s)
- Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Joon Young Choi
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yong-Bum Park
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Kwang Ha Yoo
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Konkuk University Medical Center, Konkuk University School of Medicine, Seoul, Korea.
| |
Collapse
|
2
|
Chung C, Lee JW, Lee SW, Jo MW. Clinical Efficacy of Mobile App-Based, Self-Directed Pulmonary Rehabilitation for Patients With Chronic Obstructive Pulmonary Disease: Systematic Review and Meta-Analysis. JMIR Mhealth Uhealth 2024; 12:e41753. [PMID: 38179689 PMCID: PMC10786334 DOI: 10.2196/41753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Revised: 11/20/2023] [Accepted: 11/27/2023] [Indexed: 01/06/2024] Open
Abstract
Background Pulmonary rehabilitation is well known to improve clinical symptoms (including dyspnea), quality of life, and exercise capacity in patients with chronic obstructive pulmonary disease (COPD). However, researchers have reported difficulties in practicing center-based pulmonary rehabilitation. Recently, mobile app-based pulmonary rehabilitation has become available in clinical practice. We investigated the clinical outcomes of mobile app-based pulmonary rehabilitation in patients with COPD. Objective The objective of our study was to evaluate the clinical efficacy of mobile app-based pulmonary rehabilitation versus conventional center-based pulmonary rehabilitation for patients with COPD, using a systematic review and meta-analysis. Methods A systematic search of the literature published between January 2007 and June 2023 was performed, using the PubMed, Embase, Cochrane, and CINAHL databases to identify relevant randomized controlled trials involving patients with COPD. Pulmonary rehabilitation programs needed to provide an exercise program on a smartphone app. Study outcomes, including exercise capacity, symptom scores, quality of life, and hospitalization, were evaluated. The meta-analysis evaluated mean differences in 6-minute walk test distances (6MWDs), COPD Assessment Test (CAT) scores, modified Medical Research Council (mMRC) dyspnea scale scores, St. George Respiratory Questionnaire (SGRQ) scores, and risk ratios for hospitalization resulting from disease exacerbation. Results Of the 1173 screened studies, 10 were included in the systematic review and 9 were included in the meta-analysis. Further, 6 studies were multicenter studies. There were a total of 1050 participants, and most were aged ≥65 years. There were discrepancies in the baseline participant characteristics, smartphone apps, interventions, and study outcomes among the included studies. In the meta-analysis, 5 studies assessed 6MWDs (mean difference 9.52, 95% CI -3.05 to 22.08 m), 6 studies assessed CAT scores (mean difference -1.29, 95% CI -2.39 to -0.20), 3 studies assessed mMRC dyspnea scale scores (mean difference -0.08, 95% CI -0.29 to 0.13), 2 studies assessed SGRQ scores (mean difference -3.62, 95% CI -9.62 to 2.38), and 3 studies assessed hospitalization resulting from disease exacerbation (risk ratio 0.65, 95% CI 0.27-1.53). These clinical parameters generally favored mobile app-based pulmonary rehabilitation; however, a statistically significant difference was noted only for the CAT scores (P=.02). Conclusions Despite some discrepancies in the baseline participant characteristics and interventions among studies, mobile app-based pulmonary rehabilitation resulted in favorable exercise capacity, symptom score, quality of life, and hospitalization outcomes when compared with conventional pulmonary rehabilitation. In the meta-analysis, the CAT scores of the mobile app-based pulmonary rehabilitation group were significantly lower than those of the control group (P=.02). In real-world practice, mobile app-based pulmonary rehabilitation can be a useful treatment option when conventional center-based pulmonary rehabilitation is not feasible.
Collapse
Affiliation(s)
- Chiwook Chung
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
- Department of Pulmonary and Critical Care Medicine, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea
| | - Jong Won Lee
- Division of Breast Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Sei Won Lee
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| | - Min-Woo Jo
- Department of Preventive Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea
| |
Collapse
|
3
|
Han Y, Sung H, Choi Y, Kim YS. Trends in obesity, leisure-time physical activity, and sedentary behavior in Korean adults: Korea national health and nutritional examinations survey from 2014 to 2021. PLoS One 2024; 19:e0296042. [PMID: 38170709 PMCID: PMC10763961 DOI: 10.1371/journal.pone.0296042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVES This study aimed to investigate trends in obesity by dividing it based on body mass index (BMI) and waist circumference indicators, sedentary behavior, and leisure-time physical activity (LTPA) in Korean adults from 2014 to 2021. This study also aimed to determine the adherence rate of people with obesity to physical activity. METHODS Data from the Korea National Health and Nutritional Examination Survey (KNHANES) from 2014 to 2021 were used. A total of 42,676 participants 19 years or older were included in the final analysis. Sociodemographic characteristics, anthropometric measurements, and physical activity levels were recorded. Physical activity levels were assessed using the Global Physical Activity Questionnaire, a self-reported questionnaire. Multivariable logistic regression analysis adjusted for covariates was used to investigate the prevalence of obesity and sitting time or adherence to meeting the physical activity guidelines for each survey year. RESULTS This study included 42,676 adults. The weighted prevalence of obesity in all ages significantly increased from 30.8% (29.1%-32.5%) in 2014 to 34.5% (32.9%-36.2%) in 2017 and 37.3% (35.5%-39.1%) in 2021 (p for trend < 0.004). The weighted adherence rate to LTPA ranged from 25.5% (95% confidence interval [CI], 23.7%-27.2%) in 2014 to 20.5% (95% CI, 18.7%-22.2%) in 2021(p for trend < 0.001). The weighted prevalence of sitting time for 8 h/day or more significantly increased from 46.7% (44.4%-49.0%) in 2014 to 56.2% (54.4%-58.0%) in 2017 and 63% (60.7%-65.3%) in 2021 (p for trend < 0.001). According to this study, the LTPA level among women with obesity was significantly low. CONCLUSION From 2014 to 2021, obesity and sedentary behavior significantly increased and adherence to LTPA decreased among Korean adults. Given these concerning trends, comprehensive interventions are needed at the national level to encourage healthy lifestyle behaviors.
Collapse
Affiliation(s)
- Yunmin Han
- Seoul National University, Seoul, Republic of Korea
| | - Hoyong Sung
- Department of Military Kinesiology, Korea Military Academy, Seoul, Republic of Korea
| | | | - Yeon Soo Kim
- Seoul National University, Seoul, Republic of Korea
- Institute of Sports Science, Seoul National University, Seoul, Republic of Korea
| |
Collapse
|
4
|
Lee S, Kim MJ, Lee SH, Kim HY, Kim HS, Oh IH. Comparison of Disability-Adjusted Life Years (DALYs) and Economic Burden on People With Drug-Susceptible Tuberculosis and Multidrug-Resistant Tuberculosis in Korea. Front Public Health 2022; 10:848370. [PMID: 35480575 PMCID: PMC9037376 DOI: 10.3389/fpubh.2022.848370] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2022] [Accepted: 02/23/2022] [Indexed: 11/13/2022] Open
Abstract
In the future, tuberculosis (TB) will place a heavy burden on the aging population in Korea. To prepare for this crisis, it is important to analyze the disease burden trend of drug-susceptible tuberculosis (DS-TB) and multidrug-resistant tuberculosis (MDR-TB). Measuring disability-adjusted life years (DALYs) and economic burden on MDR-TB patients can help reduce the incidence of TB. Accordingly, in this study, we measured the DALYs and economic burden on DS-TB and MDR-TB patients in 2014-2017 using a combination of National Health Insurance claims data, Annual Report on the Notified TB data, and Statistics Korea's mortality data. The incidence-based DALY approach implemented involved the summation of years of life lost and years lived with disability. For measuring economic burden, direct and indirect costs incurred by patients were totaled. From 2014 to 2017, DALYs per 100,000 people with DS-TB were 56, 49, 46, and 40, respectively, and DALYs per 100,000 people with MDR-TB were 3, 2, 2, and 2, respectively. The economic burden for the DS-TB population from 2014 to 2017 was $143.89 million, $136.36 million, $122.85 million, and $116.62 million, respectively, while that for MDR-TB was $413.44 million, $380.25 million, $376.46 million and $408.14 million, respectively. The results showed a decreasing trend in DALYs and economic burden for DS-TB, whereas MDR-TB was still found to be burdensome without a specific trend. With respect to age, the economic burden for both DS-TB and MDR-TB was higher among men than among women till ≤ 79 years. Conversely, the economic burden for women aged ≥80 years was higher as compared to their male counterparts. In conclusion, the incidence and spread of TB in all areas of society must be suppressed through intensive management of MDR-TB in the older population. We hope that the national TB management project will proceed efficiently when the infectious disease management system is biased to one side due to the COVID-19 pandemic.
Collapse
Affiliation(s)
- SeungCheor Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Moon Jung Kim
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, South Korea
| | - Seung Heon Lee
- Division of Pulmonary, Sleep and Critical Care Medicine, Department of Internal Medicine, Korea University Ansan Hospital, Ansan-si, South Korea
| | - Hae-Young Kim
- Department of Population Health, New York University Grossman School of Medicine, New York, NY, United States
| | - Hee-Sun Kim
- Department of Health Policy Research, National Evidence-Based Healthcare Collaborating Agency, Seoul, South Korea
| | - In-Hwan Oh
- Department of Medicine (AgeTech-Service Convergence Major), School of Medicine, Kyung Hee University, Seoul, South Korea
| |
Collapse
|
5
|
Lee HA, Park H. Substitution of Carbohydrates for Fats and Risk of Type 2 Diabetes among Korean Middle-Aged Adults: Findings from the Korean Genome and Epidemiology Study. Nutrients 2022; 14:nu14030654. [PMID: 35277013 PMCID: PMC8838696 DOI: 10.3390/nu14030654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 01/27/2022] [Accepted: 01/27/2022] [Indexed: 11/16/2022] Open
Abstract
Using data from a 16 year follow-up cohort of the Korean Genome Epidemiology Study, this study assessed the effects of carbohydrate intake on incident diabetes, including replacement of fats or proteins with carbohydrates. In addition, this study evaluated modification effects based on 24 genetic variants associated with type 2 diabetes. For the daily intake of macronutrients, the energy-adjusted intake and percentage of total energy intake were calculated. The effects were assessed using a Cox proportional hazards model; results were presented as hazard ratios with 95% confidence intervals (CIs). Among the 7413 participants considered to be diabetes-free at baseline, 1193 individuals were considered to have incident diabetes. The risk of incident diabetes was found to be high at both extremes of carbohydrate intake, with the lowest risk at 78 E%. The replacement of 5 E% intake from fats with isocaloric carbohydrates showed an 11% increase in the risk of diabetes (95% CI: 1.01−1.21), which was significant in men, participants >50 years of age, and participants with a high educational level. Regarding gene−environment interactions, the relationship between carbohydrate intake and incident diabetes was not dependent on genetic variants. A nonlinear relationship was observed between carbohydrate intake and incident diabetes. The substitution of carbohydrates for fats was also associated with an increased risk of incident diabetes.
Collapse
Affiliation(s)
- Hye-Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul 07985, Korea
- Correspondence: ; Tel.: +82-2265-02836
| | - Hyesook Park
- Department of Preventive Medicine, College of Medicine, Ewha Womans University, Seoul 07804, Korea;
- Department of Preventive Medicine, Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul 07804, Korea
| |
Collapse
|
6
|
Kim YE, Jung YS, Ock M, Yoon SJ. DALY Estimation Approaches: Understanding and Using the Incidence-based Approach and the Prevalence-based Approach. J Prev Med Public Health 2022; 55:10-18. [PMID: 35135044 PMCID: PMC8841194 DOI: 10.3961/jpmph.21.597] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 01/12/2022] [Indexed: 11/24/2022] Open
Abstract
Disability-adjusted life-year (DALY) estimates may vary according to factors such as the standard life expectancy, age weighting, time preference and discount rate, calculation of disability weights, and selection of the estimation method. DALY estimation methods are divided into the following 3 approaches: the incidence-based approach, the pure prevalence-based approach, and the hybrid approach. These 3 DALY estimation approaches each reflect different perspectives on the burden of disease using unique characteristics, based on which the selection of a suitable approach may vary by the purpose of the study. The Global Burden of Disease studies, which previously estimated DALYs using the incidence-based approach, switched to using the hybrid approach in 2010, while the National Burden of Disease studies in Korea still mainly apply the incidence-based approach. In order to increase comparability with other international burden of disease studies, more DALY studies using the prevalence-based approach need to be conducted in Korea. However, with the limitations of the hybrid approach in mind, it is necessary to conduct more research using a disease classification system suitable for Korea. Furthermore, more detailed and valid data sources should be established before conducting studies using a broader variety of DALY estimation approaches. This review study will help researchers on burden of disease use an appropriate DALY estimation approach and will contribute to enhancing researchers’ ability to critically interpret burden of disease studies.
Collapse
Affiliation(s)
- Young-Eun Kim
- Department of Big Data Strategy, National Health Insurance Service, Wonju, Korea
| | - Yoon-Sun Jung
- Institute for Future Public Health, Graduate School of Public Health, Korea University, Seoul, Korea
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Ulsan, Korea
- Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
- Corresponding author: Minsu Ock Department of Preventive Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, 877 Bangeojinsunhwando-ro, Dong-gu, Ulsan 44033, Korea E-mail:
| | - Seok-Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
| |
Collapse
|
7
|
Lee EG, Rhee CK. Epidemiology, burden, and policy of chronic obstructive pulmonary disease in South Korea: a narrative review. J Thorac Dis 2021; 13:3888-3897. [PMID: 34277078 PMCID: PMC8264691 DOI: 10.21037/jtd-20-2100] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 05/17/2021] [Indexed: 01/07/2023]
Abstract
Chronic obstructive pulmonary disease (COPD) is a global health problem and a significant cause of mortality and morbidity worldwide. COPD also occupies a significant and considerable economic burden on individuals and society in South Korea. We investigated the epidemiology and burden of COPD in South Korea and reviewed the policy regarding COPD. In South Korea, a national COPD prevalence survey has been conducted for two decades. The prevalence of COPD has increased with increasing age, particularly among males, and those also with a higher smoking history and with lower income. The total societal cost of COPD increased by 1.85 times between 2004 and 2013. As the use of inhaled medications has increased, the total medical cost per person has increased. The trends of increasing numbers of patients diagnosed with COPD and the total societal costs are expected to continue. There is one universal-health-coverage system in South Korea. The costs and reimbursement criteria of COPD drugs are established and controlled by the Health Insurance Review and Assessment Service (HIRA). The HIRA has also implemented quality assessment, including evaluating the appropriateness of a COPD diagnosis and treating all COPD patients to reduce the severity of illness and improve the adequacy of medical-care benefits.
Collapse
Affiliation(s)
- Eung Gu Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| |
Collapse
|
8
|
Lee HA, Park B, Min J, Choi EJ, Kim UJ, Park HJ, Park EA, Cho SJ, Kim HS, Lee H, Kim YJ, Hong YS, Kim EJ, Ha EH, Park H. Cohort profile: the Ewha Birth and Growth Study. Epidemiol Health 2021; 43:e2021016. [PMID: 33677859 PMCID: PMC8060523 DOI: 10.4178/epih.e2021016] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Accepted: 02/20/2021] [Indexed: 12/11/2022] Open
Abstract
With the introduction of life-course epidemiology, researchers realized the importance of identifying risk factors in early life to prevent chronic diseases. This led to the establishment of the Ewha Birth and Growth Study in 2001; the study is a prospective birth cohort designed to provide evidence of early life risk factors for a child's growth and health. Participants were recruited from those who visited Ewha Womans University Mokdong Hospital (a tertiary hospital in southwest Seoul, Korea) for prenatal care at 24-28 weeks of gestation. In total, 891 mothers enrolled in this study between 2001 and 2006 and their offspring (n=940) were followed-up. Regular check-up examinations of offspring were conducted at 3 years, 5 years, and 7 years of age and every year thereafter. To consider age-related health issues, extensive data were collected using questionnaires and measurements. In 2021, the study subjects will reach 19 years of age, and we are planning a check-up examination for early adulthood. About 20 years have passed since the cohort data were collected, and we have published results on childhood health outcomes associated with prenatal and birth characteristics, genetic and epigenetic characteristics related to childhood metabolism, the effects of exposure to endocrine disruptors, and dietary patterns in childhood. Recently, we started reporting on topics related to adolescent health. The findings will facilitate identification of early life risk factors for chronic diseases and the development of interventions for diseases later in life.
Collapse
Affiliation(s)
- Hye Ah Lee
- Clinical Trial Center, Ewha Womans University Mokdong Hospital, Seoul, Korea
| | - Bohyun Park
- National Cancer Control Institute, National Cancer Center, Goyang, Korea
| | - Jungwon Min
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Eun Jeong Choi
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Ui Jeong Kim
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Hyun Jin Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| | - Eun Ae Park
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Su Jin Cho
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hae Soon Kim
- Department of Pediatrics, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hwayoung Lee
- Department of Anatomy, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young Ju Kim
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea.,Department of Obstetrics and Gynecology, Ewha Womans University College of Medicine, Seoul, Korea
| | - Young Sun Hong
- Department of Internal Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eui-Jung Kim
- Department of Psychiatry, Ewha Womans University College of Medicine, Seoul, Korea
| | - Eun Hee Ha
- Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea.,Department of Occupational and Environmental Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, Ewha Womans University College of Medicine, Seoul, Korea.,Graduate Program in System Health Science and Engineering, Ewha Womans University, Seoul, Korea
| |
Collapse
|
9
|
von der Lippe E, Devleesschauwer B, Gourley M, Haagsma J, Hilderink H, Porst M, Wengler A, Wyper G, Grant I. Reflections on key methodological decisions in national burden of disease assessments. Arch Public Health 2020; 78:137. [PMID: 33384020 PMCID: PMC7774238 DOI: 10.1186/s13690-020-00519-7] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 12/08/2020] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Summary measures of population health are increasingly used in different public health reporting systems for setting priorities for health care and social service delivery and planning. Disability-adjusted life years (DALYs) are one of the most commonly used health gap summary measures in the field of public health and have become the key metric for quantifying burden of disease (BoD). BoD methodology is, however, complex and highly data demanding, requiring a substantial capacity to apply, which has led to major disparities across researchers and nations in their resources to perform themselves BoD studies and interpret the soundness of available estimates produced by the Global Burden of Disease Study. METHODS BoD researchers from the COST Action European Burden of Disease network reflect on the most important methodological choices to be made when estimating DALYs. The paper provides an overview of eleven methodological decisions and challenges drawing on the experiences of countries working with BoD methodology in their own national studies. Each of these steps are briefly described and, where appropriate, some examples are provided from different BoD studies across the world. RESULTS In this review article we have identified some of the key methodological choices and challenges that are important to understand when calculating BoD metrics. We have provided examples from different BoD studies that have developed their own strategies in data usage and implementation of statistical methods in the production of BoD estimates. CONCLUSIONS With the increase in national BoD studies developing their own strategies in data usage and implementation of statistical methods in the production of BoD estimates, there is a pressing need for equitable capacity building on the one hand, and harmonization of methods on the other hand. In response to these issues, several BoD networks have emerged in the European region that bring together expertise across different domains and professional backgrounds. An intensive exchange in the experience of the researchers in the different countries will enable the understanding of the methods and the interpretation of the results from the local authorities who can effectively integrate the BoD estimates in public health policies, intervention and prevention programs.
Collapse
Affiliation(s)
- Elena von der Lippe
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany.
| | | | - Michelle Gourley
- Indigenous Data Analysis and Reporting Unit, Australian Institute of Health and Welfare, Canberra, Australia
| | - Juanita Haagsma
- Department of Public Health, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Henk Hilderink
- Centre for Public Health Forecasting, National Institute for Public Health and the Environment, Bilthoven, The Netherlands
| | - Michael Porst
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Annelene Wengler
- Department of Epidemiology and Health Monitoring, Robert Koch Institute, Berlin, Germany
| | - Grant Wyper
- Public Health Scotland, Edinburgh, Scotland, UK
| | - Ian Grant
- Public Health Scotland, Edinburgh, Scotland, UK
| |
Collapse
|
10
|
Kim H, Lee JK. The effects of combined exercise program on several clinical parameters according to a MspI RFLP in ApoAII gene in obese middle-aged women. GAZZETTA MEDICA ITALIANA ARCHIVIO PER LE SCIENZE MEDICHE 2020. [DOI: 10.23736/s0393-3660.19.04144-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
|
11
|
Davagdorj K, Pham VH, Theera-Umpon N, Ryu KH. XGBoost-Based Framework for Smoking-Induced Noncommunicable Disease Prediction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17186513. [PMID: 32906777 PMCID: PMC7558165 DOI: 10.3390/ijerph17186513] [Citation(s) in RCA: 33] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 08/28/2020] [Accepted: 09/05/2020] [Indexed: 12/23/2022]
Abstract
Smoking-induced noncommunicable diseases (SiNCDs) have become a significant threat to public health and cause of death globally. In the last decade, numerous studies have been proposed using artificial intelligence techniques to predict the risk of developing SiNCDs. However, determining the most significant features and developing interpretable models are rather challenging in such systems. In this study, we propose an efficient extreme gradient boosting (XGBoost) based framework incorporated with the hybrid feature selection (HFS) method for SiNCDs prediction among the general population in South Korea and the United States. Initially, HFS is performed in three stages: (I) significant features are selected by t-test and chi-square test; (II) multicollinearity analysis serves to obtain dissimilar features; (III) final selection of best representative features is done based on least absolute shrinkage and selection operator (LASSO). Then, selected features are fed into the XGBoost predictive model. The experimental results show that our proposed model outperforms several existing baseline models. In addition, the proposed model also provides important features in order to enhance the interpretability of the SiNCDs prediction model. Consequently, the XGBoost based framework is expected to contribute for early diagnosis and prevention of the SiNCDs in public health concerns.
Collapse
Affiliation(s)
- Khishigsuren Davagdorj
- Database and Bioinformatics Laboratory, College of Electrical and Computer Engineering, Chungbuk National University, Cheongju 28644, Korea;
| | - Van Huy Pham
- Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh 700000, Vietnam;
| | - Nipon Theera-Umpon
- Department of Electrical Engineering, Faculty of Engineering, Chiang Mai University, Chiang Mai 50200, Thailand;
- Biomedical Engineering Institute, Chiang Mai University, Chiang Mai 50200, Thailand
| | - Keun Ho Ryu
- Faculty of Information Technology, Ton Duc Thang University, Ho Chi Minh 700000, Vietnam;
- Biomedical Engineering Institute, Chiang Mai University, Chiang Mai 50200, Thailand
- Correspondence: ; Tel.: +82-10-4930-1500
| |
Collapse
|
12
|
Jang SY, Kim MJ, Cheong HK, Oh IH. Estimating Disability-Adjusted Life Years due to Tuberculosis in Korea through to the Year 2040. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E5960. [PMID: 32824613 PMCID: PMC7459449 DOI: 10.3390/ijerph17165960] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 08/06/2020] [Accepted: 08/14/2020] [Indexed: 11/18/2022]
Abstract
Despite efforts to reduce its incidence, tuberculosis continues to burden the rapidly aging Korean society. This study aimed to investigate the current trend of tuberculosis burden in Korea and its projections to 2040. We used National Health Insurance claims data to calculate the disability-adjusted life years due to tuberculosis in Korea. Disability-adjusted life years were measured by summing the years of life lost and the years lived with disability using an incidence-based approach. We modeled the incidence rates using a time-series model for the projection of disability-adjusted life years accrued from 2020 to 2040. The total disability-adjusted life years due to tuberculosis were 69, 64, 59, and 49 disability-adjusted life years/100,000 population in 2014, 2015, 2016, and 2017, respectively. In both sexes, disability-adjusted life years were the highest in those aged ≥80 years. Projected disability-adjusted life years showed a descending trend from 38 disability-adjusted life years/100,000 in 2020, to 14 disability-adjusted life years/100,000 in 2040. Conversely, the projected disability-adjusted life years increased among females aged ≥80 years. Although the tuberculosis burden in Korea is decreasing, a high burden remains among the elderly. Therefore, interventions targeting those vulnerable are required.
Collapse
Affiliation(s)
| | | | | | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, 26 Kyungheedae-ro, Dongdaemun-gu, Seoul 02447, Korea; (S.Y.J.); (M.J.K.); (H.-K.C.)
| |
Collapse
|
13
|
Ko Y, Jang BH, Oh MS, Shin BC, Kim SJ, Cha YY, Ko YS, Hwang EH, Lee EJ, Jung JY, Song YK, Ko SG. Korean medicine registry for low back pain - A study protocol for prospective observational multi-center study (KLOS). Integr Med Res 2020; 9:100448. [PMID: 32695577 PMCID: PMC7360851 DOI: 10.1016/j.imr.2020.100448] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 06/01/2020] [Accepted: 06/02/2020] [Indexed: 10/31/2022] Open
Abstract
Background Low back pain (LBP) is a major burden in Korea. Despite its high prevalence, the government and the public health sector do not address the specific evidences of symptom control and prevention of LBP to reduce long-term healthcare costs and increase the quality of life. Thus, the Korean medicine sector encourages to collection and analysis of the medical utilization pattern of patients with LBP in Korea to provide evidences of LBP control strategy as well as political decisions. Methods KLOS, a prospective, multi-center, patient registry pilot study will collaborate with 7 traditional Korean medicine hospitals and recruit patients with LBP into the registry. A total of 150 eligible patients with new episodes of LBP, who visit a Korean hospital without any other treatment history, will be enrolled in the registry. After enrollment, we will collect the individual characteristics of each patient, such as pain intensity, LBP-related daily disability, anthropometrics, and Health-Related Quality of Life (HRQoL) at baseline and FU1 and FU2. We will also access the patients' clinical and administrative electronic records to analyze the pattern of patients' resource utilization. Overall, the aims of KLOS are to (1) explore the general characteristics of patients with new episodes of LBP and (2) evaluate the efficacy and safety of various Korean medicine treatments for LBP, based on nationwide registry outcome collecting process. Discussion The first pilot study of prospective, multi-center registry of newly diagnosed LBP patients in traditional Korean medicine hospitals. The result of this study may show the current status of LBP patients who receive Korean medicine treatments and provide evidences for reasonable decision-making on Korean medicine healthcare policy in the future. Trial registration number ClinicalTrials.gov Identifier: NCT02418286.
Collapse
Affiliation(s)
- Youme Ko
- Department of Korean Preventive Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Bo-Hyoung Jang
- Department of Korean Preventive Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| | - Min-Seok Oh
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Byung-Cheul Shin
- Department of Korean Rehabilitation Medicine, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Sun Joong Kim
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Semyung University, Jecheon, Republic of Korea
| | - Yun-Yeop Cha
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Youn Seok Ko
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Woosuk University, Wanju, Republic of Korea
| | - Eui-Hyoung Hwang
- Department of Korean Rehabilitation Medicine, School of Korean Medicine, Pusan National University, Yangsan, Republic of Korea
| | - Eun Jung Lee
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
| | - Jae Young Jung
- Department of Korean Rehabilitation Medicine, Kyung Hee University, Seoul, Republic of Korea
| | - Yun-Kyung Song
- Department of Korean Rehabilitation Medicine, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Seong-Gyu Ko
- Department of Korean Preventive Medicine, Graduate School, Kyung Hee University, Seoul, Republic of Korea
| |
Collapse
|
14
|
Kuang Y, Zhang Y, Xiao Z, Xu L, Wang P, Ma Q. Protective effect of dimethyl fumarate on oxidative damage and signaling in cardiomyocytes. Mol Med Rep 2020; 22:2783-2790. [PMID: 32945364 PMCID: PMC7453509 DOI: 10.3892/mmr.2020.11342] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2020] [Accepted: 06/26/2020] [Indexed: 12/14/2022] Open
Abstract
Myocardial ischemia/reperfusion (I/R) injury contributes to the pathogenesis of numerous diseases. Based on its antioxidant and anti-inflammatory effects, dimethyl fumarate (DMF) has been reported to exert protective effects against I/R. However, to the best of our knowledge, its potential role as a myocardial protective agent in heart disease has received little attention. Previous studies have suggested that DMF may exert its protective effects by activating nuclear factor erythroid 2-related factor 2 (Nrf2); however, the exact underlying mechanisms remain to be elucidated. The aim of the present study was to investigate the protective role of DMF in myocardial I/R injury, and to determine the role of Nrf2 in mediating the activity of DMF. H9c2 cells were incubated with DMF (20 µM) for 24 h before establishing the I/R model, and were then subjected to myocardial ischemia for 6 h, followed by reperfusion. Cell viability, lactate dehydrogenase levels, anti-oxidant enzyme expression levels and anti-apoptotic effects were evaluated, and AKT/Nrf2 pathway-associated mechanisms were investigated. The results of the present study indicated that DMF may reduce myocardial I/R injury in a Nrf2-dependent manner. DMF significantly improved cellular viability, suppressed the expression of apoptotic markers, decreased the production of reactive oxygen species and increased the expression of Nrf2-regulated antioxidative genes. Notably, these beneficial DMF-mediated effects were not observed in the control or I/R groups. In conclusion, the results of the present study suggested that DMF may exert protective effects against a myocardial I/R model, and further validated Nrf2 modulation as a primary mode of action. Thus suggesting that DMF may be a potential therapeutic agent for AKT/Nrf2 pathway activation in myocardial, and potentially systemic, diseases.
Collapse
Affiliation(s)
- Yuanyuan Kuang
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Yinzhuang Zhang
- Department of Cardiovascular Medicine, The First Hospital of Changsha, Changsha, Hunan 410005, P.R. China
| | - Zhen Xiao
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Lijun Xu
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Ping Wang
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| | - Qilin Ma
- Department of Cardiovascular Medicine, Xiangya Hospital, Central South University, Changsha, Hunan 410008, P.R. China
| |
Collapse
|
15
|
Jung H, Yeo S, Lim S. Effects of acupuncture on cardiovascular risks in patients with hypertension: a Korean cohort study. Acupunct Med 2020; 39:116-125. [PMID: 32567334 DOI: 10.1177/0964528420920290] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVES The aim of this study was to investigate the effects of acupuncture on major adverse cardiovascular events (MACE), myocardial infarction, stroke and death in hypertensive patients taking anti-hypertensives. METHODS Using the Korean National Health Insurance Service-National Sample Cohort (NHIS-NSC) database, this study identified 59,370 patients taking anti-hypertensives who had been diagnosed with hypertension between 2003 and 2006. They were divided into acupuncture and non-acupuncture groups. The follow-up period ended with the diagnosis of myocardial infarction, stroke or death. After propensity score matching (PSM), there were 18,011 patients each in the non-acupuncture and acupuncture groups. We calculated the incidence rate, hazard ratio (HR) and 95% confidence interval (CI) for MACE, myocardial infarction, stroke and death in patients with hypertension using a stratified Cox proportional hazard model. In addition, secondary outcome analyses for stroke and cardiovascular mortality were performed. RESULTS After PSM, the HRs for MACE (0.83, 95% CI 0.80-0.86), all-cause mortality (0.73, 95% CI 0.70-0.76) and myocardial infarction (0.85, 95% CI 0.79-0.92) were significantly lower in the acupuncture group than in the non-acupuncture group. Moreover, the HRs for stroke-related mortality, hemorrhage stroke-related mortality, ischemic stroke-related mortality, ischemic heart disease-related mortality and circulatory system disease-related mortality were significantly lower in the acupuncture group than in the non-acupuncture group. CONCLUSION This observational study with long-term follow-up extends the evidence base in support of the effectiveness of acupuncture for the management of hypertension and potentially reduce the burden of cardiovascular disease.
Collapse
Affiliation(s)
- Hyejin Jung
- Research Group of Pain and Neuroscience, East-West Medical Research Institute, 26723Kyung Hee University and WHO Collaborating Center for Traditional Medicine, Seoul, South Korea.,Department of Meridian & Acupoint, College of Korean Medicine, 26723Kyung Hee University, Seoul, South Korea
| | - Sujung Yeo
- Department of Meridian & Acupoint, College of Korean Medicine, 35004Sangji University, Wonju, South Korea
| | - Sabina Lim
- Research Group of Pain and Neuroscience, East-West Medical Research Institute, 26723Kyung Hee University and WHO Collaborating Center for Traditional Medicine, Seoul, South Korea.,Department of Meridian & Acupoint, College of Korean Medicine, 26723Kyung Hee University, Seoul, South Korea
| |
Collapse
|
16
|
Abstract
Cardiovascular diseases have shown a continuous increase in Korea over the past decade and became the second most common cause of mortality in Korea. Although the number and the amount of total grants for cardiovascular research have increased in Korea, the proportion of the number of grants and total amount allocated for the cardiac/cardiovascular field to all health and medical research fields has not changed much over this period. In addition, the publications related to clinical research have substantially increased in Korea along with the number of nation-wide registries for cardiovascular diseases, but basic and translational research did not show significant growth, requiring new measures to promote basic and translational cardiovascular research in Korea.
Collapse
Affiliation(s)
- Jae Il Shin
- From the Department of Pediatrics (J.I.S.), Yonsei University College of Medicine, Seoul, Korea.,Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia (J.I.S., Y.Y.)
| | - Jaewon Oh
- Cardiology Division, Severance Cardiovascular Hospital (J.O., D.C.), Yonsei University College of Medicine, Seoul, Korea
| | - Hyeon Chang Kim
- Department of Preventive Medicine (H.C.K.), Yonsei University College of Medicine, Seoul, Korea
| | - Donghoon Choi
- Cardiology Division, Severance Cardiovascular Hospital (J.O., D.C.), Yonsei University College of Medicine, Seoul, Korea
| | - Young-Sup Yoon
- Severance Biomedical Science Institute (Y.Y.), Yonsei University College of Medicine, Seoul, Korea.,Department of Medicine, Division of Cardiology, Emory University, Atlanta, Georgia (J.I.S., Y.Y.)
| |
Collapse
|
17
|
Radnaabaatar M, Kim Y, Go D, Jung Y, Jung J, Yoon S. Burden of dental caries and periodontal disease in South Korea: An analysis using the national health insurance claims database. Community Dent Oral Epidemiol 2019; 47:513-519. [DOI: 10.1111/cdoe.12493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/26/2023]
Affiliation(s)
| | - Young‐Eun Kim
- Department of Preventive Medicine Korea University College of Medicine Seoul Korea
| | - Dun‐Sol Go
- Department of Public Health, Graduate School Korea University Seoul Korea
| | - Yunsun Jung
- Department of Public Health, Graduate School Korea University Seoul Korea
| | - Jaehun Jung
- Department of Preventive Medicine Gachon University College of Medicine Incheon Korea
| | - Seok‐Jun Yoon
- Department of Preventive Medicine Korea University College of Medicine Seoul Korea
| |
Collapse
|
18
|
Egunsola O, Raubenheimer J, Buckley N. Variability in the burden of disease estimates with or without age weighting and discounting: a methodological study. BMJ Open 2019; 9:e027825. [PMID: 31427320 PMCID: PMC6701586 DOI: 10.1136/bmjopen-2018-027825] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 06/24/2019] [Accepted: 07/04/2019] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES This study examines the impact of the type of method used on the estimation of the burden of diseases. DESIGN Comparison of methods of estimating disease burden. SETTING Four metrics of burden of disease estimation, namely, years of potential life lost (YPLL), non-age weighted years of life lost (YLL) without discounting and YLL with uniform or non-uniform age weighting and discounting were used to calculate the burden of selected diseases in three countries: Australia, USA and South Africa. PARTICIPANTS Mortality data for all individuals from birth were obtained from the WHO database. OUTCOMES The burden of 10 common diseases with four metrices, and the relative contribution of each disease to the overall national burden when each metric is used. RESULTS There were variations in the burden of disease estimates with the four methods. The standardised YPLL estimates were higher than other methods of calculation for diseases common among young adults and lower for diseases common among the elderly. In the three countries, discounting decreased the contributions of diseases common among younger adults to the total burden of disease, while the contributions of diseases of the elderly increased. After discounting with age weighting, there were no distinct patterns for diseases of the elderly and young adults in the three countries. CONCLUSIONS Given the variability in the estimates of the burden of disease with different approaches, there should be transparency regarding the type of metric used and a generally acceptable method that incorporates all the relevant social values should be developed.
Collapse
Affiliation(s)
- Oluwaseun Egunsola
- Discipline of Pharmacology, University of Sydney, Sydney, New South Wales, Australia
| | - Jacques Raubenheimer
- Discipline of Pharmacology, University of Sydney, Sydney, New South Wales, Australia
| | - Nicholas Buckley
- Discipline of Pharmacology, University of Sydney, Sydney, New South Wales, Australia
| |
Collapse
|
19
|
Cho S, Shin JY, Kim HJ, Eun SJ, Kang S, Jang WM, Jung H, Kim Y, Lee JY. Chasms in Achievement of Recommended Diabetes Care among Geographic Regions in Korea. J Korean Med Sci 2019; 34:e190. [PMID: 31392852 PMCID: PMC6689488 DOI: 10.3346/jkms.2019.34.e190] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Accepted: 07/03/2019] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Although effective care for type 2 diabetes (T2DM) is well known, considerable inadequate care has been still existed. Variations in achievement of the recommended quality indicators inT2DM care among small areas are not well known in Korea. This study examined the quality of care T2DM care and its geographical variations. METHODS We used the national health insurance database and national health screening database. Seven quality indicators were used to evaluate continuity of care (medication possession ratio), process of care (hemoglobin A1c test, lipid profile, microalbuminuria test, and eye examination), and intermediate outcome (blood pressure control, and low-density lipoprotein control). Crude and age-standardized proportions were calculated for each 252 districts in Korea. RESULTS All quality indicators failed to achieve the recommended level. Only about 3% and 15% of the patients underwent eye examination and microalbuminuria test, respectively. Other indicators ranged from 48% to 68%. Wide variation in the quality existed among districts and indicators. Eye examination and microalbuminuria test varied the most showing tenfold (0.9%-9.2%) and fourfold (6.3%-28.9%) variation by districts, respectively. There were 32.4 and 42.7 percentage point gap between the best and the worst districts in hemoglobin A1c test and blood pressure control, respectively. CONCLUSION Considerable proportion of T2DM patients were not adequately managed and quality of care varied substantially district to district. To improve the quality of diabetes care, it is necessary to identify the poor performance areas and establish a well-coordinated care system tailored to the need of the district.
Collapse
Affiliation(s)
- Sanghyun Cho
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
| | - Ji Yeon Shin
- Department of Preventive Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Hyun Joo Kim
- Department of Nursing Science, Shinsung University, Dangjin, Korea
| | - Sang Jun Eun
- Department of Preventive Medicine, Chungnam National University School of Medicine, Daejeon, Korea
| | - Sungchan Kang
- Department of Public Health Science, School of Public Health, Seoul National University, Seoul, Korea
| | - Won Mo Jang
- Health Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, Korea
| | - Hyemin Jung
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Health Review and Assessment Committee, Health Insurance Review and Assessment Service, Wonju, Korea
| | - Yoon Kim
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Institute of Health Policy and Management, Medical Research Center, Seoul National University, Seoul, Korea
| | - Jin Yong Lee
- Department of Health Policy and Management, Seoul National University College of Medicine, Seoul, Korea
- Department of Public Health and Community Medicine, Seoul Metropolitan Government - Seoul National University Boramae Medical Center, Seoul, Korea.
| |
Collapse
|
20
|
Lee HA, Son N, Lee WK, Park H. A Diabetes-Related Dietary Pattern Is Associated with Incident Diabetes in Obese Men in the Korean Genome Epidemiology Study. J Nutr 2019; 149:323-329. [PMID: 30590687 DOI: 10.1093/jn/nxy274] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 06/25/2018] [Accepted: 10/06/2018] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Diet plays an important role in both the development and management of diabetes. OBJECTIVE Using data from the Korean Genome Epidemiology Study, we assessed dietary patterns associated with the clinical indicators of diabetes. METHODS This study included 7255 subjects aged 40-69 y. Individuals with chronic diseases were excluded. The daily intakes of specific food items were assessed using a dish-based semiquantitative food-frequency questionnaire comprising 103 items; the food items were then grouped into 26 food groups. Dietary patterns were analyzed by the reduced rank regression method using glycated hemoglobin, the homeostasis model of insulin resistance, and fasting glucose concentrations as dependent variables. We investigated the associations between dietary patterns and incident diabetes using the Cox proportional hazards model. RESULTS During an 11.5-y follow-up, the incidence of diabetes was 11.8/1000 person-years. The dietary pattern related to selected biomarkers of diabetes was characterized by a relatively high intake of kimchi, beef, other meat, fish, and coffee in men and a high intake of rice, kimchi, and fruit in women. In men, the association of dietary patterns with incident diabetes was significant only in the obese group, and those in the top quartile of the dietary pattern score had a 1.72 times (95% CI: 1.15, 2.56 times) greater risk of incident diabetes than those in the bottom quartile. Conversely, dietary patterns in women were not associated with incident diabetes. CONCLUSION Using reduced rank regression, we identified dietary patterns related to selected biomarkers of diabetes in a long-term study with follow-up data in Korea.
Collapse
Affiliation(s)
| | - NaYeong Son
- Departments of Statistics and.,Office of Pharmacoepidemiology, Korea Institute of Drug Safety and Risk Management, Anyang-si, Korea
| | - Won Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Hyesook Park
- Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| |
Collapse
|
21
|
Hwang TY, Kim SK, Kim SH, Kim M. A cross sectional survey on health-related quality of life among parents of children with allergic symptoms using the EQ-5D-5L. J Asthma 2019; 56:1239-1245. [PMID: 30702001 DOI: 10.1080/02770903.2019.1571086] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Object: This study aims to evaluate the HRQOL of parents of children with allergic diseases using the EQ-5D-5L. Methods: The subjects of the study were parents of children enrolled in primary schools and daycare centers. The EQ-5D-5L was self-administered in the sample population, and demographic and health information of their children were collected. We assessed the difference in EQ-5D-5L index and EQ-VAS of parents by the prevalence of allergic symptoms (wheezing, runny or blocked nose, and itchy rash) in their children in the past 12 months. In addition, we examined the difference in parents' EQ-5D-5L index and EQ-VAS score, based on the number of allergic symptoms of their children. Results: Of the 23,837 completed questionnaires, 22,904 were analyzed. There were significant differences in HRQOL between parents of children with and without allergic symptoms. There was a considerable difference in proportion of problem reporting in the "pain/discomfort" and "anxiety/depression" dimensions compared with the remaining dimensions of the EQ-5D-5L. Among three allergic symptoms, the HRQOL of parents of children with asthmatic symptoms was lowest at 0.936 on the EQ-5D-5L index and 79.3 on the EQ-VAS score. As the number of allergic symptoms of children increased, QOL of parents significantly decreased. Conclusions: Parents of children with allergic symptoms showed lower HRQOL than those parents whose children did not. The EQ-5D-5L instrument appeared to be useful to evaluate the HRQOL of parents of children with allergic diseases.
Collapse
Affiliation(s)
- Tae-Yoon Hwang
- Department of Preventive Medicine & Public Health, Yeungnam University College of Medicine , Daegu , Republic of Korea
| | - Sang-Kyu Kim
- Department of Preventive Medicine, Dongguk University College of Medicine , Gyeongju , Republic of Korea
| | - Seon-Ha Kim
- Department of Nursing, Dankook University College of Nursing , Cheonan , Republic of Korea
| | - Miok Kim
- Department of Nursing, Dankook University College of Nursing , Cheonan , Republic of Korea
| |
Collapse
|
22
|
Abstract
OBJECTIVES This study aimed to investigate the association between age at asthma diagnosis and tooth loss due to caries using data obtained from the Korean National Health and Nutrition Examination Survey. MATERIALS AND METHODS A complex sample multivariable linear regression was used, and the results were analysed. Age at diagnosis and the number of teeth lost were set as independent and dependent variables, respectively. Among the total 65,973 subjects, 10,056 aged <12 years and 11,714 with missing values in dependent and independent variables were excluded. Asthmatic subjects were divided into the following age groups based on the age at diagnosis: 0-6 years, 7-12 years, 13-18 years, 19-28 years, and 29-64 years. In each analysis, the calibration was performed by adding covariates to each model. RESULTS Compared with the no asthma group (β = 0), the values of β in asthmatic subjects belonging to the age groups 0-6 years (β = 0.794, 0.521, 0.560) and 7-12 years (β = 0.527, 0.407, 0.437) were high in all models. CONCLUSIONS Our findings revealed significant increase in tooth loss due to caries after early asthma diagnosis at 0-6 years (β = 0.560, p < .001) and 7-12 years (β = 0.437, p < .001). Clinicians need to shift their perception of dental risks in young asthmatic patients and provide active oral health care to them.
Collapse
Affiliation(s)
- Hyungkil Choi
- Department of Dental Services Management and Informatics, Seoul National University, Seoul, Republic of Korea
- Research Institute, Apple Tree Dental Hospital, Goyang-si, Korea
| | - Kwang-Hak Bae
- Research Institute, Apple Tree Dental Hospital, Goyang-si, Korea
| | - Jeong-Woo Lee
- Department of Dental Services Management and Informatics, Seoul National University, Seoul, Republic of Korea
- Department of Preventive Dentistry and Public Oral Health, Oral Science Research Institute, Yonsei University College of Dentistry, Seoul, Republic of Korea
| |
Collapse
|
23
|
Park YB, Rhee CK, Yoon HK, Oh YM, Lim SY, Lee JH, Yoo KH, Ahn JH. Revised (2018) COPD Clinical Practice Guideline of the Korean Academy of Tuberculosis and Respiratory Disease: A Summary. Tuberc Respir Dis (Seoul) 2018; 81:261-273. [PMID: 29926554 PMCID: PMC6148094 DOI: 10.4046/trd.2018.0029] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 03/30/2018] [Accepted: 04/01/2018] [Indexed: 12/19/2022] Open
Abstract
Chronic obstructive pulmonary disease (COPD) results in high morbidity and mortality among patients nationally and globally. The Korean clinical practice guideline for COPD was revised in 2018. The guideline was drafted by the members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Health Insurance Review and Assessment Service, Korean Physicians' Association, and Korea Respiration Trouble Association. The revised guideline encompasses a wide range of topics, including the epidemiology, diagnosis, assessment, monitoring, management, exacerbation, and comorbidities of COPD in Korea. We performed systematic reviews assisted by an expert in meta-analysis to draft a guideline on COPD management. We expect this guideline to facilitate the treatment of patients with respiratory conditions by physicians as well other health care professionals and government personnel in South Korea.
Collapse
Affiliation(s)
- Yong Bum Park
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Hallym University Kangdong Sacred Heart Hospital, Seoul, Korea
| | - Chin Kook Rhee
- Division of Pulmonary, Allergy and Critical Care Medicine, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yeon Mok Oh
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Seong Yong Lim
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jin Hwa Lee
- Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea
| | - Kwang Ha Yoo
- Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
| | - Joong Hyun Ahn
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea.
| |
Collapse
|
24
|
Won JC, Lee JH, Kim JH, Kang ES, Won KC, Kim DJ, Lee MK. Diabetes Fact Sheet in Korea, 2016: An Appraisal of Current Status. Diabetes Metab J 2018; 42:415-424. [PMID: 30113146 PMCID: PMC6202557 DOI: 10.4093/dmj.2018.0017] [Citation(s) in RCA: 77] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 05/02/2018] [Indexed: 02/04/2023] Open
Abstract
BACKGROUND This report presents the recent prevalence and comorbidities related to diabetes in Korea by analyzing the nationally representative data. METHODS Using data from the Korea National Health and Nutrition Examination Survey for 2013 to 2014, the percentages and the total number of subjects over the age of 30 years with diabetes and prediabetes were estimated and applied to the National Population Census in 2014. Diagnosis of diabetes was based on fasting plasma glucose (≥126 mg/dL), current taking of antidiabetic medication, history of previous diabetes, or glycosylated hemoglobin (HbA1c) ≥6.5%. Impaired fasting glucose (IFG) was defined by fasting plasma glucose in the range of 100 to 125 mg/dL among those without diabetes. RESULTS About 4.8 million (13.7%) Korean adults (≥30 years old) had diabetes, and about 8.3 million (24.8%) Korean adults had IFG. However, 29.3% of the subjects with diabetes are not aware of their condition. Of the subjects with diabetes, 48.6% and 54.7% were obese and hypertensive, respectively, and 31.6% had hypercholesterolemia. Although most subjects with diabetes (89.1%) were under medical treatment, and mostly being treated with oral hypoglycemic agents (80.2%), 10.8% have remained untreated. With respect to overall glycemic control, 43.5% reached the target of HbA1c <7%, whereas 23.3% reached the target when the standard was set to HbA1c <6.5%, according to the Korean Diabetes Association guideline. CONCLUSION Diabetes is a major public health threat in Korea, but a significant proportion of adults were not controlling their illness. We need comprehensive approaches to overcome the upcoming diabetes-related disease burden in Korea.
Collapse
Affiliation(s)
- Jong Chul Won
- Department of Internal Medicine, Cardiovascular and Metabolic Disease Center, Inje University Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jae Hyuk Lee
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Myongji Hospital, Goyang, Korea
| | - Jae Hyeon Kim
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Eun Seok Kang
- Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea
| | - Kyu Chang Won
- Department of Internal Medicine, Yeungnam University College of Medicine, Daegu, Korea
| | - Dae Jung Kim
- Department of Endocrinology and Metabolism, Ajou University School of Medicine, Suwon, Korea.
| | - Moon Kyu Lee
- Division of Endocrinology and Metabolism, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
| |
Collapse
|
25
|
Kim JH, Oh IH, Park JH, Cheong HK. Premature Deaths Attributable to Long-term Exposure to Ambient Fine Particulate Matter in the Republic of Korea. J Korean Med Sci 2018; 33:e251. [PMID: 30190659 PMCID: PMC6125317 DOI: 10.3346/jkms.2018.33.e251] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2017] [Accepted: 08/12/2018] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Ambient fine particulate matter (PM2.5) is the major environmental health risk factor in Korea. Exposure to PM2.5 has been a growing public concern nationwide. With the rapid aging of the Korean population, the health effects attributable to long-term exposure to PM2.5 were expected to increase further in the future. We aimed to estimate premature deaths attributable to long-term exposure to ambient PM2.5 in Korea. METHODS A modelled estimation of long-term exposure to PM2.5 was used to calculate the nationwide exposure level. Hazard ratios of long-term exposure to PM2.5 were obtained from a large prospective cohort study in North America. Modified cause of death (CoD) data, which applied the garbage code reclassification algorithm, were used to calculate premature deaths attributable to long-term exposure to PM2.5. RESULTS From 1990 to 2013, the average population-weighted PM2.5 concentration in Korea was 30.2 μg/m3. The estimated number of premature deaths was 17,203 (95% confidence interval [CI], 11,056-22,772). The most common CoD was ischemic stroke (5,382; 3,101-7,403), followed by cancer of trachea, bronchus, and lung (4,958; 2,857-6,820), hemorrhagic stroke (3,452; 1,989-4,748), and ischemic heart disease (3,432; 1,383-5,358). CONCLUSION Premature deaths due to long-term exposure to PM2.5 accounted for 6.4% of all deaths in Korea. However, individual efforts alone cannot prevent the effects of air pollution. This disease burden study can serve as a basis for the establishment of government policies and budgets and can be used to assess the effectiveness of environmental health policies.
Collapse
Affiliation(s)
- Jong-Hun Kim
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - In-Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Jae-Hyun Park
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| | - Hae-Kwan Cheong
- Department of Social and Preventive Medicine, Sungkyunkwan University School of Medicine, Suwon, Korea
| |
Collapse
|
26
|
Diet-Related Risk Factors for Incident Hypertension During an 11-Year Follow-Up: The Korean Genome Epidemiology Study. Nutrients 2018; 10:nu10081077. [PMID: 30104485 PMCID: PMC6115751 DOI: 10.3390/nu10081077] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/06/2018] [Accepted: 08/09/2018] [Indexed: 12/28/2022] Open
Abstract
Using long-term follow-up cohort data from the Korean Genome Epidemiology Study, we assessed the dietary risk factors for incident hypertension (HTN). In total, 6792 subjects (3300 males and 3492 females) aged 40⁻69 years were included in the study. Physician-diagnosed HTN self-reported by the participants was used as the outcome. Daily intake of 20 food groups was assessed while using a dish-based semi-quantitative food-frequency questionnaire. After controlling for known risk factors, the food groups that were most closely associated with HTN were identified by forward stepwise selection while using the Cox proportional hazards model. The median follow-up period was 11.5 years (interquartile range, 6.0⁻11.7 years) and the incidence of HTN was 20 per 1000 person-years. Older age, obesity, lower education level, high alcohol intake, and having at least one parent with HTN were associated with the risk for HTN. In addition, a high intake of salted seafood and a low intake of eggs and meat were independently associated with the incidence of HTN after controlling for the known risk factors. Those in the top quartile of salted seafood intake had a 28% greater risk for incident HTN than those in the bottom quartile. The population-attributable fraction of three dietary factors accounted for 29.0% of the incidence of HTN. A high intake of salted seafood and a low intake of eggs and meat were associated with a greater risk for HTN.
Collapse
|
27
|
Lee D, Shin HY, Park SM. Cost-effectiveness of antiviral prophylaxis during pregnancy for the prevention of perinatal hepatitis B infection in South Korea. COST EFFECTIVENESS AND RESOURCE ALLOCATION 2018; 16:6. [PMID: 29467596 PMCID: PMC5815213 DOI: 10.1186/s12962-018-0088-9] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/20/2018] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND In Korea, hepatitis B virus (HBV) infection accounts for approximately 65-75% of HBV-related diseases, such as chronic hepatitis and liver cancer, and mother-to-child transmission is presumed to be a major source of the infection. To tackle this issue, the Korean government launched the national Perinatal Hepatitis B Prevention Program (PHBPP) in 2002. This study analyzed the cost-effectiveness of the PHBPP with antiviral prophylaxis compared with the current PHBPP and/or universal vaccination, as well as identified the optimal strategy to eliminate mother-to-child transmission of HBV in Korea. METHODS A decision tree model with the Markov process was developed and simulated over the lifetime of a birth cohort in Korea during the year 2014. The current PHBPP providing HBV vaccine and hepatitis B immune globulin to neonates born to HBV positive mothers was compared against two other strategies, universal vaccination of HBV and PHBPP with antiviral prophylaxis, with respect to their costs and health outcomes. The Korean National Health Insurance database was investigated to estimate the costs of HBV-related diseases and utilization of health resources. Costs were assessed from the health care system perspective and converted to 2014 US dollars. Health outcome measures were quality-adjusted life years (QALYs) and number of HBV-related diseases and deaths. Both costs and QALYs were discounted at 5%, following the recommendation of the Health Insurance Review & Assessment Service in Korea. The incremental cost-effectiveness ratio (ICER) obtained from the analysis was evaluated using the willingness-to-pay (WTP) in the Korean society. RESULTS PHBPP with antiviral prophylaxis in Korea was cost-effective compared with the current PHBPP. An introduction of antiviral prophylaxis to pregnant women with a high viral load of HBV averted 13 HBV-related deaths per 100,000 people and saved 82 QALYs in total (ICER: $16,159/QALY). CONCLUSIONS Considering that WTP in Korea is $29,000, PHBPP with antiviral prophylaxis appears to be a cost-effective strategy. To further decrease the burden of perinatal hepatitis B in Korea, adding antiviral prophylaxis to PHBPP is recommended.
Collapse
Affiliation(s)
- Donghoon Lee
- Department of Preventive Medicine, Kyung Hee University College of Medicine, Seoul, South Korea
| | - Hyun-Young Shin
- Department of Family Medicine, Myongji Hospital, Goyang, South Korea
| | - Sang Min Park
- Department of Biomedical Sciences, Seoul National University College of Medicine, Seoul, South Korea
- Department of Family Medicine, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
28
|
An TJ, Yoon HK. Prevalence and socioeconomic burden of chronic obstructive pulmonary disease. JOURNAL OF THE KOREAN MEDICAL ASSOCIATION 2018. [DOI: 10.5124/jkma.2018.61.9.533] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Affiliation(s)
- Tai Joon An
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| | - Hyoung Kyu Yoon
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Yeouido St. Mary's Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea
| |
Collapse
|
29
|
Kim GR, Nam CM. Temporal trends in educational inequalities in non-communicable diseases in Korea, 2007-2015. PLoS One 2017; 12:e0190143. [PMID: 29284021 PMCID: PMC5746222 DOI: 10.1371/journal.pone.0190143] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2017] [Accepted: 12/09/2017] [Indexed: 11/19/2022] Open
Abstract
Background Socioeconomic inequalities in non-communicable diseases are known to exist; however there is a paucity of research describing the secular trends in these inequalities. To this end, the current study aims to explore the recent time trends in social patterning of selected non-communicable diseases among Korean adults between 2007 and 2015. Methods Using data from the Korea National Health and Nutrition Examination Survey (KNHANES), temporal trends in socioeconomic inequalities in diabetes, arthritis, asthma and depressive symptoms were assessed across three time points. Respondents were adults aged 20 years or over (N = 47,091, 20,180 men and 26,911 women). Socioeconomic circumstance was assessed based on highest level of educational attainment. We estimated prevalence ratios with 95% confidence intervals using Poisson regression with robust variance estimation (adjusted for age, smoking status, alcohol consumption, obesity, and physical activity) separately for men and women. The magnitude of the inequalities was computed using the relative index of inequality (RII). Results In men, diabetes was not associated with educational attainment, while there was evidence of a negative association in women across surveys. Similar inverse associations were found with arthritis and depressive symptoms, but these associations were less clear for asthma. RII showed a non-significant increasing trend in educational disparities in depressive symptoms. Meanwhile, relative inequalities in diabetes, arthritis and asthma have narrowed. These trends were, in general, more pronounced in women. Conclusions The findings of this study indicate higher burden of selected NCDs among the lower educational groups, particularly among women. In addition, our results indicated some improvements in inequalities in diabetes, arthritis and asthma in recent years. These findings have important implications for understanding the causes of social patterning of NCDs and for the targeting of effective interventions.
Collapse
Affiliation(s)
- Gyu Ri Kim
- Department of Biostatistics, Graduate School of Public Health, Yonsei University, Seoul, Korea
| | - Chung Mo Nam
- Department of Preventive Medicine, College of Medicine, Yonsei University, Seoul, Korea
- * E-mail:
| |
Collapse
|
30
|
Abebe SM, Andargie G, Shimeka A, Alemu K, Kebede Y, Wubeshet M, Tariku A, Gebeyehu A, Bayisa M, Yitayal M, Awoke T, Azmeraw T, Birku M. The prevalence of non-communicable diseases in northwest Ethiopia: survey of Dabat Health and Demographic Surveillance System. BMJ Open 2017; 7:e015496. [PMID: 29061601 PMCID: PMC5665308 DOI: 10.1136/bmjopen-2016-015496] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVE The main objective of this study was to investigate the magnitude and associated factors of non-communicable chronic diseases (NCDs) at the Dabat Health and Demographic Surveillance System (DHDSS) site in the northwestern part of Ethiopia. DESIGN A population-based cross-sectional study was conducted from October to December 2014. SETTING HDSS site, Ethiopia. PARTICIPANTS A total population of 67 397 living in 16 053 households was included in the study. MEASURES Structured interviewer-administered questionnaire was used to collect data. Self-reported morbidity was used to ascertain NCD. A binary logistic regression model was employed to identify the determinants of NCDs. RESULT One thousand one hundred sixty (1.7%) (95% CI 1.62 to 1.82) participants were found with at least one type of NCD. Heart disease and hypertension which accounted for 404 (32.2%) and 401 (31.9%), of the burden, respectively, were the most commonly reported NCDs, followed by 347 (27.7%) asthma, 62 (4.9%) diabetes mellitus and 40 (3.2%) cancer cases. Advanced age (≥65 year) (adjusted OR (AOR)=19.6; 95% CI 5.83 65.70), urban residence (AOR=2.20; 95% CI 1.83 to 2.65), household food insecurity (AOR=1.71; 95% CI 1.37 to 2.12) and high income (AOR=1.28; 95% CI 1.02 to 1.59) were significantly associated with the reported history of NCDs, whereas low (AOR=0.36; 95% CI 0.31 to 0.42) and moderate (AOR=0.33; 95% CI 0.22 to 0.48) alcohol consumption, farming occupation (AOR=0.72; 95% CI 0.57 to 0.91), and work-related physical activities (AOR=0.66; 95% CI 0.50 to 0.88) were inversely associated with NCDs. CONCLUSION There is a high burden of NCDs at the Dabat HDSS site. Promotion of regular physical exercise and reducing alcohol consumption are essential to mitigate the burden of NCDs. In addition, preventive interventions of NCDs should be strengthened among urban dwellers, older age people and people of higher economic status.
Collapse
Affiliation(s)
- Solomon Mekonnen Abebe
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Andargie
- Department of Health Service Management and Health Economics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Alemayehu Shimeka
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
| | - Kassahun Alemu
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
| | - Yigzaw Kebede
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
| | - Mamo Wubeshet
- Department of Environmental and Occupational Health and Safety, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Amare Tariku
- Department of Human Nutrition, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Abebaw Gebeyehu
- Dabat Research Centre Health and Demographic Surveillance System, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
| | - Mulugeta Bayisa
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
| | - Mezgebu Yitayal
- Department of Health Service Management and Health Economics, Institute of Public Health College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tadesse Awoke
- Department of Epidemiology and Biostatistics, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
| | - Temesgen Azmeraw
- Dabat Research Centre Health and Demographic Surveillance System, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
| | - Melkamu Birku
- Dabat Research Centre Health and Demographic Surveillance System, Institute of Public Health College of Medicine and Health Sciences,University of Gondar, Gondar, Ethiopia
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Department of Reproductive Health, Institute of Public Health, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| |
Collapse
|
31
|
Yoon J, Oh IH, Seo H, Kim EJ, Gong YH, Ock M, Lim D, Lee WK, Lee YR, Kim D, Jo MW, Park H, Yoon SJ. Disability-adjusted Life Years for 313 Diseases and Injuries: the 2012 Korean Burden of Disease Study. J Korean Med Sci 2016; 31 Suppl 2:S146-S157. [PMID: 27775252 PMCID: PMC5081296 DOI: 10.3346/jkms.2016.31.s2.s146] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2016] [Accepted: 06/12/2016] [Indexed: 01/28/2023] Open
Abstract
This study is part of a 5-year research project on the national burden of diseases, injuries, and risk factors in Korea. Using disability-adjusted life years (DALYs), a metric introduced by the 1990 Global Burden of Disease (GBD) project, we performed a comprehensive and detailed assessment of the magnitude and distribution of both fatal and non-fatal health problems in the Korean population. The concept and general approach were consistent with the original GBD study, with some methodological modifications to make the study more suitable for Korea. We computed DALYs for 313 causes in both sexes and nine age groups using the entire population's medical records and newly generated Korean disability weights. In 2012, the dominant disease burden was non-communicable diseases, which accounted for 85.21% of total DALYs, while injuries accounted for 7.77% and communicable, maternal, neonatal, and nutritional disorders for 7.02%. Of the total DALYs, 88.67% were from years lived with disability and 11.32% were from years of life lost due to premature mortality. Diabetes mellitus was the leading cause of DALYs, followed by low back pain, chronic obstructive pulmonary disease, ischemic heart disease, ischemic stroke, cirrhosis of the liver, falls, osteoarthritis, motorized vehicle with three or more wheels, and self-harm. The results reported here identify key health challenges and opportunities for future health interventions and policy changes, and provide information that will help assess the major public health issues in Korea, a nation faced with one of the world's most rapidly ageing populations.
Collapse
Affiliation(s)
- Jihyun Yoon
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - In Hwan Oh
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Hyeyoung Seo
- Department of Public Health, Graduate School, Korea University, Seoul, Korea
| | - Eun Jung Kim
- Department of Nursing, Pyeongtaek University, Pyeongtaek, Korea
| | - Young Hoon Gong
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Minsu Ock
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Dohee Lim
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Won Kyung Lee
- Department of Social and Preventive Medicine, Inha University School of Medicine, Incheon, Korea
| | - Ye Rin Lee
- Department of Preventive Medicine, School of Medicine, Kyung Hee University, Seoul, Korea
| | - Dongwoo Kim
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea
| | - Min Woo Jo
- Department of Preventive Medicine, University of Ulsan College of Medicine, Seoul, Korea
| | - Hyesook Park
- Department of Preventive Medicine, School of Medicine, Ewha Womans University, Seoul, Korea
| | - Seok Jun Yoon
- Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea.
| |
Collapse
|
32
|
Yoon J, Yoon SJ. Quantifying Burden of Disease to Measure Population Health in Korea. J Korean Med Sci 2016; 31 Suppl 2:S101-S107. [PMID: 27775246 PMCID: PMC5081290 DOI: 10.3346/jkms.2016.31.s2.s101] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2016] [Accepted: 09/03/2016] [Indexed: 02/06/2023] Open
Abstract
Quantitative assessments of the health status of a population are essential to make decisions and set priorities in the field of public health. Changing epidemiologic patterns increase the demand for comprehensive estimates of population health across the full health spectrum, including non-communicable diseases and injuries. Burden of disease (BoD) analysis has helped meet this need. With the success of the Global Burden of Disease (GBD) Study, the BoD technique has become predominantly associated with the GBD approach and its methodology using disability-adjusted life year (DALY) has been rapidly disseminated and generally accepted over the last several years. The first Korean BoD study using the DALY metric was presented in 2002. Various BoD studies have since been conducted, but the DALY concept has remained primarily academic and has not yet been actively utilized in the health policy arena. Here, we review the DALY metric and population-based Korean BoD studies using national health data, with the intent of increasing the understanding of their value and their potential role in strengthening future assessments of the Korean population's health status.
Collapse
Affiliation(s)
- Jihyun Yoon
- Department of Public Health, Korea University Graduate School, Seoul, Korea
| | - Seok Jun Yoon
- Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea.
| |
Collapse
|