Epidemiology and Health

Methods

Validation of self-reported morbidities in the Korean Atomic Bomb Survivor Cohort: Ansun Jeong, Somin Jeon, Seong-geun Moon, Mi Kyung Kim, Inah Kim, Yu-Mi Kim, Boyoung Park; Epidemiol Health. 2024;46:e2024058. Published online June 28, 2024; DOI: https://doi.org/10.4178/epih.e2024058

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Abstract

OBJECTIVES
This study aimed to evaluate the agreement of disease status collected through a survey of the Korean Atomic Bomb Survivor Cohort (K-ABC), compared with medical claim records from the Korean National Health Insurance Service (NHIS) database and the Korean Central Cancer Registry (KCCR).

METHODS

Data on the lifetime physician-diagnosed morbidities of 1,215 K-ABC participants were collected through an interviewer-administered questionnaire between 2020 and 2022. Survey data were linked to the NHIS and KCCR databases. Eleven diseases were included for validation. We evaluated the following indicators: sensitivity, specificity, positive predictive value, negative predictive value, accuracy, the area under the curve, and the kappa coefficient.

RESULTS

The mean±standard deviation age was 62.1±18.7 years, and 42.6% of the participants were aged ≥70 years. Hypertension and cataracts showed the highest prevalence rates (33.8 and 28.8%, respectively). Hypertension, diabetes, and cancer demonstrated high sensitivity (>0.8) and specificity (>0.9), whereas diabetes, cancer, myocardial infarction, angina pectoris, and asthma exhibited high accuracy (>0.9). In contrast, arthritis, allergic rhinitis, and asthma showed low sensitivity (<0.4) and kappa values (<0.3). In the participants aged ≥70 years, the kappa value was ≥0.4 for all diseases except arthritis, allergic rhinitis, and asthma.

CONCLUSIONS

The results from this initial analysis showed relatively high agreement between the survey and NHIS/KCCR databases, especially for hypertension, diabetes, and cancer. Our findings suggest that the information on morbidities collected through the questionnaires in this cohort was valid for both younger and older individuals.

Summary

Korean summary
한국인 원폭피해자 코호트에서 설문으로 조사한 질병 과거력과 국민건강보험공단/암등록자료와의 일치도는 높은 편이었으며, 특히 고혈압, 당뇨, 암에서 높았다. 설문으로 조사한 질병 과거력은 젊은 대상자와 고령 대상자 모두에서 높았다.

Key Message
High agreement between the survey and NHIS/KCCR databases, especially for hypertension, diabetes, and cancer in the Korean Atomic Bomb Survivor Cohort was observed. The information on morbidities collected through the questionnaires in this cohort was valid for both younger and older individuals.

Citations

Citations to this article as recorded by

Validation of self-reported cancer diagnoses in the Korean Atomic Bomb Survivor Cohort study
Hamin Lee, Jin-Wu Nam, Mi Kyung Kim, Inah Kim, Yu-Mi Kim, Boyoung Park
Cancer Epidemiology.2025; 97: 102817. CrossRef

Original Article

A comprehensive study of deaths due to exposure to humidifier disinfectant in Korea: focusing on medical records, assessment of exposure to humidifier disinfectants, and causes of death: Yeong Jun Ju, Seungho Lee, Seungsoo Sheen, Dong-Woo Choi, Jong-Han Leem, Soon Young Lee; Epidemiol Health. 2021;43:e2021091. Published online November 1, 2021; DOI: https://doi.org/10.4178/epih.e2021091

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Abstract Summary PDF Supplementary Material

Abstract

OBJECTIVES
We aimed to determine the characteristics of the deceased victims of deaths caused by exposure to humidifier disinfectants, and present the distribution of the victims’ data submitted for damage application, demographic characteristics, imaging findings, characteristics of humidifier disinfectant exposure, and distribution of the causes of death.

METHODS

An integrated database of victims was established using the medical records data of 1,413 victims submitted during the application for death damage caused by exposure to humidifier disinfectants, and the demographic characteristics, medical records, imaging findings, exposure characteristics, and cause of death were examined.

RESULTS

The average numbers of data submissions of each applicant for death damage were 3.0 medical use records. A total of 608 (43.0%) victims had more than one finding of acute, subacute, or chronic interstitial lung diseases. The average daily and cumulative use times of the victims were 14.40 and 24,645.81 hours, respectively, indicating greater exposure in this group than in the survivors. The humidifier disinfectants’ components comprised polyhexamethylene guanidine (72.8%), chloromethylisothiazolinone/methylisothiazolinone (10.5%), other components (15.0%), and oligo-[2-(2-ethoxy)-ethoxyethyl] guanidine chloride (1.5%). The components’ distribution was 67.8% for single-component use, which was higher than that in the survivors (59.8%). The distribution of the causes of death were: respiratory diseases (54.4%), neoplasms (16.8%), and circulatory diseases (6.3%). Other interstitial lung diseases (65.5%) were the most common cause of death among those who died due to respiratory diseases.

CONCLUSIONS

Careful discussions of appropriate remedies should be conducted based on a comprehensive understanding of the characteristics of the deceased victims, considering their specificities and limitations.

Summary

Korean summary
가습기 살균제 사망 피해 신청자 들 중 건강피해를 인정받지 못한 신청자들이 여전히 많이 남아있으며 (약 40%), 피해판정의 복잡성과 다양한 이슈들이 산적해 있어 사망 피해 신청자들의 적정 구제를 위해 종합적인 특성파악을 바탕으로 세심한 관점에서의 검토가 필요하다. 특히, 가습기 살균제 사망 피해 신청자의 특수성과 피해구제의 제한점을 고려하여야 하며, 기계적인 건강피해 판정을 지양하고 사망 피해 신청자 중심의 세밀한 특성 파악을 바탕으로 다양한 전문가집단이 참여하는 종합적인 논의를 통해 적정구제를 이루어 나가야 함을 제안한다.

Key Message
Careful discussions of appropriate remedies should be conducted based on a comprehensive understanding of the characteristics of the deceased victims, considering their specificities and limitations.

Citations

Citations to this article as recorded by

Polyhexamethylene Guanidine Phosphate Enhanced Procoagulant Activity through Oxidative-Stress-Mediated Phosphatidylserine Exposure in Platelets
Ju Hee Choi, Keunyoung Kim
Toxics.2024; 12(1): 50. CrossRef
Next generation risk assessment of biocides (PHMG-p and CMIT/MIT)-induced pulmonary fibrosis using adverse outcome pathway-based transcriptome analysis
Jun Woo Kim, Hyung Sik Kim, Ha Ryong Kim, Kyu Hyuck Chung
Journal of Hazardous Materials.2024; 476: 134986. CrossRef
Metabolite analysis of 14C-labeled chloromethylisothiazolinone/methylisothiazolinone for toxicological consideration of inhaled isothiazolinone biocides in lungs
Jung Eun Park, Seung-Hun Ryu, Satoshi Ito, Hyunil Shin, Young-Hee Kim, Jongho Jeon
Chemosphere.2024; 362: 142666. CrossRef
Toxicity and Safety Analysis of Polyhexamethylene Guanidine: A Comprehensive Systematic Review
Ivan Ivanov, Daria Kirillova, Kenes Erimbetov, Denis Shatalov
Sciences of Pharmacy.2024; 3(3): 153. CrossRef
Gene expression related to lung cancer altered by PHMG-p treatment in PBTE cells
Yoon Hee Park, Sang Hoon Jeong, Hyejin Lee, Cherry Kim, Yoon Jeong Nam, Ja Young Kang, Jin Young Choi, Yu-Seon Lee, Su A. Park, Jaeyoung Kim, Eun-Kee Park, Yong-Wook Baek, Hong Lee, Ju-Han Lee
Molecular & Cellular Toxicology.2023; 19(1): 205. CrossRef
Health Effects Associated With Humidifier Disinfectant Use: A Systematic Review for Exploration
Ji-Hun Song, Joonho Ahn, Min Young Park, Jaeyoung Park, Yu Min Lee, Jun-Pyo Myong, Jung-Wan Koo, Jongin Lee
Journal of Korean Medical Science.2022;[Epub] CrossRef

Review

Registry-based stroke research in Taiwan: past and future: Cheng-Yang Hsieh, Darren Philbert Wu, Sheng-Feng Sung; Epidemiol Health. 2018;40:e2018004. Published online February 4, 2018; DOI: https://doi.org/10.4178/epih.e2018004

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20 Web of Science
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Abstract PDF

Abstract

Stroke registries are observational databases focusing on the clinical information and outcomes of stroke patients. They play an important role in the cycle of quality improvement. Registry data are collected from real-world experiences of stroke care and are suitable for measuring quality of care. By exposing inadequacies in performance measures of stroke care, research from stroke registries has changed how we manage stroke patients in Taiwan. With the success of various quality improvement campaigns, mortality from stroke and recurrence of stroke have decreased in the past decade. After the implementation of a nationwide stroke registry, researchers have been creatively expanding how they use and collect registry data for research. Through the use of the nationwide stroke registry as a common data model, researchers from many hospitals have built their own stroke registries with extended data elements to meet the needs of research. In collaboration with information technology professionals, stroke registry systems have changed from web-based, manual submission systems to automated fill-in systems in some hospitals. Furthermore, record linkage between stroke registries and administrative claims databases or other existing databases has widened the utility of registry data in research. Using stroke registry data as the reference standard, researchers have validated several algorithms for ascertaining the diagnosis of stroke and its risk factors from claims data, and have also developed a claims-based index to estimate stroke severity. By making better use of registry data, we believe that we will provide better care to patients with stroke.

Summary

Citations

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STAIR X
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Original Articles

Is the Tuberculosis Case Reporting Rate of Medical Care Institutions in Private Sector low?: Jong Seon Han, Won Gi Jhang, Young Hwangbo, Sung Soo Lee, Moran Ki; Korean J Epidemiol. 2008;30(2):230-238. Published online December 31, 2008; DOI: https://doi.org/10.4178/kje.2008.30.2.230

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Abstract PDF: Abstract
PURPOSE
To estimate the reporting rate of tuberculosis in one medium-sized city in Korea.
METHODS
Data claimed by national health insurance corporationand notification data of KTBS (Korea Tuberculosis Surveillance System) were compared through medical record-linkage method. Regarding the cases that were claimed medical care fee as tuberculosis but not notified to KTBS, we reviewed medical charts of the patients and investigated the reasons of failure to notify.
RESULTS
Number of cases claimed health insurance fee as tuberculosis occurrences in Cheonan was 2,331 in 2007, while 956 cases were matched as notified cases to KTBS after electronic record-linkage by personal identifier. Among remaining 1,375 cases that were not matched, real missed cases through medical record review survey were found to be 104. The reasons of failure to notify were because of 'not tuberculosis patients' (500, 36.4%), 'notified in 2006' (421, 30.6%), 'diseases coding error' (341, 24.8%) and 'notified as other diseases' (9, 0.7%). Therefore, the corrected reporting rate was calculated at 93% (95% CI: 91.6% - 94.2%). Notably, reporting rate of clinics (58.1%) was significantly lower than those of hospitals (93.4%) or general hospitals (96.6%).
CONCLUSIONS
All cases of tuberculosis diagnosis, which were claimed and not notified, were verified, the reporting rate was not as low as that of the data known through media. However, to reach the goal of tuberculosis elimination (reporting rate over 95%), more effort into improvement of the reporting system is necessary.; Summary

Case Series of Pediatric Mycoplasma Pneumoniae Pneumonia Inpatients in A Hospital.: Young Sun Min, Hyun Sul Lim; Korean J Epidemiol. 2006;28(1):112-118.

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Abstract PDF: Abstract
OBJECTIVES
The aim of this report is to examine characteristics of pediatric Mycoplasma Pneumoniae pneumonia inpatients.
METHODS
The authors conducted a medical record survey among 236 children under seventeen were hospitalized in a university hospital due to Mycoplasma Pneumoniae pneumonia, 2001-2003. The author reviewed gender, age, address, developed date of symptoms, admission day, discharge day, etc.
RESULTS
The number of inpatients was increased during late summer and fall. The mean age of all cases was 3.7+/-2.9 years old. One hundred ninety three cases (81.8%) had lung infiltration findings. The mean symptomatic period was 11.9+/-6.4 days (maximum 44 days, minimum 4 days, median 10 days), the mean hospital length of stay was 5.2+/-2.5 days (maximum 17 days, minimum 0 day, median 5 days).
DISCUSSION
The authors reviewed characteristics during last 3 years for Mycoplasma Pneumoniae pneumonia. This report is meaningful with its basic data for the epidemiologic characteristics of Mycoplasma Pneumoniae pneumonia inpatients.; Summary

Occupational Relationship of Cancer Patients Diagnosed in Two University Hospitals.: Geun Ryang Bae, Hyun Sul Lim, Doohie Kim; Korean J Epidemiol. 1999;21(1):64-71.

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Abstract PDF: Abstract
OBJECTIVES
This study was performed to evaluate the occupational relationship on 190 cases of cancer selected out of 622 cases of cancer registered in two university hospitals from January 1, 1996 to December 31, 1997.
METHODS
The selection criteria was for the patient to be more than 40 years old with lung, liver, urinary bladder, nasal cavity and skin cancer or leukemia. We reviewed the medical records to update the missing data and occupational histories. Telephone interviews were used to obtain complete occupational histories on the subjects.
RESULTS
The sites of cancer in the order of relative frequency was lung (51.0%), followed by liver (32.9%), urinary bladder (14.1%) and skin (2.0%) in male, liver (41.5%), followed by lung (31.7%), skin (19.5%) and urinary bladder (7.3%) in female. The occupational histories of 190 cases with suspected cancer-causing occupations were recorded 5.8% on the doctor's medical records and 33.2% on the nursing records. The response rates of the telephone interviews were 87.4%. The distribution of occupation according to the telephone interviews was farmer (47.7%), office worker (16.1%), salesman (12.8%), production worker (6.7%), simple laborer (3.4%) and unknown (13.4%) in male, housewife (63.4%), farmer (17.1%), saleswoman (9.8%) and unknown (9.8%) in female. And there were two cases of suspected occupational relationships in the lung cancer cases.
CONCLUSIONS
We could not discover definite cases of occupational cancer but found out two cases of suspected occupational relationships. Occupational cancer is likely to increase in the near future, so the efforts to detect occupational relationships with cancer should be continued.; Summary

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