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Epidemiological investigation of a food-borne outbreak in a kindergarten, Jeju Province, Korea
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Kyoung Mi Kim, Eun Suk Cho, Seong Bae Ahn, Eun Ok Kang, Jong-Myon Bae
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Epidemiol Health. 2023;45:e2023047. Published online April 17, 2023
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DOI: https://doi.org/10.4178/epih.e2023047
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Abstract
OBJECTIVES On Monday, September 6, 2021, at a kindergarten in Jeju Province, a large number of children vomited and developed food poisoning symptoms, and this necessitated an epidemiological investigation.
METHODS The team surveyed symptoms and food intake history of kindergarten children, teachers, and workers who ate lunch between September 2 (Thursday) and September 6 (Monday), excluding weekends. In addition to rectal swabs, environmental samples from preserved foods, cooking utensils, drinking water, and refrigerator handles were collected. Pulsed field gel electrophoresis (PFGE) for genetic fingerprint analysis was also performed.
RESULTS There were 19 cases among 176 subjects, which indicated an attack rate of 10.8%. The epidemic curve showed a unimodal shape, and the average incubation period was 2.6 hours. While no food was statistically significant in food intake history, the analysis of 35 rectal smear samples detected Bacillus cereus in 7 children, 4 teachers, and 1 cooking staff. Enterotoxins were also detected in 12 samples. Out of 38 environmental samples, B. cereus and enterotoxins were detected in the morning snack cereal, lunch bean sprouts, and afternoon snack steamed potatoes on Monday, September 6th. The result of the PFGE test on 10 isolates of B. cereus showed that there was no genetic homology.
CONCLUSIONS Our results indicated that this outbreak was simultaneously caused by various strains of B. cereus from the environment.
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Korean summary
모 유치원에서 제공한 급식 취식아동에서 발열이 없고 구토형의 주증상인 식중독이 발생되었다. 평균 잠복기 2.6시간 (최소 0.8, 최대 4.5시간)이며, 인체 및 환경 검체에서 바실러스 세레우스 균이 분리되었다. 이에 해당 집단발생은 구토형 바실러스 세레우스 감염증에 의한 식중독을 결론지었다.
Key Message
A large number of children in a kindergarten vomited suddenly. The average incubation period was 2.6 hours (min 0.8, max 4.5 hours) with uni-modal shape in the epidemic curve. Bacillus cereus and entertoxin were detected in rectal smear and environmental samples.
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- Surge of acute gastroenteritis outbreaks due to rising norovirus GII.4 transmission in Seoul childcare centers and kindergartens in 2022 compared to 2019–2021
Euncheol Son, Young-Hoon Kim Archives of Virology.2024;[Epub] CrossRef
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Interpretation of the hygiene and microflora hypothesis for allergic diseases through epigenetic epidemiology
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Jong-Myon Bae
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Epidemiol Health. 2018;40:e2018006. Published online March 10, 2018
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DOI: https://doi.org/10.4178/epih.e2018006
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14,762
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The hygiene hypothesis (HH) proposed by Strachan in 1989 was expanded to explain the inverse association between the occurrence of allergy disorders and the risk of infectious diseases and parasite infestation. The microflora hypothesis (MH) suggests that gut microbial dysbiosis in early life might trigger hypersensitivity disorders. The sharing concept of both HH and MH is gene-environment interaction, which is also a key concept in epigenetics. The amalgamation of epidemiology and epigenetics has created a scientific discipline termed epigenetic epidemiology. To accomplish an era of gene-environment-wide interaction studies, it is necessary to launch a national human epigenome project.
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Korean summary
1989년 제시된 위생가설 (Hygiene hypothesis)은 최근 체내미생물가설 (Microflora hypothesis) 대치되어 알레르기 질환의 발생기전을 해석하고 있다. 두 가설 모두 유전-환경 상호작용 gene-environment interaction) 을 강조하고 있다는 점에서 향후 후성유전역학 연구에 대한 활성화가 필요하다.
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Citations
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- Multicenter study of seasonal and regional airborne allergens in Chinese preschoolers with allergic rhinitis
Zhifeng Huang, Aoli Li, Huiqing Zhu, Junxiu Pan, Jun Xiao, Jiang Wu, Yumin Han, Lili Zhong, Xuhui Sun, Lei Wang, Liang Hu, Cuihua Wang, Xingkai Ma, Zaixia Qiao, Min Zhang, Ling Yuan, Xin Liu, Jun Tang, Yue Li, Hong Yu, Zhaobing Zheng, Baoqing Sun Scientific Reports.2024;[Epub] CrossRef - A Higher Incidence of Isolated Biliary Atresia in Rural Areas
Mark Nomden, Daan B.E. van Wessel, Solomon Ioannou, Henkjan J. Verkade, Ruben H. de Kleine, Behrooz Z. Alizadeh, Janneke L.M. Bruggink, Jan B.F. Hulscher Journal of Pediatric Gastroenterology and Nutrition.2021; 72(2): 202. CrossRef - Eradication of Helicobacter pylori and Gastric Cancer: A Controversial Relationship
Mariagrazia Piscione, Mariangela Mazzone, Maria Carmela Di Marcantonio, Raffaella Muraro, Gabriella Mincione Frontiers in Microbiology.2021;[Epub] CrossRef - Pathogenesis of Children’s Allergic Diseases: Refocusing the Role of the Gut Microbiota
Tingting Hu, Yinmiao Dong, Chenghao Yang, Mingyi Zhao, Qingnan He Frontiers in Physiology.2021;[Epub] CrossRef - Pilot study of the SCFA Headspace Analysis of Streptococcus mutans Metabolites in Media with and without Polyols
Goudarzi S Habibi, B Kabat, M Cannon, M Gashkoff, R Zurek Edelweiss Journal of Biomedical Research and Review.2020; : 24. CrossRef - Blockade of enhancer of zeste homolog 2 alleviates renal injury associated with hyperuricemia
Yingfeng Shi, Liuqing Xu, Min Tao, Lu Fang, Jiasun Lu, Hongwei Gu, Shuchen Ma, Tao Lin, Yi Wang, Wenfang Bao, Andong Qiu, Shougang Zhuang, Na Liu American Journal of Physiology-Renal Physiology.2019; 316(3): F488. CrossRef - Researches of Epigenetic Epidemiology for Infections and Radiation as Carcinogen
Jong-Myon Bae Journal of Preventive Medicine and Public Health.2018; 51(4): 169. CrossRef - Necessity of Epigenetic Epidemiology Studies on the Carcinogenesis of Lung Cancer in Never Smokers
Jong-Myon Bae Journal of Preventive Medicine and Public Health.2018; 51(5): 263. CrossRef
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Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students
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Eun Hee Kim, Jong-Myon Bae
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Epidemiol Health. 2018;40:e2018035. Published online July 27, 2018
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DOI: https://doi.org/10.4178/epih.e2018035
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14,053
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Abstract
The prevalence of latnet Mycobacterium tuberculosis infection (LTBI) in the first-grade high school students in South Korea was 2.1%, which was the lowest level at congregated settings in 2017. For LTBI cases refusing anti-tuberculosis (TB) medication or having poor compliance, additional support should be considered. Eight systematic reviews concluded that vitamin D (VD) deficiency is a risk factor for TB. While three of four South Korean adolescents were VD deficiency, VD supplementation could be a practical remedy to protect LTBI students of refusing anti-TB medication or having poor compliance.
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Summary
Korean summary
잠복결핵검진 검사 양성자이면서 항결핵제 복용을 거부하는 고1학생에 대한 사후 조치가 필요하다. 그동안의 연구결과들에 근거할 때, 잠복결핵이 활동성결핵으로의 전환을 억제하기 위해서 비타민 D 보충제의 투여를 검토해 볼 수 있다.
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Citations
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- Vitamin D and the risk of latent tuberculosis infection: a systematic review and meta-analysis
Yan Cao, Xinjing Wang, Ping Liu, Yue Su, Haotian Yu, Jingli Du BMC Pulmonary Medicine.2022;[Epub] CrossRef - Association of vitamin D levels and risk of latent tuberculosis in the hemodialysis population
Shang-Yi Lin, Yi-Wen Chiu, Hui-Ru Yang, Tun-Chieh Chen, Min-Han Hsieh, Wen-Hung Wang, Yen-Hsu Chen Journal of Microbiology, Immunology and Infection.2021; 54(4): 680. CrossRef - A scoping review on climate change and tuberculosis
Bijay Maharjan, Ram Sharan Gopali, Ying Zhang International Journal of Biometeorology.2021; 65(10): 1579. CrossRef - Tuberculosis risk is associated with genetic polymorphisms in the LRP2, CUBN, and VDR genes
Sung-Soo Kim, Sang In Lee, Hyun-Seok Jin, Sangjung Park Genes & Genomics.2020; 42(10): 1189. CrossRef
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Prophylactic efficacy of probiotics on travelers’ diarrhea: an adaptive meta-analysis of randomized controlled trials
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Jong-Myon Bae
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Epidemiol Health. 2018;40:e2018043. Published online August 29, 2018
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DOI: https://doi.org/10.4178/epih.e2018043
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16,515
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Abstract
OBJECTIVES The 2017 guideline for the prevention of travelers’ diarrhea (TD) by the International Society of Travel Medicine suggested that ‘there is insufficient evidence to recommend the use of commercially available prebiotics or probiotics to prevent or treat TD.’ However, a meta-analysis published in 2007 reported significant efficacy of probiotics in the prevention of TD (summary relative risk [sRR], 0.85, 95% confidence interval [CI], 0.79 to 0.91). This study aimed to synthesize the efficacy of probiotics on TD by updating the meta-analysis of double-blind, placebo-controlled, randomized human trials.
METHODS The search process was conducted by the adaptive meta-analysis method using the ‘cited by’ and ‘similar articles’ options provided by PubMed. The inclusion criteria were double-blind, placebo-controlled, randomized human trials with hypotheses of probiotics as intervention and TD as an outcome. The adaptive meta-analysis was conducted using Stata software using the csi, metan, metafunnel, and metabias options.
RESULTS Eleven articles were selected for the meta-analysis. The sRR was 0.85 (95% CI, 0.79 to 0.91) and showed statistical significance. There was no heterogeneity (I-squared=28.4%) and no publication bias.
CONCLUSIONS Probiotics showed statistically significant efficacy in the prevention of TD.
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Summary
Korean summary
활생제가 여행자설사를 예방하는 효과가 있는가에 대한 기존 메타분석결과들과 지침간의 괴리가 확인되어서 갱신용 메타분석을 수행하였다. 총 11편의 무작위배정, 위약대조비교 임상시험결과에 대한 메타분석결과 통계적으로 유의한 효과가 있는 것으로 산출되었다 (summary relative risk =0.85; 95% confidence interval: 0.77-0.91).
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Nicoleta-Maricica Maftei, Cosmin Raducu Raileanu, Alexia Anastasia Balta, Lenuta Ambrose, Monica Boev, Denisa Batîr Marin, Elena Lacramioara Lisa Microorganisms.2024; 12(2): 234. CrossRef - Next generation probiotics: Engineering live biotherapeutics
Sanjeeva Kumar Murali, Thomas J. Mansell Biotechnology Advances.2024; 72: 108336. CrossRef - Bismuth subsalicylate, probiotics, rifaximin and vaccines for the prevention of travelers’ diarrhea: a systematic review and network meta-analysis
Hao Fan, I-Chun Liu, Lei Gao, Lanka Wu Frontiers in Pharmacology.2024;[Epub] CrossRef - Haben Probiotikastämme einen nachweisbaren Stellenwert?
Jonas Früh Flugmedizin · Tropenmedizin · Reisemedizin - FTR.2024; 31(03): 110. CrossRef - Controlling Intestinal Infections and Digestive Disorders Using Probiotics
Sanjeev Kumar, Md Faruque Ahmad, Priyakshi Nath, Rubina Roy, Rudrarup Bhattacharjee, Eman Shama, Indira Gahatraj, Manisha Sehrawat, Vaishali Dasriya, Harmeet Singh Dhillon, Monica Puniya, Mrinal Samtiya, Tejpal Dhewa, Rotimi E. Aluko, Gulab D. Khedkar, An Journal of Medicinal Food.2023; 26(10): 705. CrossRef - Antibiotic treatment to reduce the duration and severity of travellers’ diarrhoea
Romeo Toriro, William Nevin, Rebecca Kuehn, Hannah Ryan, Nicholas Beeching, Tom Fletcher, Dan Burns Cochrane Database of Systematic Reviews.2023;[Epub] CrossRef - Phenotypic Assessment of Probiotic and Bacteriocinogenic Efficacy of Indigenous LAB Strains from Human Breast Milk
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Bantayehu Addis Tegegne, Bekalu Kebede Heliyon.2022; 8(6): e09725. CrossRef - Probiotics and rifaximin for the prevention of travelers’ diarrhea: A systematic review and network meta-analysis
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Seasonality of tuberculosis in the Republic of Korea, 2006-2016
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Eun Hee Kim, Jong-Myon Bae
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Epidemiol Health. 2018;40:e2018051. Published online October 20, 2018
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DOI: https://doi.org/10.4178/epih.e2018051
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Abstract
OBJECTIVES While the seasonality of notified tuberculosis has been identified in several populations, there is not a descriptive epidemiological study on the seasonality of tuberculosis in Korea. This study aimed to evaluate the seasonality of tuberculosis in Korea from 2006 to 2016.
METHODS Data regarding notified cases of tuberculosis by year and month was obtained from the Infectious Diseases Surveillance Yearbook, 2017 published by the Korea Centers for Disease Control and Prevention. Seasonal decomposition was conducted using the method of structural model of time series analysis with simple moving averages.
RESULTS While the trough season was winter from 2006 to 2016, the peak season was summer between 2006 and 2012, but shifted to spring between 2013 and 2016.
CONCLUSIONS Notified tuberculosis in Korea also showed seasonality. It is necessary to evaluate factors related to the seasonality of tuberculosis for controlling tuberculosis.
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Summary
Korean summary
2006-2016년 신고된 신환자의 연보를 근거로 결핵발생의 계절성 여부를 분석한 결과, 2006-2012년까지는 여름, 2013년이후는 봄에 발생 신고율이 높은 계절성을 확인하였다. 계절성을 야기하는 이유들을 찾아서 향후 결핵 예방에 활용할 필요가 있다.
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Incidence of varicella in children in Jeju-do, Korea, 2005-2016: age-period-cohort analysis
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Jinhee Kim, Ji-Eun Kim, Jong-Myon Bae
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Epidemiol Health. 2018;40:e2018054. Published online November 8, 2018
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DOI: https://doi.org/10.4178/epih.e2018054
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Abstract
OBJECTIVES Although the nationwide inoculation rate of varicella vaccine was approximately 95% in Korean children recently, the number of notified varicella cases is unexpectedly continuously increasing till now. To suggest some hypotheses regarding this discrepancy, an age-period-cohort (APC) analysis as a descriptive epidemiology study was conducted for children residing in Jeju-do, Korea.
METHODS The raw data were obtained from the nationwide database for insurance claim of healthcare fee provided by the National Health Insurance Service, Korea. The selection criteria were children aged 2-13 years who visited any healthcare center due to varicella from 2005 to 2016 while residing in Jeju-do. After calculating the birth cohort-specific crude incidence rates by age and year, the intrinsic estimator method was used to perform the APC analysis.
RESULTS As the annual crude incidence rates decreased with increasing age between 2005 and 2016, the age and period effects also decreased. The intrinsic estimator coefficients suggesting the cohort effect shifted from positive to negative in 2011, the starting year of free varicella vaccine program in Jeju-do.
CONCLUSIONS The results suggested that inoculated varicella vaccines have preventive effects. However, further studies to evaluate waning immunity would be needed.
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Korean summary
2011년 이후 생후 12-15개월 유아에게 수두백신 무상접종을 시행해 오고 있는 제주도에 있어서, 수두발생 신고건수가 증가하는 괴리 현상에 있어, 국민건강보험공단의 수진자료를 확보하여 연령-기간-코호트 (age-period-cohort, APC) 분석을 시행하였다. 그 결과 연령이 증가하고 연도가 최근으로 올수록 수두 발생에 대한 연령과 기간효과는 점점 감소하는 반면, 수두백신 무상접종이 시작된 2011년을 전후해서 코호트 효과는 양에서 음으로 전환하였다. 따라서 현재 접종하고 있는 수두 백신은 수두발생을 예방하는 효과가 있으며, 돌발수두 발생은 이차백신 실패로 볼 수 있다.
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Citations
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- The comparison of seroconversion rates among different varicella vaccines administered Turkish children; MAV/06 and vOka
Zuhal Umit, Zumrut Sahbudak Bal, Aysin Zeytinoglu, Tansu Gulbahar Aydogan, Ozlem Bag, Gizem Guner Ozenen, Ferda Ozkinay, Zafer Kurugol Human Vaccines & Immunotherapeutics.2021; 17(11): 4190. CrossRef - Recent increase in pertussis incidence in Korea: an age-period-cohort analysis
Chanhee Kim, Seonju Yi, Sung-il Cho Epidemiology and Health.2021; 43: e2021053. CrossRef - Incidence of Scarlet Fever in Children in Jeju Province, Korea, 2002-2016: An Age-period-cohort Analysis
Jinhee Kim, Ji-Eun Kim, Jong-Myon Bae Journal of Preventive Medicine and Public Health.2019; 52(3): 188. CrossRef
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Is there evidence that Kudoa septempunctata can cause an outbreak of acute food poisoning?
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Young-Bae Chung, Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017004. Published online January 30, 2017
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DOI: https://doi.org/10.4178/epih.e2017004
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19,989
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Abstract
After publishing results of a study that revealed diarrheagenic and emetic activity in 4-5-day old mice infected with <i>Kudoa septempunctata</i> (<i>K. septempunctata</i>) spores, the Korea Centers for Disease Control and Prevention reported 11 events of “<i>Kudoa</i> food poisoning” in 2015. The epidemiological design of the previous study was descriptive rather than analytical; therefore, this study aimed to further investigate the pathogenicity of <i>K. septempunctata</i>. Academic articles showing evidence of the pathogenicity of <i>K. septempunctata</i> were searched via PubMed using the citation discovery tool. Information regarding the kinds of experimental animals and inoculum spores used, as well as study results were extracted. Four articles evaluating the pathogenicity of Myxospran parasites were selected; the first article suggested the pathogenicity of <i>K. septempunctata</i>, while the remaining three articles reported no abnormal symptoms or histopathologic changes. Our findings indicate that there is weak evidence supporting the pathogenicity of <i>K. septempunctata</i>. Further studies evaluating the pathogenicity of <i>K. septempunctata</i> are needed urgently.
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Summary
Korean summary
“질병관리본부는 2015년 쿠도아충 환자 사례조사 (cases reports)를 발표하였다. 제주산 광어에서 발견되는 칠성쿠도아충이 급성 식중독을 일으키는 병인 원충이라는 주장과 관련한 병인성 (pathogenicity) 근거들을 정리한 결과 실험실적 근거에 일관성이 없었다. 이렇게 실험실적 근거가 불충분한 상황에서, 오직 환자사례 결과들만으로 칠성쿠도아충을 급성식중독의 역학적 인과성 (epidemiologic causality)을 부여하는 것은 과학적 타당성이 떨어진다.”
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- Molecular detection and genotype analysis of Kudoa septempunctata from food poisoning outbreaks in Korea
Gyung-Hye Sung, In-Ji Park, Hee-Soo Koo, Eun-Hee Park, Mi-Ok Lee Parasites, Hosts and Diseases.2023; 61(1): 15. CrossRef - Detection and characterization of Kudoa thunni from uncooked yellowfin tuna (Thunnus albacares) in Southeast Asia
Truong Dinh Hoai, Doan Thi Nhinh, Nguyen Thi Huong Giang, Saengchan Senapin, Ha Thanh Dong Parasitology International.2022; 87: 102536. CrossRef - Morphometric and molecular characterization of Kudoa encrasicoli n. sp. (Myxozoa: Myxosporea) from the European anchovy, Engraulis encrasicolus (L.) (Clupeiformes: Engraulidae)
Raúl Iglesias, Luís Filipe Rangel, Fabio Fernández-Vázquez, Maria João Santos, José M. García-Estévez Systematic Parasitology.2022; 99(5): 621. CrossRef - Immune-triggering effect of the foodborne parasite Kudoa septempunctata through the C-type lectin Mincle in HT29 cells
Ji-Hun Shin, Jung-Pyo Yang, Seung-Hwan Seo, Sang-Gyun Kim, Eun-Min Kim, Do-Won Ham, Eun-Hee Shin BMB Reports.2020; 53(9): 478. CrossRef - First report of Myxobolus (Cnidaria: Myxozoa) spores in human feces in Brazil
Lisiane Lappe dos REIS, Lucas Carvalho de JESUS, Ormezinda Celeste Christo FERNANDES, David Eduardo BARROSO Acta Amazonica.2019; 49(2): 162. CrossRef - Additional experimental and epidemiologic studies for evaluating pathogenecity of Kudoa septempunctata should be needed
Jong-Myon Bae International Journal of Food Microbiology.2018; 266: 222. CrossRef - Foodborne Illness Outbreaks in Gyeonggi Province, Korea, Following Seafood Consumption Potentially Caused by <italic>Kudoa septempunctata</italic> between 2015 and 2016
Joon Jai Kim, Sukhyun Ryu, Heeyoung Lee Osong Public Health and Research Perspectives.2018; 9(2): 66. CrossRef - Analysis of Kudoa septempunctata as a cause of foodborne illness and its associated differential diagnosis
Sung Uk Lee Epidemiology and Health.2017; 39: e2017014. CrossRef - Production of a novel monoclonal antibody applicable for an immunochromatographic assay for Kudoa septempunctata spores contaminating the raw olive flounder ( Paralichthys olivaceus )
Michio Jinnai, Takao Kawai, Tetsuya Harada, Yasutaka Nishiyama, Hiroshi Yokoyama, Sho Shirakashi, Hiroshi Sato, Junko Sakata, Yuko Kumeda, Yutaka Fukuda, Kikuyo Ogata, Kentaro Kawatsu International Journal of Food Microbiology.2017; 259: 59. CrossRef - Relationship between shipping amounts of olive flounder aquacultured from Jejudo and the reported events of acute food poisoning by Kudoa septempunctata in 2015, South Korea: an ecological study
Jong-Myon Bae Epidemiology and Health.2017; 39: e2017041. CrossRef
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An opposing view on including high school students in a latent tuberculosis infection control program in Korea
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Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017015. Published online March 31, 2017
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DOI: https://doi.org/10.4178/epih.e2017015
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Abstract
The Korea Centers for Diseases Control and Prevention (KCDC) has announced a control program against latent <i>Mycobacterium tuberculosis</i> infection (LTBI), for a “TB-safe country” this year with the goal of a “TB-free Korea” by 2025. The program includes high school students as one target group; however, some school health teachers and parents have expressed their opposition to this. The 2015 World Health Organization guidelines do not recommend inclusion of asymptomatic high school students in LTBI control programs. Based on this guideline, the KCDC should consider excluding this population from the program.
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Summary
Korean summary
질병관리본부는 결핵안심국가를 만들기 위하여 고등학교 1학년생을 포함한 잠복결핵감염 검사사업을 2017년 추진하기로 공고하였다. 그러나 2015년에 발표된 WHO 지침에 따르면 해당 대상자들은 검사대상자로 제시되어 있지않다. 근거중심의 보건정책 추진을 위해서 사업 대상 선정을 재검토할 필요가 있다.
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- The cascade of care for latent tuberculosis infection in congregate settings: A national cohort analysis, Korea, 2017–2018
Jinsoo Min, Hyung Woo Kim, Helen R. Stagg, Molebogeng X. Rangaka, Marc Lipman, Ibrahim Abubakar, Yunhee Lee, Jun-Pyo Myong, Hyunsuk Jeong, Sanghyuk Bae, Ah Young Shin, Ji Young Kang, Sung-Soon Lee, Jae Seuk Park, Hyeon Woo Yim, Ju Sang Kim Frontiers in Medicine.2022;[Epub] CrossRef - Latent tuberculosis infection: recent progress and challenges in South Korea
Doosoo Jeon The Korean Journal of Internal Medicine.2020; 35(2): 269. CrossRef - Vitamin D supplementation as a control program against latent tuberculosis infection in Korean high school students
Eun Hee Kim, Jong-Myon Bae Epidemiology and Health.2018; 40: e2018035. CrossRef - Suggestions for the promotion of evidence-based public health in South Korea
Jong-Myon Bae Epidemiology and Health.2017; 39: e2017030. CrossRef - 결핵정책에 대하여
찬병 박 Public Health Affairs.2017; 1(1): 13. CrossRef
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Suggestions for the promotion of evidence-based public health in South Korea
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Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017030. Published online July 19, 2017
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DOI: https://doi.org/10.4178/epih.e2017030
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Evidence-based public health (EBPH) is defined as public health decision-making based on current best evidence. Debates about the latent tuberculosis infection control program suggested by the Korea Centers for Disease Control and Prevention in 2017 highlight the need to promote EBPH. Three strategies have been proposed, including providing necessary evidence by evaluating policy-evidence gaps; delivering high-quality, relevant, and timely evidence by conducting systematic reviews and adapting public health guidelines; and making value-driven decisions by training and educating public health policymakers.
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Summary
Korean summary
근거중심 공중보건 (EBPH)는 공중보건영역에서 최신과 최선의 근거에 기반하여 의사결정을 하는 것이다. EBPH를 활성화하기 위해서는 정책-근거 간의 간극을 알아내고, 체계적 고찰을 통한 공중보건지침을 개발하며, 의사결정참여자의 역량을 높이기 위한 교육훈련을 추진하는 것이다.
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- Comparative efficacy on outcomes of C-CABG, OPCAB and ONBEAT in coronary heart disease: A systematic review and network meta-analysis of randomized controlled trials
Lin Zhu, Dongjie Li, Xu Zhang, Sitong Wan, Yuyong Liu, HongJia Zhang, Junjie Luo, Yongting Luo, Peng An, Wenjian Jiang International Journal of Surgery.2023;[Epub] CrossRef - Ethical, pedagogical, socio-political and anthropological implications of quaternary prevention
Marc Jamoulle, Michel Roland, Jong-Myon Bae, Bruno Heleno, Giorgio Visentin, Gustavo Diniz Ferreira Gusso, Maciek Godycki-Ćwirko, Miguel Pizzanell, Patrick Ouvrard, Ricardo La Valle, Luis Filipe Gomes, Daniel Widmer, Jorge Bernstein, Mariana Mariño, Hamil Revista Brasileira de Medicina de Família e Comunidade.2018; 13(40): 1. CrossRef - Network meta-analysis: application and practice using Stata
Sungryul Shim, Byung-Ho Yoon, In-Soo Shin, Jong-Myon Bae Epidemiology and Health.2017; 39: e2017047. CrossRef
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Relationship between shipping amounts of olive flounder aquacultured from Jejudo and the reported events of acute food poisoning by Kudoa septempunctata in 2015, South Korea: an ecological study
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Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017041. Published online September 6, 2017
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DOI: https://doi.org/10.4178/epih.e2017041
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OBJECTIVES Confirmation of <i>Kudoa septempunctata</i> (<i>K. septempunctata</i>) as the pathogenic agent causing acute food poisoning remains under debate owing to inconsistencies in the reproducibility of experimental evidence. Higher intake of olive flounder infected with <i>K. septempunctata</i> would result in increased diagnosis of food poisoning by <i>K. septempunctata</i>, if the latter was one of the causal agents of acute food poisoning. The aim was to evaluate the relationship between the shipping amount of olive flounder aquacultured from Jejudo and the incidence of <i>K. septempunctata</i> food poisoning in 2015, Korea.
METHODS Data of shipping amounts between March 2014 and February 2016 and of monthly reported events of <i>Kudoa</i> food poisoning were taken from Jejudo Fish-Culture Fisheries Cooperatives and Korea Centers for Disease Control and Prevention, respectively. Non-parametric correlation analyses were conducted.
RESULTS Shipping amounts indicated the seasonal changes according to variation of consumption. Spearman’s rho and Kendall’s tau-a between the monthly shipping amounts and the reported events in 2015 were 0.39 (p=0.21) and 0.27 (p=0.20), respectively.
CONCLUSIONS An independent relationship was noted between the shipping amount and the reported events, which contrasted with the claim that the virulence of <i>K. septempunctata</i> caused acute food poisoning.
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Summary
Korean summary
질병관리본부가 보고한 2015년도 쿠도아 식중독 발생 사례의 월별 분포와, 같은 기간에 제주도 수산협동조합이 국내 시장에 제공한 출하량 간의 상관성 (correlation)을 알아보았을 때, 유의한 관련성이 없었다. 이는 칠성 쿠도아충이 급성식중독을 일으킨다는 주장을 의심케 하는 근거의 하나이다.
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- An update of the species of Myxosporea (Cnidaria, Myxozoa) described from Indian fish
Jorge C. Eiras, Gyan Deb Barman, Sukanya Chanda, Ashis Kumar Panigrahi Journal of Parasitic Diseases.2023; 47(1): 12. CrossRef - Additional experimental and epidemiologic studies for evaluating pathogenecity of Kudoa septempunctata should be needed
Jong-Myon Bae International Journal of Food Microbiology.2018; 266: 222. CrossRef
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Network meta-analysis: application and practice using Stata
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Sungryul Shim, Byung-Ho Yoon, In-Soo Shin, Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017047. Published online October 27, 2017
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DOI: https://doi.org/10.4178/epih.e2017047
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This review aimed to arrange the concepts of a network meta-analysis (NMA) and to demonstrate the analytical process of NMA using Stata software under frequentist framework. The NMA tries to synthesize evidences for a decision making by evaluating the comparative effectiveness of more than two alternative interventions for the same condition. Before conducting a NMA, 3 major assumptions—similarity, transitivity, and consistency—should be checked. The statistical analysis consists of 5 steps. The first step is to draw a network geometry to provide an overview of the network relationship. The second step checks the assumption of consistency. The third step is to make the network forest plot or interval plot in order to illustrate the summary size of comparative effectiveness among various interventions. The fourth step calculates cumulative rankings for identifying superiority among interventions. The last step evaluates publication bias or effect modifiers for a valid inference from results. The synthesized evidences through five steps would be very useful to evidence-based decision-making in healthcare. Thus, NMA should be activated in order to guarantee the quality of healthcare system.
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Korean summary
같은 치료 목적을 가진 여러 치료법들 간의 효과를 상호 비교한 결과들을 통합하기 위해 개발된 네트워크 메타분석 (NMA) 결과는 의사결정의 우선순위를 정하는데 있어 가장 상위의 과학적 설득력을 갖는다. STATA 통계프로그램에서 제공하는 빈도주의 틀에 기반한 NMA를 수행하는데 점검해야 할 가정들과 실제 적용 과정을 소개한다.
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Shared decision making: relevant concepts and facilitating strategies
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Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017048. Published online October 30, 2017
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DOI: https://doi.org/10.4178/epih.e2017048
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Abstract
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Abstract
As the paradigm in healthcare nowadays is the evidence-based, patient-centered decision making, the issue of shared decision making (SDM) is highlighted. The aims of this manuscript were to look at the relevant concepts and suggest the facilitating strategies for overcoming barriers of conducting SDM. While the definitions of SDM were discordant, several concepts such as good communication, individual autonomy, patient participants, and patient-centered decision-making were involved. Further, the facilitating strategies of SDM were to educate and train physician, to apply clinical practice guidelines and patient decision aids, to develop valid measurement tools for evaluation of SDM processes, and to investigate the impact of SDM.
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Summary
Korean summary
오늘날 보건의료가 지향하는 목표가 근거에 기반한 환자중심의 의사결정 (Evidence-based Patient-centered Decision Making)인 점에서, 공유된 의사결정 (Shared Decision Making, SDM)의 중요성이 강조되고 있다. 본 원고는 SDM의 관련 개념들을 정리하고, 진료에 적용하는 과정에서의 한계점들과 이를 극복하기 위한 방안들을 살펴보았다.
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Vaccination history in elementary school children enrolled in the varicella epidemic investigations held in Jeju-si, Korea in the first half of 2017
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Hyun-Suk Oh, Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017053. Published online November 13, 2017
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DOI: https://doi.org/10.4178/epih.e2017053
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13,612
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Abstract
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Abstract
OBJECTIVES The reported incidence rate of varicella infection in Jeju-do is higher compared with the national average. This study aimed to examine varicella vaccination history and evaluate clinical manifestation of varicella cases in Jeju-do.
METHODS Based on the guideline suggested by the Korea Centers for Disease Control and Prevention (KCDC), two epidemic investigations for varicella infection were conducted in the first half of 2017. The history of varicella vaccination was confirmed using the Integrated Control System for Diseases and Health operated by the KCDC.
RESULTS Out of a total of 60 elementary school children as the study subjects, all had been previously vaccinated against varicella. Twenty cases (33%) showed mild clinical manifestations and no complications.
CONCLUSIONS As the government of Jeju-do has supplied a single-labeled vaccine since 2011, there is a need to evaluate the type of vaccination failure such as primary or secondary.
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Summary
Korean summary
수두 발생 신고률에 있어 제주도는 전국에 비해 높은 수준을 보이고 있지만, 수둑접종률은 전국과 유사한 수준이다. 이에 2017년 상반기 수두 집단발생에 대응한 2건의 역학조사를 수행한 결과, 33%에서 돌발수두 임상 증상을 보였고 모두 백신 접종력이 있었다. 높은 발생 신고률은 지역사회 소아 개원의들의 높은 신고에 의한 것으로 유추할 수 있으며, 수두 백신 실패에 대한 추후 조사가 필요하다.
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- Seroprevalence and molecular characteristics of varicella-zoster virus infection in Chinese children
Lin Luan, Xiaochen Shen, Jing Qiu, Yang Jing, Jingqi Zhang, Jie Wang, Jun Zhang, Chen Dong BMC Infectious Diseases.2019;[Epub] CrossRef - Cost-effectiveness analysis of universal varicella vaccination in Turkey using a dynamic transmission model
Lara J. Wolfson, Vincent J. Daniels, Matthew Pillsbury, Zafer Kurugöl, Cuneyt Yardimci, Jeffrey Kyle, Ener Cagri Dinleyici, Georges M.G.M. Verjans PLOS ONE.2019; 14(8): e0220921. CrossRef - Incidence of varicella in children in Jeju-do, Korea, 2005-2016: age-period-cohort analysis
Jinhee Kim, Ji-Eun Kim, Jong-Myon Bae Epidemiology and Health.2018; 40: e2018054. CrossRef - Analysis of sero-epidemiological characteristics of varicella in healthy children in Jiangsu Province, China
Lei Zhang, Wang Ma, Yuanbao Liu, Yong Wang, Xiang Sun, Ying Hu, Xiuying Deng, Peishan Lu, Fenyang Tang, Zhiguo Wang, Minghao Zhou BMC Infectious Diseases.2018;[Epub] CrossRef
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Letter to the Editor: Epidemiological characteristics of scrub typhus on the Jeju Island
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Jong-Myon Bae
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Epidemiol Health. 2017;39:e2017060. Published online December 26, 2017
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DOI: https://doi.org/10.4178/epih.e2017060
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- Epidemiological and Clinical Characteristics of Confirmed Cases of Severe Fever With Thrombocytopenia Syndrome in Jeju Province, Korea, 2014-2018
Jinhee Kim, Jong-Myon Bae Journal of Preventive Medicine and Public Health.2019; 52(3): 195. CrossRef
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Comparison of methods of extracting information for meta-analysis of observational studies in nutritional epidemiology
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Jong-Myon Bae
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Epidemiol Health. 2016;38:e2016003. Published online January 11, 2016
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DOI: https://doi.org/10.4178/epih.e2016003
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Abstract
OBJECTIVES A common method for conducting a quantitative systematic review (QSR) for observational studies related to nutritional epidemiology is the “highest versus lowest intake” method (HLM), in which only the information concerning the effect size (ES) of the highest category of a food item is collected on the basis of its lowest category. However, in the interval collapsing method (ICM), a method suggested to enable a maximum utilization of all available information, the ES information is collected by collapsing all categories into a single category. This study aimed to compare the ES and summary effect size (SES) between the HLM and ICM.
METHODS A QSR for evaluating the citrus fruit intake and risk of pancreatic cancer and calculating the SES by using the HLM was selected. The ES and SES were estimated by performing a meta-analysis using the fixedeffect model. The directionality and statistical significance of the ES and SES were used as criteria for determining the concordance between the HLM and ICM outcomes.
RESULTS No significant differences were observed in the directionality of SES extracted by using the HLM or ICM. The application of the ICM, which uses a broader information base, yielded more-consistent ES and SES, and narrower confidence intervals than the HLM.
CONCLUSIONS The ICM is advantageous over the HLM owing to its higher statistical accuracy in extracting information for QSR on nutritional epidemiology. The application of the ICM should hence be recommended for future studies.
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Summary
Korean summary
영양역학과 관련하여 관찰연구 결과를 체계적 고찰을 할 때, 통상적으로 섭취가 가장 낮은 군을 기준으로 하여 가장 높은 군의 effect size (ES) 정보를 추출하는 Highest versus Lowest Method (HLM)을 적용한다. 그러나 주어진 정보를 최대한 활용한다는 점에서 구간의 정보들을 통합한 ES 정보로 메타분석에 적용하는 Interval Collapse Method (ICM)법이 제안되었다. HLM에 비하여 더 많은 정보를 활용한 ICM 적용을 한 결과, ES 뿐만 아니라 SES에서도 일치성을 보이면서 표준오차가 작아지는 현상을 확인하였다. 영양역학의 메타분석을 위해 추출하는 방법 중 정보를 보다 더 많이 활용하는 ICM이 HLM에 비하여 통계적 정확성의 이득을 더 갖기 때문에, 향후 적극 활성화할 필요가 있다.
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Ali Nikparast, Elahe Etesami, Jamal Rahmani, Nazgoli Rafiei, Matin Ghanavati Frontiers in Nutrition.2024;[Epub] CrossRef - The Association Between Overall, Healthy, and Unhealthy Plant-Based Diet Index and Risk of Prediabetes and Type 2 Diabetes Mellitus: A Systematic Review and Dose-Response Meta-Analysis of Prospective Studies
Ali Nikparast, Parmis Mirzaei, Zeinab S Tadayoni, Golaleh Asghari Nutrition Reviews.2024;[Epub] CrossRef - A 7-Step Guideline for Qualitative Synthesis and Meta-Analysis of Observational Studies in Health Sciences
Marija Glisic, Peter Francis Raguindin, Armin Gemperli, Petek Eylul Taneri, Dante Jr. Salvador, Trudy Voortman, Pedro Marques Vidal, Stefania I. Papatheodorou, Setor K. Kunutsor, Arjola Bano, John P. A. Ioannidis, Taulant Muka Public Health Reviews.2023;[Epub] CrossRef - Maternal uric acid levels and risk of gestational diabetes mellitus: A systematic review and dose–response meta‐analysis of cohort studies including 105,380 participants
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Golgis Karimi, Zahra Heidari, Somayyeh Firouzi, Fahimeh Haghighatdoost Nutrition, Metabolism and Cardiovascular Diseases.2020; 30(5): 717. CrossRef - Dietary patterns and frailty: a systematic review and meta-analysis
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A suggestion for quality assessment in systematic reviews of observational studies in nutritional epidemiology
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Jong-Myon Bae
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Epidemiol Health. 2016;38:e2016014. Published online April 26, 2016
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DOI: https://doi.org/10.4178/epih.e2016014
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Abstract
OBJECTIVES It is important to control the quality level of the observational studies in conducting meta-analyses. The Newcastle-Ottawa Scale (NOS) is a representative tool used for this purpose. We investigated the relationship between high-quality (HQ) defined using NOS and the results of subgroup analysis according to study design.
METHODS We selected systematic review studies with meta-analysis which performed a quality evaluation on observational studies of diet and cancer by NOS. HQ determinations and the distribution of study designs were examined. Subgroup analyses according to quality level as defined by the NOS were also extracted. Equivalence was evaluated based on the summary effect size (sES) and 95% confidence intervals computed in the subgroup analysis.
RESULTS The meta-analysis results of the HQ and cohort groups were identical. The overall sES, which was obtained by combining the sES when equivalence was observed between the cohort and case-control groups, also showed equivalence.
CONCLUSIONS The results of this study suggest that it is more reasonable to control for quality level by performing subgroup analysis according to study design rather than by using HQ based on the NOS quality assessment tool.
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Summary
Korean summary
관찰연구에 대한 메타분석을 수행할 때, 선정된 논문들의 질적 수준을 통제하기 위해 개발된 Newcastle-Ottawa Scale (NOS)는 평가 항목의 속성상 환자-대조군연구보다는 코호트 연구에서 High quality (HQ) 판정이 될 가능성이 높다. 이에, 식이와 암의 관련성을 연구한 관찰연구에 대한 메타분석에 있어 대부분의 코호트 연구를 HQ로 판정하였기에, HQ 군과 Cohort 군의 메타분석 결과는 동일하였다. 코호트군과 환자-대조군 간의 summary effect size (sES)가 동질성을 보일 경우 이를 합친 Overall sES 또한 동질성을 보였다. 이에, 식이역학에 특화된 질적평가도구가 개발되기 까지는 NOS를 적용하기 보다는 연구설계별로 하부군 분석을 하는 것을 권한다.
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Reinterpretation of the results of a pooled analysis of dietary carotenoid intake and breast cancer risk by using the interval collapsing method
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Jong-Myon Bae
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Epidemiol Health. 2016;38:e2016024. Published online June 2, 2016
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DOI: https://doi.org/10.4178/epih.e2016024
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Abstract
Summary
PDFSupplementary Material
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Abstract
OBJECTIVES A pooled analysis of 18 prospective cohort studies reported in 2012 for evaluating carotenoid intakes and breast cancer risk defined by estrogen receptor (ER) and progesterone receptor (PR) statuses by using the “highest versus lowest intake” method (HLM). By applying the interval collapsing method (ICM) to maximize the use of the estimated information, we reevaluated the results of the previous analysis in order to reinterpret the inferences made.
METHODS In order to estimate the summary effect size (sES) and its 95% confidence interval (CI), meta-analyses with the random-effects model were conducted for adjusted relative risks and their 95% CI from the second to the fifth interval according to five kinds of carotenoids and ER/PR status.
RESULTS The following new findings were identified: α-Carotene and β-cryptoxanthin have protective effects on overall breast cancer. All five kinds of carotenoids showed protective effects on ER− breast cancer. β-Carotene level increased the risk of ER+ or ER+/PR+ breast cancer. α-Carotene, β-carotene, lutein/zeaxanthin, and lycopene showed a protective effect on ER−/PR+ or ER−/PR− breast cancer.
CONCLUSIONS The new facts support the hypothesis that carotenoids that show anticancer effects with anti-oxygen function might reduce the risk of ER− breast cancer. Based on the new facts, the modification of the effects of α-carotene, β-carotene, and β-cryptoxanthin should be evaluated according to PR and ER statuses.
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Summary
Korean summary
Carotenoids 가 항암기전이 있다면 steroid hormone에 무관한 estrogen receptor negative (ER-) 혹은 progesterone receptor negative (PR-) 유방암의 발생을 억제할 것이란 가설에 따라, 18개의 코호트에 대한 pooled analysis 결과가 2012년도에 발표되었다. 이를 재분석한 결과, 5 종류의 carotenoids 모두 ER- 유방암 억제하는 것을 확인하였다.
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Slaven Jurić, Marina Jurić, Żaneta Król-Kilińska, Kristina Vlahoviček-Kahlina, Marko Vinceković, Verica Dragović-Uzelac, Francesco Donsì Food Reviews International.2022; 38(8): 1735. CrossRef - Is There an Association between β-Carotene and Breast Cancer? A Systematic Review on Breast Cancer Risk
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Dietary intakes of citrus fruit and risk of gastric cancer incidence: an adaptive meta-analysis of cohort studies
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Jong-Myon Bae, Eun Hee Kim
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Epidemiol Health. 2016;38:e2016034. Published online July 25, 2016
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DOI: https://doi.org/10.4178/epih.e2016034
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Abstract
OBJECTIVES In the context of supplementary antioxidants having no anticancer effect, it is important to update the meta-analysis to evaluate whether there is an association between intake of citrus fruit and gastric cancer risk.
METHODS The list of articles to be searched was established using citation discovery tools provided by PubMed and Scopus. The effect size of each article to be used in meta-analysis was calculated using the interval-collapse method. Summary effect size (sES) and 95% confidence intervals (CI) were obtained by conducting this meta-analysis. Random effect dose–response meta-regression (DRMR) was performed to investigate the dose–response relationship.
RESULTS A total of five cohort studies were selected. The result was 13% reduction of gastric cancer according to the intake of citrus fruit (sES, 0.87; 95% CI, 0.76 to 0.99; I-squared=69.6%). In subgroup analysis, it was found that the intake of citrus fruit inhibited cardia gastric cancer (CGC) (sES, 0.67; 95% CI, 0.55 to 0.81; I-squared=46.1%) and as a result of DRMR, 100 g of citrus fruit intake per day inhibits CGC by 40% (relative risk, 0.60; 95% CI, 0.44 to 0.83).
CONCLUSIONS It is suggested that the intake of citrus fruit inhibits the development of CGC. This conclusion can be used as a primary prevention measure in the future when the incidence of CGC may be on the rise.
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Summary
Korean summary
항산화제 첨가제가 항암효과가 없다는 결론이 난 상황에서, 감귤섭취가 위암발생을 억제한다는 기존의 체계적 고찰연구에 대한 갱신 메타연구를 수행하였다. PubMed와 Scopus에서 제공하는 citation discovery tools를 활용하여 총 5편의 코호트 연구 논문을 선정하였다. 감귤섭취에 따라 위암발생을 13% 억제하며 (sES=0.87, 95% CI: 0.76-0.99, I-squared: 69.6%), 특히 위문부 위암을 억제한다고 나왔다 (sES= 0.67, 95% CI: 0.55-0.81, I-squared=46.1%), 또한, 하루 100 gram 감귤섭취를 하면 CGC 를 40% 억제하는 것으로 나왔다 (RR=0.60, 95% CI: 0.44-0.83).
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Parameter estimation without confidence intervals?
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Jong-Myon Bae
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Epidemiol Health. 2016;38:e2016036. Published online August 18, 2016
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DOI: https://doi.org/10.4178/epih.e2016036
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Meta-analysis for genome-wide association studies using case-control design: application and practice
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Sungryul Shim, Jiyoung Kim, Wonguen Jung, In-Soo Shin, Jong-Myon Bae
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Epidemiol Health. 2016;38:e2016058. Published online December 18, 2016
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DOI: https://doi.org/10.4178/epih.e2016058
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4
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Abstract
This review aimed to arrange the process of a systematic review of genome-wide association studies in order to practice and apply a genome-wide meta-analysis (GWMA). The process has a series of five steps: searching and selection, extraction of related information, evaluation of validity, meta-analysis by type of genetic model, and evaluation of heterogeneity. In contrast to intervention meta-analyses, GWMA has to evaluate the Hardy–Weinberg equilibrium (HWE) in the third step and conduct meta-analyses by five potential genetic models, including dominant, recessive, homozygote contrast, heterozygote contrast, and allelic contrast in the fourth step. The ‘genhwcci’ and ‘metan’ commands of STATA software evaluate the HWE and calculate a summary effect size, respectively. A meta-regression using the ‘metareg’ command of STATA should be conducted to evaluate related factors of heterogeneities.
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Summary
Korean summary
오늘날 활발히 수행되고 있는 유전체역학연구는 재현성의 문제, 대상자 크기의 한계 등으로 유전체 메타분석 연구가 요구되고 있다. 유전체 메타분석의 전반적인 수행 단계는 약물, 수술 등의 중개연구의 메타분석처럼 5 단계를 밟아 수행된다. 그러나, 유전체 메타분석은 3번째 과정에서 Hardy–Weinberg equilibrium (HWE) 검정과 4번째 과정에서 5가지 가능한 유전형 모델에 따라 메타분석이 이루어진다는 점에서 중개연구의 메타분석과 차이가 있다.
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Overdiagnosis: epidemiologic concepts and estimation
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015004. Published online February 10, 2015
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DOI: https://doi.org/10.4178/epih/e2015004
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Abstract
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Abstract
Overdiagnosis of thyroid cancer was propounded regarding the rapidly increasing incidence in South Korea. Overdiagnosis is defined as ‘the detection of cancers that would never have been found were it not for the screening test’, and may be an extreme form of lead bias due to indolent cancers, as is inevitable when conducting a cancer screening programme. Because it is solely an epidemiological concept, it can be estimated indirectly by phenomena such as a lack of compensatory drop in post-screening periods, or discrepancies between incidence and mortality. The erstwhile trials for quantifying the overdiagnosis in screening mammography were reviewed in order to secure the data needed to establish its prevalence in South Korea.
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Summary
Korean summary
최근 갑상선암의 발생 증가는 과진단에 기인한 것이란 주장이 제기되었다. 과진단은 ‘평생동안 몰랐을 암을 검진으로 알아낸 경우’로 정의하는 바, 예상보다 늦은 진행으로 예후가 더 좋고 치료를 안해도 사망률 변동을 만들지 못하는 암에 대하여 반복되는 암검진에 더 잘 진단되는 기간차이 바이어스가 개입되는 것을 제대로 통제하지 못해서 생긴 것이다. 검진을 더 이상 하지 않았을 경우 발생률이 본래대로 되돌아오지 않는 현상을 보이거나, 사망률과 발생률 간의 변동에서 큰 차이를 보일 때 과진단이 있다고 판단한다. 국내에서 발생하는 과진단의 크기를 측정하기 위한 방법들을 알아보기 위하여, 기존의 유방암 조기검진용 유방촬영술에 대한 과진단 크기를 알아낸 연구방법들을 살펴보았다.
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Jong-Myon Bae Epidemiology and Health.2015; 37: e2015018. CrossRef - It needs adaptation to the 2015 Korean guideline for breast cancer screening
Jong-Myon Bae Journal of the Korean Medical Association.2015; 58(9): 833. CrossRef
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The necessity of an observational study on the interactions between allergic history and citrus fruit intake for the prevention of pancreatic cancer
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015028. Published online June 16, 2015
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DOI: https://doi.org/10.4178/epih/e2015028
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19,552
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Abstract
Summary
PDFSupplementary Material
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Abstract
While the main product of Jeju Island is citrus fruit and the prevalence of atopic dermatitis among the students who live there is relatively high, the incidence of pancreatic cancer is lowest in Korea. Systematic reviews reporting allergic history and intake of citrus fruit as protective factors against pancreatic cancer (PCC) were published in 2005 and 2008, respectively. Although there were discrepancies in the results of the subgroup analyses between case-control and cohort studies, it is necessary to evaluate an interaction effect between allergic history and intake of citrus fruits on PCC risk.
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Summary
Korean summary
췌장암 발생과 관련한 요인들의 규명이 절실한 상황에서, 알레르기 질환과 감귤섭취 각각이 발생억제 효과가 있다는 체계적 고찰연구가 있다. 그러나 코호트 연구들만으로 메타분석을 하였을 때는 두 억제 요인 모두 통계적 유의성이 없는 것으로 나왔다. 한편 지역별 췌장암 발생률에서 낮은 수준을 보이는 제주도는 주요 감귤생산지이면서, 초중고등학생의 아토피 유병률이 상대적으로 높은 것으로 알려져 있다. 이런 사실들에 근거할 때 췌장암 발생에 있어 알레르기질환과 감귤섭취의 상호작용을 규명하는 코호트 연구를 제안한다.
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Jong-Myon Bae, Eun Hee Kim Journal of Preventive Medicine and Public Health.2016; 49(2): 129. CrossRef - Hormonal Replacement Therapy and the Risk of Lung Cancer in Women: An Adaptive Meta-analysis of Cohort Studies
Jong-Myon Bae, Eun Hee Kim Journal of Preventive Medicine and Public Health.2015; 48(6): 280. CrossRef - Human papillomavirus infection and risk of lung cancer in never-smokers and women: an ‘adaptive’ meta-analysis
Jong-Myon Bae, Eun Hee Kim Epidemiology and Health.2015; 37: e2015052. CrossRef - Hormone Replacement Therapy and Risk of Breast Cancer in Korean Women: A Quantitative Systematic Review
Jong-Myon Bae, Eun Hee Kim Journal of Preventive Medicine and Public Health.2015; 48(5): 225. CrossRef
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Epidemiological evidences on overdiagnosis of prostate and kidney cancers in Korean
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015015. Published online March 7, 2015
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DOI: https://doi.org/10.4178/epih/e2015015
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Abstract
OBJECTIVES The prostate specific antigen test is widely used as the main method of screening prostate cancer in Korea. Additionally, the use of ultrasound sonography may lead to overdiagnosis of kidney cancer as well as thyroid cancer. This study aimed to highlight epidemiological evidences regarding overdiagnosis of prostate and kidney cancers in Korean.
METHODS The annual trends of national incidence and mortality of prostate and kidney cancers provided by the Korean Statistical Information Service were evaluated.
RESULTS The rate of increase in the incidence of prostate and kidney cancer was 6 and 5 times higher than that of mortality between 2000 and 2011, respectively. Additionally, the age group showing the highest incidence in prostate cancer shifted from 85 years and older to 75-79 years.
CONCLUSIONS This evidence suggests that prostate and kidney cancers are overdiagnosed in Korea. Further research in this area, using national cancer registry databases, should be encouraged to prevent overdiagnosis.
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Summary
Korean summary
갑상선암의 과진단은 목초음파검사의 시행에 따른 것이란 주장에 따라, 전립선암과 신장암은 각각 전립선특이항원검사와 복부초음파검사의 시행에 따라 과진단이 있을 것으로 예상된다. 과진단의 여부는 검사 시행 이후 발생률이 증가하는 반면, 사망률은 변동이 없는 것으로 판단할 수 있다. 통계청의 해당 암 발생률과 사망률 추이를 살펴볼 때, 국내에서도 전립선암과 신장암에서 과진단이 있음을 확인할 수 있었다.
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Development and application of patient decision aids
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015018. Published online April 8, 2015
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DOI: https://doi.org/10.4178/epih/e2015018
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20,139
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Abstract
With the current overdiagnosis of thyroid cancer resulting from routine screening in Korea, it is necessary to educate the public that not all cancers are malignant. The exposure to patient decision aids (PtDAs) compared to usual care reduced the number of people choosing to undergo prostate-specific antigen screening. This article introduces the definition, usefulness, and developmental processes of PtDAs and suggests the urgent need for a Korean PtDA related to thyroid cancer screening.
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Jong-Myon Bae Epidemiology and Health.2017; 39: e2017048. CrossRef - Overdiagnosis across medical disciplines: a scoping review
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Value-based medicine: concepts and application
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015014. Published online March 4, 2015
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DOI: https://doi.org/10.4178/epih/e2015014
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25,307
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Global healthcare in the 21st century is characterized by evidence-based medicine (EBM), patient-centered care, and cost effectiveness. EBM involves clinical decisions being made by integrating patient preference with medical treatment evidence and physician experiences. The Center for Value-Based Medicine suggested value-based medicine (VBM) as the practice of medicine based upon the patient-perceived value conferred by an intervention. VBM starts with the best evidence-based data and converts it to patient value-based data, so that it allows clinicians to deliver higher quality patient care than EBM alone. The final goals of VBM are improving quality of healthcare and using healthcare resources efficiently. This paper introduces the concepts and application of VBM and suggests some strategies for promoting related research.
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Korean summary
21세기 의학은 근거기반, 환자중심, 비용효과적인 의료를 지향하고 있다. 근거기반의학은 의사결정에 있어 최선의 의학적 근거를 기반으로 하려는 패러다임이다. 이런 근거기반의학에 더하여 환자의 가치를 치료 결정에 적극 반영하기 위하여 가치기반의학이 제기되었다. 가치기반의학은 최선의 근거에 따라 진료를 하면서도 의료자원을 효율적으로 사용하도록 만들어서, 궁극적으로 한 나라의 보건의료의 질적 향상을 도모하게 한다. 본 논문의 목적은 가치기반의학의 개념을 소개하고 관련 연구의 활성화를 위한 전략적 제언을 하는 것이다.
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Human papillomavirus 16 infection as a potential risk factor for prostate cancer: an adaptive meta-analysis
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015005. Published online February 11, 2015
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DOI: https://doi.org/10.4178/epih/e2015005
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Abstract
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Abstract
OBJECTIVES Although an expert review published in 2013 concluded that an association between human papillomavirus (HPV) infection and prostate cancer (PCa) risk had not yet been firmly established, a 2011 systematic review of 14 articles revealed an increased prevalence of HPV-16 DNA in PCa tissues. Another meta-analysis of the related articles is needed to evaluate the potential link between HPV infection and PCa risk.
METHODS A snowballing search strategy was applied to the previously cited articles in the above-mentioned expert review and systematic review. Additional articles selected for this meta-analysis should fulfill all following inclusion criteria: (a) evaluation of detected HPV-16 DNA in tissue samples and the PCa risk and (b) report of the HPV-16 prevalence in both cancer and control tissues. Estimated summary odds ratios (sOR) with 95% confidence intervals (CI) were calculated using fixed effect or random-effect models.
RESULTS Hand searching identified 16 new articles. The sOR of the total 30 articles indicated a significant HPV-16 infection-related increase in the PCa risk (sOR, 1.851; 95% CI, 1.353 to 2.532, I2=37.82%).
CONCLUSIONS These facts provide additional supportive evidence for a causal role of HPV-16 infection in prostate carcinogenesis. As the PCa incidence rates have increased rapidly in Asian countries, including Korea, during the last several decades, further studies of HPV-related PCa carcinogenesis may be necessary.
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Summary
Korean summary
전립선암의 교정가능한 위험요인으로 만성재발성 염증을 야기하는 HPV 감염이 주목받고 있다. 지금까지의 체계적 고찰과 전문가 종설은 뚜렷한 인과성이 없다고 결론내고 있다. 이에 새로이 발표된 관련 논문들을 확보하여 메타분석을 다시 수행하였다. 총 30개의 대상논문에 대한 메타분석을 시행하였을 때, HPV 16 감염이 위험요인임을 확인하였다. (sOR = 1.851, 95% CI: 1.353 – 2.532, I2=37.82%).
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Surveillance operation for the 141st confirmed case of Middle East Respiratory Syndrome coronavirus in response to the patient’s prior travel to Jeju Island
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015035. Published online August 7, 2015
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DOI: https://doi.org/10.4178/epih/e2015035
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18,867
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Abstract
The provincial government of Jeju, South Korea, was notified that a 42-year-old man infected with the Middle East Respiratory Syndrome (MERS) coronavirus had gone sightseeing in Jeju Island. Although the visiting period might be interpreted as the incubation period of MERS, the province decided to conduct active surveillance to prevent a worst-case scenario. Based on the channel of movement of the patient, healthy isolation and active monitoring were conducted for persons who came in contact with the patient. During the active surveillance, none of the 56 persons in self-isolation and 123 persons under active monitoring became infected. This fact supports that MERS is not contagious during the incubation period.
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Summary
Korean summary
141번 MERS 양성확진자에 대한 역학조사를 통해 잠복기간에 제주도를 여행한 것이 확인되었다. 이에 제주도 MERS 방역본부는 최악의 경우를 염두에 두고, 밀접접촉자 56명과 일상접촉자 123명을 각각 자택격리와 능동모니터링 대상자로 조치하였다. 잠복기 14일을 기준으로 감시체계를 운영하였지만, 양성감염자는 전무하였다. 이는 MERS의 잠복기 동안에는 감염력이 없다는 근거가 된다.
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Moonkyong Hwang, Jong-Myon Bae Journal of Preventive Medicine and Public Health.2021; 54(4): 245. CrossRef - A database of geopositioned Middle East Respiratory Syndrome Coronavirus occurrences
Rebecca E. Ramshaw, Ian D. Letourneau, Amy Y. Hong, Julia Hon, Julia D. Morgan, Joshua C. P. Osborne, Shreya Shirude, Maria D. Van Kerkhove, Simon I. Hay, David M. Pigott Scientific Data.2019;[Epub] CrossRef
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“The Duty to Prevent” during an epidemic situation like 2015 Korean MERS outbreak
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015037. Published online August 15, 2015
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DOI: https://doi.org/10.4178/epih/e2015037
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15,553
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Abstract
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Summary
Korean summary
2015년 6월 초에 중동호흡기증후군이 지역사회 유행으로 진행될 우려에 따라, 예방의학 전공의들까지 역학조사에 참여하게 되었다. 이 과정에서 조사자의 감염에 대한 우려가 제시되었다. 이에 예방의학 전문가로서 ‘예방 의무”에 대한 윤리적 성찰을 제시하였다.
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- Effects of operational decisions on the diffusion of epidemic disease: A system dynamics modeling of the MERS-CoV outbreak in South Korea
Nina Shin, Taewoo Kwag, Sangwook Park, Yon Hui Kim Journal of Theoretical Biology.2017; 421: 39. CrossRef - Identifying determinants of heterogeneous transmission dynamics of the Middle East respiratory syndrome (MERS) outbreak in the Republic of Korea, 2015: a retrospective epidemiological analysis
Hiroshi Nishiura, Akira Endo, Masaya Saitoh, Ryo Kinoshita, Ryo Ueno, Shinji Nakaoka, Yuichiro Miyamatsu, Yueping Dong, Gerardo Chowell, Kenji Mizumoto BMJ Open.2016; 6(2): e009936. CrossRef - Epidemiology and challenges on the Middle East respiratory syndrome coronavirus (MERS-CoV) outbreak in Korea, 2015
Moo-Sik Lee Korean Journal of Health Education and Promotion.2015; 32(3): 1. CrossRef
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Modifiable risk factors of lung cancer in “never-smoker” women
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Jong-Myon Bae
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Epidemiol Health. 2015;37:e2015047. Published online October 29, 2015
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DOI: https://doi.org/10.4178/epih/e2015047
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20,093
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Abstract
Korean women with a history of never smoking and with adenocarcinoma showed an increasing trend in lung cancer occurrence during 2002 to 2012. The two modifiable factors of never-smoker lung cancer in women are hormone and oncogenic virus infection. Based on previous studies, hormone replacement therapy (HRT) and human papillomavirus (HPV) infection might afford protection or be a risk factor, respectively. It is necessary to perform a pooled analysis of cohort studies to evaluate HRT and never-smoker lung cancer in women and a systematic review of case-control studies to determine the association between HPV infection and never-smoker lung cancer.
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Summary
Korean summary
2002년에서 2012년간 폐암 통계를 살펴보면 비흡연 여성에서 선암종의 발생이 크게 증가하는 것으로 확인된다. 이렇게 여성에서 비흡연 폐암발생과 관련한 요인들로는 호르몬 대체요법 (HRT)과 인유두종바이러스 (HPV) 감염이 알려져 있다. 환자-대조군연구를 이용한 메타분석에 따르면 호르몬대체요법은 폐암발생을 억제하는 것으로 나왔다. HPV에 대한 메타분석은 아직 없는 가운데 위험요인으로 의심하고 있다. 따라서 HRT에 대하여는 코호트 연구 결과를 이용한 연합분석 (pooled analysis)이 필요하며, HPV에 대하여는 환자-대조군연구 결과를 이용한 메타분석이 수행될 필요가 있다.
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Human papillomavirus infection and risk of lung cancer in never-smokers and women: an ‘adaptive’ meta-analysis
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Jong-Myon Bae, Eun Hee Kim
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Epidemiol Health. 2015;37:e2015052. Published online November 17, 2015
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DOI: https://doi.org/10.4178/epih/e2015052
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Abstract
OBJECTIVES The incidence of lung cancer in Koreans is increasing in women and in both men and women with a never-smoking history. Human papillomavirus (HPV) infection has been suggested as a modifiable risk factor of lung cancer in never-smokers and women (LCNSW). This systematic review (SR) aimed to evaluate an association between HPV infection and lung cancer risk in LCNSW.
METHODS Based on a prior SR and some expert reviews, we identified refereed, cited, or related articles using the PubMed and Scopus databases. All case-control studies that reported the odds ratio of HPV infection in LCNSW were selected. An estimate of the summary odds ratio (SOR) with 95% confidence intervals (CI) was calculated.
RESULTS A total of four case-control studies were included. The fixed-effect model was applied because of homogeneity (I-squared=0.0%). The SORs in women and in never-smokers were 5.32 (95% CI, 1.75 to 16.17) and 4.78 (2.25 to 10.15) respectively.
CONCLUSIONS These results showed a significant effect of HPV infection in LCNSW. It is evident that developing a preventive plan against LCNSW may be necessary.
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The clinical decision analysis using decision tree
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Jong-Myon Bae
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Epidemiol Health. 2014;36:e2014025. Published online October 30, 2014
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DOI: https://doi.org/10.4178/epih/e2014025
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Abstract
The clinical decision analysis (CDA) has used to overcome complexity and uncertainty in medical problems. The CDA is a tool allowing decision-makers to apply evidence-based medicine to make objective clinical decisions when faced with complex situations. The usefulness and limitation including six steps in conducting CDA were reviewed. The application of CDA results should be done under shared decision with patients’ value.
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Distribution of dense breasts using screening mammography in Korean women: a retrospective observational study
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Jong-Myon Bae, Sang Yop Shin, Eun Hee Kim, Yoon-Nam Kim, Chung Mo Nam
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Epidemiol Health. 2014;36:e2014027. Published online November 4, 2014
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DOI: https://doi.org/10.4178/epih/e2014027
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Abstract
OBJECTIVES This retrospective observational study evaluated the distribution of dense breasts by age group among healthy Korean women.
METHODS Participants were women aged 30 years and older who voluntarily underwent screening mammography between January 2007 and December 2011. Women who received the Breast Imaging Reporting and Data System for mammographic density of 3 or 4 were defined as having dense breasts. The proportion of women with dense breasts (PDB, %) was calculated by dividing the number of participants with dense breasts by the total number of participants.
RESULTS Among the 231,058 women who participated, 78.15% were classified as having dense breasts. PDB was highest in the youngest age group (PDB=94.87%) and lowest in the oldest age group. The greatest difference in PDB between adjacent age groups was observed in the group aged 60-64 years.
CONCLUSIONS The results show that the proportion of dense breasts by age group increased in all age groups, except in those aged 35-39 years. These findings suggest an association between the age distribution of dense breasts and trends in breast cancer incidence. Further studies are needed to estimate the change in breast cancer incidence rate by age and the accumulation of fatty breast tissue in Korean women.
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Narrative reviews
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Jong-Myon Bae
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Epidemiol Health. 2014;36:e2014018. Published online September 11, 2014
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DOI: https://doi.org/10.4178/epih/e2014018
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25,309
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Abstract
Summary
PDFSupplementary Material
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Abstract
Although qualitative researches (QR) are invaluable in understanding complex healthcare situations, the quantitative systematic reviews could not treat them. To improve quality of healthcare services, results of QR should be considered in healthcare decision-making processes. Several methods and theories for synthesizing evidences of QR have been developed. In order to activate the narrative reviews and mixed methods reviews in Korean healthcare academies, I arranged the related nomenclatures and suggested some issues to conduct them.
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Summary
Korean summary
질적연구는 보건의료의 복잡성을 이해하는데 매우 유용함에도 불구하고, 메타분석을 수행하는 체계적 고찰에서는 다루어지지 않는다. 그렇지만 보건의료의 질적 향상을 도모하려면 질적 연구의 결과를 보건의료 결정과정에서 반영해야 한다. 질적 연구 결과들을 합성하려는 여러 시도들이 있어온 것을 요약하고, 관련한 용어들을 정리하여 질적연구와 이를 합성하는 서술적 고찰이 활성화되는 바탕을 마련코자 한다.
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Meta-epidemiology
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Jong-Myon Bae
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Epidemiol Health. 2014;36:e2014019. Published online September 25, 2014
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DOI: https://doi.org/10.4178/epih/e2014019
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20,928
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200
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12
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Abstract
The concept of meta-epidemiology has been introduced with considering the methodological limitations of systematic review for intervention trials. The paradigm of meta-epidemiology has shifted from a statistical method into a new methodology to close gaps between evidence and practice. Main interest of meta-epidemiology is to control potential biases in previous quantitative systematic reviews and draw appropriate evidences for establishing evidence-base guidelines. Nowadays, the network meta-epidemiology was suggested in order to overcome some limitations of meta-epidemiology. To activate meta-epidemiologic studies, implementation of tools for risk of bias and reporting guidelines such as the Consolidated Standards for Reporting Trials (CONSORT) should be done.
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Summary
Korean summary
질적연구는 보건의료의 복잡성을 이해하는데 매우 유용함에도 불구하고, 메타분석을 수행하는 체계적 고찰에서는 다루어지지 않는다. 그렇지만 보건의료의 질적 향상을 도모하려면 질적 연구의 결과를 보건의료 결정과정에서 반영해야 한다. 질적 연구 결과들을 합성하려는 여러 시도들이 있어온 것을 요약하고, 관련한 용어들을 정리하여 질적연구와 이를 합성하는 서술적 고찰이 활성화되는 바탕을 마련코자 한다.
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Two hypotheses of dense breasts and viral infection for explaining incidence of breast cancer by age group in Korean women
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Jong-Myon Bae
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Epidemiol Health. 2014;36:e2014020. Published online September 26, 2014
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DOI: https://doi.org/10.4178/epih/e2014020
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22,521
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Abstract
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Abstract
Breast cancer, the second leading type of cancer in Korean women, has shown increasing incidence over the past 10 years. However, the curves of incidence by age group cast doubt on the birth cohort effect hypothesis. To explain the curves, here I suggest two alternative hypotheses of breast density and viral infection based on pre-existing evidences. Evaluating these hypotheses would require important clues to find unknown risk factors of breast cancer and to plan more effective strategies for breast cancer control in Korean women.
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Summary
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Citations
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An overview of systematic reviews of diagnostic tests accuracy
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Jong-Myon Bae
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Epidemiol Health. 2014;36:e2014016. Published online August 29, 2014
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DOI: https://doi.org/10.4178/epih/e2014016
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22,454
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14
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Abstract
Summary
PDFSupplementary Material
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Abstract
The Cochrane Collaboration says that the Cochrane handbook for diagnostic test accuracy reviews (DTAR) is currently in development as per the Cochrane Collaboration. This implies that the methodology of systematic reviews (SR) of diagnostic test accuracy is still a matter of debate. At this point, comparison of methodologies for SR in case of interventions as against diagnostics would be helpful to understand DTAR.
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Summary
Korean summary
코크란연합은 진단검사의 정확도 평가를 위한 방법론을 현재 개발 중이라고 한다. 이는 해당 방법론 개발에 있어 적극적인 이해가 있어야 한다는 뜻이다. 진단검사의 정확도 평가를 위한 체계적 고찰 수행에 관한 내용을 보다 쉽게 이해하기 위하여, 이미 정립되어 적극 활용되고 있는 개입효과 평가를 위한 체계적 고찰의 수행 과정별로 비교하여 살펴보았다.
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Methodological issues for determining intervals of subsequent cancer screening
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Jong-Myon Bae
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Epidemiol Health. 2014;36:e2014010. Published online July 30, 2014
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DOI: https://doi.org/10.4178/epih/e2014010
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19,775
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143
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5
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5
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Abstract
Summary
PDFSupplementary Material
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Abstract
The gap between nationwide recommendations of cancer screening and the related evidences obtained from Korean adults should be filled. Estimation of the mean sojourn time (MST) in a specific cancer is important to determine the intervals of subsequent screening. This author arranged the methods for calculating MST into 5 categories based on the parameters used. Under the legal barrier for protection of individual privacy and confidentiality in a Korean academic situation, the methods involving the use of transition rates or prevalence/incidence ratio would be applicable among these methods.
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Summary
Korean summary
국가 암조기 검진사업에서 제시하는 검진지침은 우리나라 국민을 대상으로 한 역학연구 결과에 근거하여 개발해야 한다. 특정 암에 대한 조기검진 지침에는 검진방법, 시작 및 종료 연령과 함께 검사 주기를 담아야 한다. 이중 반복검사의 간격은 해당 암의 평균체류기간을 산출하여 결정한다. 저자는 특정 암의 평균체류기간을 구하는 방법을 5가지로 분류하여 제시하였다. 또한 현재 개인정보 보호를 강조하는 여건에서 수행이 가능한 방법을 검토하였다.
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- Quantifying the duration of the preclinical detectable phase in cancer screening: a systematic review
Sandra M. E. Geurts, Anne M. W. M. Aarts, André L. M. Verbeek, Tony H. H. Chen, Mireille J. M. Broeders, Stephen W. Duffy Epidemiology and Health.2022; 44: e2022008. CrossRef - Baseline and annual repeat rounds of screening: implications for optimal regimens of screening
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