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Volume 12 (2); December 1990
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Korean J Epidemiol. 1990;12(2):223-225.
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List
List of membership
Korean Society of Epidemiology
Korean J Epidemiol. 1990;12(2):217-222.
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Article
Articles of association
Korean Society of Epidemiology
Korean J Epidemiol. 1990;12(2):216-216.
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Special Articles
Usefulness of epidemiologic study data obtained by joint survey with 6th National Tuberculosis Prevalence Survey
Joung Soon Kim
Korean J Epidemiol. 1990;12(2):211-215.
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Mortality of Koreans in the fourth decade of age
Il Soon Kim, Sun Ha Jee, Hee Choul Oh, Il Suh
Korean J Epidemiol. 1990;12(2):191-210.
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Abstract
The Mortality experience among Koreans in their forties during the past eight yeasrs was compared to the countries, of Singapore, Czechoslovakia, Hungary, Poland, U.S.A.,U.K., Japan, and Germany in order to determine the mortality status and structure of Koreans in the fifth decade of age. The major findings are as follows ; 1. The age — specific and sex — specific death rates of Koreans showed a continuous decrease during the past eight years. When compared to other countries, the death rate among males in Korea was similar to or lower than the rate in the developing countries but higher than the rate in the developed countries. On the other hand, there was no significant difference in death rates among females compared with the developed countries. 2. When comparing the causes of death among Koreans with the Japanese, infections disease was 3.4 — 4.5 times greater and chronic non—infectious desease was 1.5 — 2.1 times greater, for both sexes. Pulmonary tuberculosis was 30 times higher for males in their twenties to fities, and hepatic carcinoma and gastric carcinoma were 4 一 7 times and 1.5 — 2 times higher, respectively, for males in their thirties to forties. The higher death rates among Koreans compared with the developed countries are attributed to infectious disease, hepatic carcinoma, and gastric carcinoma, which have decreased in recent years. In conclusion, the death rates of Koreans in their forties are higher compared with the developed countries but lower compared to the developing countries, along the lines of socioeconomic achievement.
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Original Articles
A study on the behavioral determinants of compliance with health screening of some urban people
Hyun Chang Moon, Yong Tae Yum, Myung Sook Lee
Korean J Epidemiol. 1990;12(2):184-190.
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Abstract
The government has implemented primary health service programs in several target areas of Seoul. One of them was established in Guro 6 Dong for which Korea University provided consultant services. This research was conducted to explore preventive health behavior which was one of the special programs performed in Guro Project. The data were collected by conducting free health screening examinations for married women and interviews with 688 participants and 429 non-participants on motives for participation and reasons of non-participation. The survey included the evaluation of behavioral determinants such as health concerns, benefits, barriers and of others. The results were as follows. 1. Majority of participants (74.4%) expressed that confirmation of their good health was the reason for participating in the health screening program. These people had no subjective symptoms. 2. Majority of nonparticipants gave lack of free time as their reason for nonparticipation in the health screening program. Among these people, 78.1% had no known symptoms and 14.0% complained of some ill health. 3. As a part of preventive health action, health belief study was carried out to reveal that both of health concern and benefit components were higher in participants as well as the barrier of hospital time, barriers of hospital cost and procedure components of barriers.
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Cost-benefit analysis of the hepatitis B prevention program in Korea
Kong Kyun Ro, Kwan Ki Min, So Young Cho
Korean J Epidemiol. 1990;12(2):165-183.
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Abstract
This study has been conducted to evaluate the efficiency of a Hepatitis B prevention program in Korea. The major program policy for the prevention is to interrupt vertical transmission of Hepatitis B virus from mother to newborn baby. The efficiency is measured by analysing cost-benefit ratio based on human capital and prevalance rate approaches. Cost for the program is determined by price of the HBV vaccine in the year of 1987,and the direct and indirect costs are calculated by the expenses involved in treating the patient and losses caused by work-days lost and death repsectively. The cost-benefit has been estimated from the low of 0.28 to the high of 6.43 depending on what prevalance rate and discount rate is used. For the suspected HBV carriers only, the ratio is estimated to be less than one. But the cost-benefit ratio estimated for all population exceeds one whatever discount ratios may have been used. In conclusion, the prevention program is recommended for implementation for comprehensive targets, i. e., for all mothers and their newborn babies. The selection of discount rate should be studied further since it significantly influences the result of analysis.
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A study on the effect of noise exposure to the health of a population
Sung Il Cho, Joung Soon Kim, Hyun Sul Lim, Hae Kwan Cheong, Byung Soon Choi
Korean J Epidemiol. 1990;12(2):153-164.
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Abstract
For the purpose of evaluating the effect of noise exposure to the health of a population in a village near an air force shooting practice site, a cross-sectional study was conducted from April 1 to April 23 in 1989, on the inhabitants of the village as exposed group and on the population of another provincial village as nonexposed group, which was similar to the exposed in socioeconomic status but had not been exposed to the environmental noise. Subjective symptoms, pulse rate, blood pressure, and pure tone thresholds were compared in the exposed group and the nonexposed group. 150 and 93 subjectes studied were analyzed in each group. The results were as follows : 1) There was a significant difference between the two groups in the frequency of subjective symptoms including otalgia, hearing loss, tinnitus, ear fullness, nausea, diarrhea, indigestion, and anxiety. 2) There was no significant difference between the two groups in average pulse rate, while significant differences were seen in average systolic and diastolic arterial blood pressures, which were 138± 23.2mmHg and 84.5±14.4mmHg in the exposed group and 126.8±19.3mmHg and 73.8±11.3mmHg in the nonexposed group. The prevalence of hypertension by WHO criteria was 24.0% in the exposed group and 8.6% in the nonexposed group, of which difference was statistically significant. 3) There was no significant difference between the two groups in average hearing loss value, while the prevalence of hearing impairment in the exposed and the nonexposed group was 24.0% and 13.4% each according to the criteria of 500, 1000, 2000Hzx pure tone average greater than 26dB, showing a significant difference between the two groups. 4) As the duration of residence increased the hearing loss value increased in the exposed group, but age-corrected percentage hearing loss did not show any increase ; further study may be necessary to determine whether the significantly high prevalence of hearing loss in the exposed group was due to the environmental noise exposure.
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Disease pattern of Korean aged population
Joung Soon Kim
Korean J Epidemiol. 1990;12(2):144-152.
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Abstract
The proportion of aged population among Koreans had been relatively low till 1970's. The percent of the age group older than 65 years was 3.5% in 1975, 4.6% in 1989 and estimated to be around 6.4% in the year 2000. This stydy was done by reviewing mortality and morbidity data of the group to identify some major diseases that lead them to deaths and make suffer them from for the specified age group. Leading causes of deaths among the aged population in 1988 were cerebro-vascular diseases, hypertensive diseases, malignant neoplasm of stomach, cardiac dysrhythmia, and chronic obstructive lung diseases ; senility as cause of death increased in its frequency as age advanced. On the other hand, the five most frequent disease among the group for which they have utilized medical facilities were diseases of musculoskeletal system and connective tissues, hypertensive diseases, diseases of nervous system, diseases of ear and mastoid process, and dislocation, sprain and strains for male ; diseases of musculoskeletal system and connective tissues, hypertensive diseases, dislocation, sprain and strains, and diseases of nervous system for females. Detailed information is presented in tables.
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A study on validity and usefulness of various tests for mass screening of diabetes mellitus
Joung Soon Kim, Soon Gyu Yun
Korean J Epidemiol. 1990;12(2):137-143.
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Abstract
This study was carried out to determine validity and usefulness of various tests for mass screening of diabetes mellitus prior to the national diabetes mellitus prevalence survey. The tests studied include capillary blood sugar value measured by Glucometer II in comparison with verified Oxidase method, validity of fasting blood sugar and 2hrs. postprandial blood sugar and urine sugar test by uristix(Ames Co.),and usefulness of some risk factors as a screening tool. The results obtained are as follows : 1. Capillary blood sugar values measured by Glucometer II showed 0.872 correlation coefficient with the values measured by oxidase method : the Glucometer II measurement of blood sugar appeared to be very useful, particularly in a field survey, owing to its high validity and its technical simplicity. 2. The sensitivity and the specificity of fasting blood sugar based on WHO diagnostic criteria (FBS : ≥ 120 mg/dl and 2hr. PPBS ≥ 200mg/dl) was 100% and 93.3% respectively. On the other hand these of 2hr. PPBS were all 100%. Therefore it would be most valid and economic for diabetes mass survey if ≥ 120mg/dl FBS is used for screening and then confirmed by ≥ 200mg/dl 2hr. PPBS. 3. Urine sugar test was neither sensitive nor specific enough to be useful in diabetes screening. 4. Risk factors such as family history of diabetes mellitus, overweight or obesity and sex did not show strong association with the presence of diabetes mellitus so as to discriminate or select out diabetics from nondiabetic normal population. 5. More deterministic conclusion may be expected when over 20,000 subjects studied are analyzed.
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Controversy
Coffee consumption and coronary heart disease
Kwang Ho Meng
Korean J Epidemiol. 1990;12(2):131-136.
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Abstract
The high prevalence of coffee drinking and of coronary heart disease in many countries has led to studies of coffee use as a possible coronary disease risk factor, with conflicting results. A possible link between coffee consumption and coronary heart disease was first hypothesized by a longitudinal study of heart disease in Chicago in 1963. Since then, there have been many case-control and prospective epidemiological studies supporting the hypothesis. However, the positive association between coffee consumptions and coronary heart disease was contradicted by many other epidemiological studies. Differences in research methods, selection of case and control subjects, type of coffee consumed and brewing process, and amounts normally drunk are often cited as possible reasons for the discordance among the studies. This paper summarizes the results of those conflicting studies resulted in positive and negative associations between coffee consumption and coronary heart disease, and discusses the reasons for the differences.
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Reviews
A review of test for trend : score tests and likelihood ratio tests using linear logistic model and log-linear model with computer programs
Keun Young Yoo
Korean J Epidemiol. 1990;12(2):115-130.
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Abstract
Evidence of a dose-response effect is fundamental in making a causal interpretation of an association in epidemiological research. The analysis method known as tests for trend includes score test methods used in traditional analysis, as well as logistic models, which have been widely used since they were proposed in the 1960s, and the likelihood ratio for testing a hypothesis using a log-linear model. Although the score test method using Pearson statistics involves relatively simple calculations, it becomes complicated when adjusting for multiple variables and becomes practically impossible for the qualitative analysis of continuous variables. However, more powerful and diverse dose-response effect analyses are possible if linear models are used. In fact, it is possible to adjust for the effects of multiple variables simultaneously, test for the qualitative associations of a specific variable, and investigate and adjust for the effect of variables that show a proxy effect or interactions with that specific variable in testing the linear trend. Moreover, using such models has the advantage of eliminating randomly selected exposure levels, which can give rise to statistical bias and inconsistency. In this review, we present the theoretical background of conventional score test methods and their application in assessing dose-response relationships, the theoretical aspects and methods of interpreting the results of trend analysis using logistic models, and practical procedures with examples using log-linear models for trend analysis. Programs for SAS and the GLIM statistical package are also included to assist in the application of these methods.
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Research methodology in medical studies
Yoon Ok Ahn, Hyung-gi Lee
Korean J Epidemiol. 1990;12(2):107-114.
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Abstract
Research methodology in medical studies has seldom been touched upon in Korea. The curricula on research methodology in the postgraduate or residential training courses have been adopted by few medical schools/societies for medical science. So, actually most of the medical researchers in Korea have learned about study nethodology by themselves through doing researches. In this paper, the authors emphasize the important role of methodology itself in science advancement. The development and evolution in philosophical thinking about scientific methods e.g. deduction, induction, falsificationism, post-positivism, and activity theory were reviewed. Methodological issues in medical science must be more important and subtle than in other sciences, because the primary material of medical researches is the living human. Biostatistical techniques and probability theories should be some essential parts of the pillars in medicine. The authors suggest that Korean societies for medical science should pay attention to the research methodology itself, and have more frequent and active arguementations on research methodology which is an indispensable activities in science.
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Contents
Contents
Editorial department
Korean J Epidemiol. 1990;12(2):105-106.
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Epidemiol Health : Epidemiology and Health