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Original article
Changes in metabolic syndrome and risk of breast and endometrial cancers according to menopause
Thi Xuan Mai Tran, Soyeoun Kim, Boyoung Park
Epidemiol Health. 2023;e2023049.   Published online May 1, 2023
DOI: https://doi.org/10.4178/epih.e2023049    [Accepted]
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AbstractAbstract
Abstract
Objectives
This study investigated how changes in metabolic syndrome (MetS) are associated with the subsequent risk of breast and endometrial cancer according to menopausal status.
Methods
This cohort study, using data from the National Health Insurance Service database, included women aged ≥40 years who underwent 2 biennial cancer screenings (2009–2010 and 2011–2012) and were followed up until 2020. Participants were grouped into MetS-free, MetS-recovery, MetS-development, and MetS-persistent groups. Menopausal status (premenopausal, perimenopausal, and postmenopausal) was assessed at 2 screenings. Cox proportional hazard regression was used to assess the association between MetS changes and cancer risk.
Results
In 3,031,980 women, breast and endometrial cancers were detected in 39,184 and 4,298, respectively. Compared with the MetS-free group, those who recovered, developed, or had persistent MetS showed an increased risk of breast cancer, with adjusted hazard ratios (aHRs) of 1.05, 1.05, and 1.11, respectively (p<0.005). MetS persistence was associated with an increased risk of breast cancer in postmenopausal women (aHR=1.12, 95% CI, 1.08–1.16) but not in premenopausal or perimenopausal women. MetS persistence was associated with an increased risk of endometrial cancer in premenopausal, perimenopausal, and postmenopausal women, with aHRs of 1.41 (95% CI, 1.17–1.70), 1.59 (95% CI, 1.19–2.12), and 1.47 (95% CI, 1.32–1.63), respectively.
Conclusions
Increased breast cancer risk was associated with recovered, developed, and persistent MetS in postmenopausal women. Meanwhile, increased endometrial cancer risk was found in obese women who recovered from MetS or persistently had MetS, regardless of menopausal status, when compared to MetS-free women.
Summary
Korean summary
Key Message
Erratum
Erratum: Trends in gastrointestinal infections before and during non-pharmaceutical interventions in Korea in comparison with the United States
Soyeoun Kim, Jinhyun Kim, Bo Youl Choi, Boyoung Park
Epidemiol Health. 2022;44:e2022011.E.   Published online December 31, 2022
DOI: https://doi.org/10.4178/epih.e2022011.E
Corrects: Epidemiol Health 2022;44:e2022011
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Abstract
Summary
Korean summary
Key Message
COVID-19: Brief Communication
Trends in gastrointestinal infections before and during non-pharmaceutical interventions in Korea in comparison with the United States
Soyeoun Kim, Jinhyun Kim, Bo Youl Choi, Boyoung Park
Epidemiol Health. 2022;44:e2022011.   Published online January 3, 2022
DOI: https://doi.org/10.4178/epih.e2022011
Correction in: Epidemiol Health 2022;44(0):e2022011.E
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  • 1 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
This study examined how trends in the weekly frequencies of gastrointestinal infectious diseases changed before and during the coronavirus disease 2019 (COVID-19) pandemic in Korea, and compared them with the trends in the United States.
METHODS
We compared the weekly frequencies of gastrointestinal infectious diseases (16 bacterial and 6 viral diseases) in Korea during weeks 5-52 before and after COVID-19. In addition, the weekly frequencies of 5 gastrointestinal infectious diseases in the United States (data from the Centers for Disease Control and Prevention) that overlapped with those in Korea were compared.
RESULTS
The mean weekly number of total cases of gastrointestinal infectious diseases in Korea showed a significant decrease (from 522 before COVID-19 to 245 after COVID-19, p<0.01). Only bacterial gastrointestinal infectious diseases caused by Campylobacter increased significantly; other bacterial gastrointestinal infectious diseases showed either a decrease or no change. The incidence of all other viral diseases decreased. In the United States, the weekly numbers of Salmonella, Campylobacter, typhoid, shigellosis, and hepatitis A virus cases sharply decreased after the COVID-19 outbreak. The weekly case numbers of all viral diseases markedly decreased in both countries; however, bacterial gastrointestinal infectious diseases showed a different pattern.
CONCLUSIONS
The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak. In contrast, Campylobacter infections showed an increasing trend in Korea, but a decreasing trend in the United States. Further studies are needed to elucidate the different trends in bacterial and viral infectious diseases before and after non-pharmaceutical interventions and between different countries.
Summary
Korean summary
한국과 미국 모두 코로나-19 발생 이후 위장관 감염 질환의 발생은 감소하고 있습니다. 하지만, 미국과 달리 한국에서는 캄필로박터 감염은 증가 하고 있습니다. 이는 COVID-19이 발생한 이후 캄필로박터 감염의 열악한 통제의 가능성을 설명할 수 있습니다.
Key Message
The incidence of gastrointestinal infectious diseases decreased after the COVID-19 outbreak, however, campylobacter infections showed an increasing trend in Korea, unlike the United States, which could explain the poor control of Campylobacter.

Citations

Citations to this article as recorded by  
  • Impact of the COVID‐19 pandemic on the circulation of other pathogens in England
    Lauren J. Hayes, Hannah Uri, Denisa Bojkova, Jindrich Cinatl, Mark N. Wass, Martin Michaelis
    Journal of Medical Virology.2023;[Epub]     CrossRef
COVID-19: Brief Communication
Time-variant reproductive number of COVID-19 in Seoul, Korea
Seong-Geun Moon, Yeon-Kyung Kim, Woo-Sik Son, Jong-Hoon Kim, Jungsoon Choi, Baeg-Ju Na, Boyoung Park, Bo Youl Choi
Epidemiol Health. 2020;42:e2020047.   Published online June 28, 2020
DOI: https://doi.org/10.4178/epih.e2020047
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  • 2 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To estimate time-variant reproductive number (Rt) of coronavirus disease 19 based on either number of daily confirmed cases or their onset date to monitor effectiveness of quarantine policies.
METHODS
Using number of daily confirmed cases from January 23, 2020 to March 22, 2020 and their symptom onset date from the official website of the Seoul Metropolitan Government and the district office, we calculated Rt using program R’s package “EpiEstim”. For asymptomatic cases, their symptom onset date was considered as -2, -1, 0, +1, and +2 days of confirmed date.
RESULTS
Based on the information of 313 confirmed cases, the epidemic curve was shaped like ‘propagated epidemic curve’. The daily Rt based on Rt_c peaked to 2.6 on February 20, 2020, then showed decreased trend and became <1.0 from March 3, 2020. Comparing both Rt from Rt_c and from the number of daily onset cases, we found that the pattern of changes was similar, although the variation of Rt was greater when using Rt_c. When we changed assumed onset date for asymptotic cases (-2 days to +2 days of the confirmed date), the results were comparable.
CONCLUSIONS
Rt can be estimated based on Rt_c which is available from daily report of the Korea Centers for Disease Control and Prevention. Estimation of Rt would be useful to continuously monitor the effectiveness of the quarantine policy at the city and province levels.
Summary
Korean summary
우리나라 전체와 각 시도별 일별 증상 발현자 수 또는 확진자 수를 이용하여 추정한 Rt로 방역정책의 효과를 국가 및 시도 수준에서 지속적으로 모니터링 할 필요가 있다.
Key Message

Citations

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  • Reproduction Factor Based Latent Epidemic Model Inference: A Data-Driven Approach Using COVID-19 Datasets
    Sujin Ahn, Minhae Kwon
    IEEE Journal of Biomedical and Health Informatics.2023; 27(3): 1259.     CrossRef
  • COVID-19 early-alert signals using human behavior alternative data
    Anasse Bari, Aashish Khubchandani, Junzhang Wang, Matthias Heymann, Megan Coffee
    Social Network Analysis and Mining.2021;[Epub]     CrossRef
Original Articles
Socioeconomic inequalities in obesity among Korean women aged 19-79 years: the 2016 Korean Study of Women’s Health-Related Issues
Eunji Choi, Ha Na Cho, Da Hea Seo, Boyoung Park, Sohee Park, Juhee Cho, Sue Kim, Yeong-Ran Park, Kui Son Choi, Yumie Rhee
Epidemiol Health. 2019;41:e2019005.   Published online February 13, 2019
DOI: https://doi.org/10.4178/epih.e2019005
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  • 5 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
While the prevalence of obesity in Asian women has remained stagnant, studies of socioeconomic inequalities in obesity among Asian women are scarce. This study aimed to examine the recent prevalence of obesity in Korean women aged between 19 years and 79 years and to analyze socioeconomic inequalities in obesity.
METHODS
Data were derived from the 2016 Korean Study of Women’s Health-Related Issues. The chi-square test and logistic regression analysis were used to analyze the associations between socioeconomic factors and obesity using Asian standard body mass index (BMI) categories: low (<18.5 kg/m2 ), normal (18.5-22.9 kg/m2 ), overweight (23.0-24.9 kg/m2 ), and obese (≥25.0 kg/ m2 ). As inequality-specific indicators, the slope index of inequality (SII) and relative index of inequality (RII) were calculated, with adjustment for age and self-reported health status.
RESULTS
Korean women were classified into the following BMI categories: underweight (5.3%), normal weight (59.1%), overweight (21.2%), and obese (14.4%). The SII and RII revealed substantial inequalities in obesity in favor of more urbanized women (SII, 4.5; RII, 1.4) and against of women who were highly educated (SII, -16.7; RII, 0.3). Subgroup analysis revealed inequalities in obesity according to household income among younger women and according to urbanization among women aged 65-79 years.
CONCLUSIONS
Clear educational inequalities in obesity existed in Korean women. Reverse inequalities in urbanization were also apparent in older women. Developing strategies to address the multiple observed inequalities in obesity among Korean women may prove essential for effectively reducing the burden of this disease.
Summary
Korean summary
한국 성인 여성의 과체중 및 비만유병률은 서구여성에 비해 낮으며 2005년 이후 큰 변화 없이 약40%대로 일정하게 유지되어왔으나, 사회경제적불평등에 대한 연구는 체계적으로 이루어지지 않음. 경사불평등(Slope index of inequality)과 상대불평등(Relative index of inequality) 지표를 사용하여 비만유병률에서 발견되는 사회경제적불평등을 조사한 결과, 교육수준별 불평등이 유의하게 나타남. 19-44세의 젊은 여성층에서는 소득수준이 낮은 집단에, 65-79세의 노년기 여성층에서는 도시화된 지역에 사는 집단에 비만유병률이 치중되어있음.
Key Message

Citations

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  • Disparities in Obesity Rates among Adults: Analysis of 514 Districts in Indonesia
    Dumilah Ayuningtyas, Dian Kusuma, Vilda Amir, Dwi Hapsari Tjandrarini, Pramita Andarwati
    Nutrients.2022; 14(16): 3332.     CrossRef
  • Socioeconomic Disparities in Cardiovascular Health in South Korea
    Chi-Young Lee, Eun-Ok Im
    Journal of Cardiovascular Nursing.2021; 36(1): 8.     CrossRef
  • Incidence and risk of venous thromboembolism according to primary treatment in women with ovarian cancer: A retrospective cohort study
    Jin-Sung Yuk, Banghyun Lee, Kidong Kim, Myoung Hwan Kim, Yong-Soo Seo, Sung Ook Hwang, Sang-Hee Yoon, Yong Beom Kim, Wen-Chi Chou
    PLOS ONE.2021; 16(4): e0250723.     CrossRef
  • Regional Differences in Dietary Total Fat and Saturated Fatty Acid Intake and Their Associations with Metabolic Diseases among Korean Adults: Using the 2016~2019 Korea National Health and Nutrition Examination Surveys
    SuJin Song, Jae Eun Shim
    Korean Journal of Community Nutrition.2021; 26(6): 495.     CrossRef
  • Regional disparities in the associations of cardiometabolic risk factors and healthy dietary factors in Korean adults
    Kyungho Ha, YoonJu Song, Hye-Kyeong Kim
    Nutrition Research and Practice.2020; 14(5): 519.     CrossRef
Physician’s awareness of lung cancer screening and its related medical radiation exposure in Korea
Seri Hong, Suyeon Kim, Mina Suh, Boyoung Park, Kui Son Choi, Jae Kwan Jun
Epidemiol Health. 2018;40:e2018002.   Published online January 20, 2018
DOI: https://doi.org/10.4178/epih.e2018002
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  • 1 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Through a survey on perception of lung cancer screening and accompanying medical radiation exposure in Korea, the present study was to investigate its current situations and evaluate various perception of physicians regarding it in order to propose measures for improvements.
METHODS
Medical specialists in national cancer screening institutions selected through stratified random sampling were subjected to face-to-face interview using a structured questionnaire. We investigated physicians’ perception on effectiveness of lung cancer screening depending on screening modality, selection criteria for subjects of screening, types of equipment used to screen, and perception for seriousness of adverse effects following the test. In addition, odds ratios to underestimate risk of radiation exposure from screening were calculated through logistic regression analysis.
RESULTS
Each response that chest X-ray is effective for lung cancer screening and that smoking history is not considered prior to screening recommendation accounted for more than 60% of respondents, suggesting the chance of unnecessary screening tests. Regarding adverse effects of lung cancer screening, about 85% of respondents replied that false positive, radiation exposure, and overdiagnosis could be ignored. About 70% of respondents underestimated radiation dose from lung cancer screening, and a low proportion of physicians informed patients of radiation exposure risk.
CONCLUSIONS
It was found that most physicians underestimated harms of lung cancer screening including radiation exposure and were lack of awareness regarding lung cancer screening. It should be noted that physicians need to have proper perceptions about screening recommendation and accompanying possible harms, for successful implementation of the screening program.
Summary
Korean summary
전국 100여개 국가암검진 기관을 대상으로 폐암검진 관련 설문을 수행한 결과, 효과적인 폐암검진의 수단이나 방법에 대한 이해 및 검사에 수반되는 각종 부작용에 대한 의사들의 인식이 확연히 부족한 것으로 조사되었다. 그 중에서도 특히 의료방사선 노출에 대한 낮은 인지도는, 촬영 시 피폭량에 대한 전반적인 과소평가 및 방사선 노출 위험과 관련한 환자 교육의 부재를 통해 확인할 수 있었다. 인구집단 대상 선별검사의 도입에 따른 잠재적인 위해 가능성과 그 결과에 대한 고민은 반드시 필요하며, 이와 관련된 의료제공자들의 인식 개선을 촉구하는 본 연구는 정책 도입에 앞서 선결되어야 할 과제로서 공중보건학적 측면에서 중요한 의의를 지닌다.
Key Message

Citations

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  • Why clinicians overtest: development of a thematic framework
    Justin H. Lam, Kristen Pickles, Fiona F. Stanaway, Katy J. L. Bell
    BMC Health Services Research.2020;[Epub]     CrossRef
Cancer screening rate in people with diabetes in the Korean population: results from the Korea National Health and Nutrition Examination Survey 2007-2009
Kumban Walter Chuck, Minji Hwang, Kui Son Choi, Mina Suh, Jae Kwan Jun, Boyoung Park
Epidemiol Health. 2017;39:e2017036.   Published online August 10, 2017
DOI: https://doi.org/10.4178/epih.e2017036
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  • 13 Citations
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
To investigate the screening rates for gastric, breast, and cervical cancer in people with diabetes compared with people without diabetes.
METHODS
Data from the Korea National Health and Nutrition Examination Survey (2007-2009) were used. Cancer-free men who were 40 years old and over and cancer-free women who were 30 years old and over were included. The lifetime screening rate and regular screening rate were compared in people with and without diabetes.
RESULTS
Fewer people with diabetes than people without diabetes had ever received cancer screening (53.5 vs. 59.5%, p<0.001 for gastric cancer; 60.5 vs. 71.5%, p<0.001 for breast cancer; and 49.1 vs. 59.6%, p<0.001 for cervical cancer). Fewer people with diabetes than people without diabetes received the recommended screenings for gastric cancer (38.9 vs. 42.9%, p<0.001), breast cancer (38.8 vs. 44.6%, p<0.001), and cervical cancer (35.1 vs. 51.2%, p<0.001). In subgroup analyses according to socioeconomic factors, the lifetime and recommended screening rates were lower in the diabetic population in most socioeconomic subgroups. In the multivariate analysis adjusted for socioeconomic factors, people with diabetes showed lower lifetime screening rates for gastric and cervical cancer (odds ratio [OR], 0.8; 95% confidence interval [CI], 0.7 to 0.9 and OR, 0.7; 95% CI, 0.6 to 0.9), and lower regular screening rates for breast and cervical cancer (OR, 0.7; 95% CI, 0.6 to 0.9 and OR, 0.7; 95% CI, 0.5 to 0.9).
CONCLUSIONS
The cancer screening rate in people with diabetes was lower than in people without diabetes. Considering the higher cancer risk in people with diabetes, efforts to increase the screening rate in this high-risk population should be implemented.
Summary
Korean summary
기존의 여러 연구에서 당뇨병이 있는 사람에서 당뇨병이 없는 경우에 비해 암 발생의 위험이 증가하는 것이 확인되었다. 본 연구에서 당뇨병이 있는 사람과 없는 사람에서 암 수검률을 비교했을 때, 당뇨병이 있는 사람의 위암, 유방암, 자궁경부암의 평생 수검률과 권고안 이행 수검률은 모두 낮았다. 당뇨병 환자가 암 발생의 고위험군임을 고려하였을 때 이들을 대상으로 암 검진 수검률을 높이려는 노력이 필요하다.
Key Message

Citations

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  • Increased Breast and Colorectal Cancer Risk in Type 2 Diabetes: Awareness Among Adults With and Without Diabetes and Information Provision on Diabetes Websites
    Laura Ashley, Kathryn A Robb, Daryl B O’Connor, Rebecca Platt, Mollie Price, Olivia Robinson, Elizabeth Travis, Lorraine Lipscombe, Ramzi Ajjan, Rebecca Birch
    Annals of Behavioral Medicine.2023; 57(5): 386.     CrossRef
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    Jae Won Hong
    The Journal of Korean Diabetes.2023; 24(1): 12.     CrossRef
  • Do diabetic complications influence cancer-related events in people with type 2 diabetes? A cohort approach
    Evelyne Liuu, Pierre-Jean Saulnier, Elise Gand, Gautier Defossez, Amélie Jamet, Stéphanie Ragot, Marc Paccalin, Samy Hadjadj
    Diabetes & Metabolism.2022; 48(2): 101289.     CrossRef
  • Factors associated with adherence to colonoscopy among individuals who were positive in the preliminary screening for colorectal neoplasms
    Ji‐Bin Li, Keng‐Jian Ke, Wei‐Li Zhang, Ling‐Yan Wang, Yan‐Ping Wu, Fan Weng, Huan Tian, Zhi‐Yu Qiu, Yin Li, Shi‐Yong Lin, Mei‐Xian Ye, Qing‐Jian Ou, Cheng‐Hua Gong, Zhen‐Hai Lu, Zhi‐Zhong Pan, De‐Sen Wan, Jian‐Hong Peng, Yu‐Jing Fang
    Cancer Medicine.2022; 11(22): 4321.     CrossRef
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    Hans Scherübl
    Zeitschrift für Gastroenterologie.2022;[Epub]     CrossRef
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    Diagnostics.2022; 12(8): 1967.     CrossRef
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    Diabetes aktuell.2022; 20(06): 287.     CrossRef
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    Chin-Hsiao Tseng
    Biomolecules.2021; 11(7): 1022.     CrossRef
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    Christian von Wagner, Dorina Cadar, Ruth A Hackett, Panayotes Demakakos, Rebecca J Beeken, Stacy Cooper Bailey, Michael Wolf, Andrew Steptoe, Cristina Renzi, Sandro T Stoffel
    Journal of Medical Screening.2020; 27(1): 25.     CrossRef
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    Dominika Bhatia, Iliana C. Lega, Wei Wu, Lorraine L. Lipscombe
    Diabetologia.2020; 63(1): 34.     CrossRef
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    Iliana C Lega, Lorraine L Lipscombe
    Endocrine Reviews.2020; 41(1): 33.     CrossRef
  • The Incidences and Characteristics of Various Cancers in Patients on Dialysis: a Korean Nationwide Study
    Soon Kil Kwon, Joung-Ho Han, Hye-Young Kim, Gilwon Kang, Minseok Kang, Yeonkook J. Kim, Jinsoo Min
    Journal of Korean Medical Science.2019;[Epub]     CrossRef
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    Sunghwan Suh, Kwang-Won Kim
    Diabetes & Metabolism Journal.2019; 43(6): 733.     CrossRef
Cancer mortality-to-incidence ratio as an indicator of cancer management outcomes in Organization for Economic Cooperation and Development countries
Eunji Choi, Sangeun Lee, Bui Cam Nhung, Mina Suh, Boyoung Park, Jae Kwan Jun, Kui Son Choi
Epidemiol Health. 2017;39:e2017006.   Published online February 5, 2017
DOI: https://doi.org/10.4178/epih.e2017006
  • 14,647 View
  • 424 Download
  • 57 Citations
AbstractAbstract PDF
Abstract
OBJECTIVES
Assessing long-term success and efficiency is an essential part of evaluating cancer control programs. The mortality-to-incidence ratio (MIR) can serve as an insightful indicator of cancer management outcomes for individual nations. By calculating MIRs for the top five cancers in Organization for Economic Cooperation and Development (OECD) countries, the current study attempted to characterize the outcomes of national cancer management policies according to the health system ranking of each country.
METHODS
The MIRs for the five most burdensome cancers globally (lung, colorectal, prostate, stomach, and breast) were calculated for all 34 OECD countries using 2012 GLOBOCAN incidence and mortality statistics. Health system rankings reported by the World Health Organization in 2000 were updated with relevant information when possible. A linear regression model was created, using MIRs as the dependent variable and health system rankings as the independent variable.
RESULTS
The linear relationships between MIRs and health system rankings for the five cancers were significant, with coefficients of determination ranging from 49 to 75% when outliers were excluded. A clear outlier, Korea reported lower-than-predicted MIRs for stomach and colorectal cancer, reflecting its strong national cancer control policies, especially cancer screening.
CONCLUSIONS
The MIR was found to be a practical measure for evaluating the long-term success of cancer surveillance and the efficacy of cancer control programs, especially cancer screening. Extending the use of MIRs to evaluate other cancers may also prove useful.
Summary
Korean summary
Key Message

Citations

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Reliability of Quadruplicated Serological Parameters in the Korean Genome and Epidemiology Study
Jae Jeong Yang, Ji Hyun Yang, Jimin Kim, Lisa Y. Cho, Boyoung Park, Seung Hyun Ma, Sang Hoon Song, Won-Ki Min, Sung Soo Kim, Man Suck Park, Sue K. Park
Epidemiol Health. 2011;33:e2011004.   Published online May 19, 2011
DOI: https://doi.org/10.4178/epih/e2011004
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AbstractAbstract PDF
Abstract
OBJECTIVES

The aim of this study was to evaluate whether clinical test values from different laboratories in the Korean Genome and Epidemiology Study (KoGES) can be integrated through a statistical adjustment algorithm with appropriate intra- and inter-laboratory reliability.

METHODS

External quality control data were obtained from the Korean Society for Laboratory Medicine and quadruplicated standardized serological samples (N=3,200) were manufactured in order to check the intra- and inter-laboratory reliability for aspartic acid transaminase (AST), alanine transaminase (ALT), gamma-glutamyl transpeptidase (γ-GTP), blood urea nitrogen (BUN), creatinine, uric acid (UA), fasting blood sugar (FBS), cholesterol, and triglyceride (TG). As an index of inter- and intra-rater reliability, Pearson's correlation coefficient, intraclass correlation coefficients and kappa statistics were estimated. In addition, to detect the potential for data integration, we constructed statistical compensation models using linear regression analysis with residual analysis, and presented the R-square values.

RESULTS

All correlation coefficient values indicated good intra- and inter-laboratory reliability, which ranged from 0.842 to 1.000. Kappa coefficients were greater than 0.75 (0.75-1.00). All of the regression models based on the trial results had strong R-square values and zero sums of residuals. These results were consistent in the regression models using external quality control data.

CONCLUSION

The two laboratories in the KoGES have good intra- and inter-laboratory reliability for ten chemical test values, and data can be integrated through algorithmic statistical adjustment using regression equations.
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