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Special Articles
Incidence and case fatality of acute myocardial infarction in Korea, 2011-2020
Yeeun Seo, Jenny Moon, Hyeok-Hee Lee, Hyeon Chang Kim, Fumie Kaneko, Sojung Shin, Eunji Kim, Jang-Whan Bae, Byeong-Keuk Kim, Seung Jun Lee, Min Kim, Hokyou Lee
Epidemiol Health. 2024;46:e2024002.   Published online December 26, 2023
DOI: https://doi.org/10.4178/epih.e2024002
  • 7,089 View
  • 144 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
Cardiovascular diseases are a leading cause of mortality worldwide, and acute myocardial infarction (AMI) is particularly fatal condition. We evaluated the incidence and case fatality rates of AMI in Korea from 2011 to 2020.
METHODS
We utilized data from the National Health Insurance Services to calculate crude, age-standardized, and age-specific incidence rates, along with 30-day and 1-year case fatality rates, of AMI from 2011 to 2020. Age-standardized incidence rates were determined using direct standardization to the 2005 population.
RESULTS
The crude incidence rate of AMI per 100,000 person-years consistently increased from 44.7 in 2011 to 68.3 in 2019, before decreasing slightly to 66.2 in 2020. The age-standardized incidence rate of AMI displayed a 19% rise from 2011 to 2019, followed by a slight decline in 2020. The increasing trend for AMI incidence was more pronounced in males than in females. Both 30-day and 1-year case fatality rates remained stable among younger individuals but showed a decrease among older individuals. There was a minor surge in case fatality in 2020, particularly among recurrent AMI cases.
CONCLUSIONS
Over the past decade, the AMI incidence rate in Korea has consistently increased, with a slight downturn in 2020. The case fatality rate has remained relatively stable except for a minor increase in 2020. This study provides data for continuous surveillance, the implementation of targeted interventions, and the advancement of research aimed at AMI in Korea.
Summary
Key Message
This study observed the incidence rate of acute myocardial infarction using data from Korean National Health Insurance Service. From 2011 to 2019, the incidence rate increased, but there was a slight decrease in 2020. Additionally, the fatality rate remained relatively stable throughout the study period, except for an increase in 2020. The study emphasizes the importance of continuous monitoring and preventive strategies for effective management of acute myocardial infarction.

Citations

Citations to this article as recorded by  
  • Recurrent myocardial infarction as an unsolved problem of evidence-based medicine
    S. Yu. Martsevich
    Cardiovascular Therapy and Prevention.2024; 23(6): 4019.     CrossRef
Identification of acute myocardial infarction and stroke events using the National Health Insurance Service database in Korea
Minsung Cho, Hyeok-Hee Lee, Jang-Hyun Baek, Kyu Sun Yum, Min Kim, Jang-Whan Bae, Seung-Jun Lee, Byeong-Keuk Kim, Young Ah Kim, JiHyun Yang, Dong Wook Kim, Young Dae Kim, Haeyong Pak, Kyung Won Kim, Sohee Park, Seng Chan You, Hokyou Lee, Hyeon Chang Kim
Epidemiol Health. 2024;46:e2024001.   Published online December 26, 2023
DOI: https://doi.org/10.4178/epih.e2024001
  • 7,722 View
  • 168 Download
  • 1 Crossref
AbstractAbstract AbstractSummary PDF
Abstract
OBJECTIVES
The escalating burden of cardiovascular disease (CVD) is a critical public health issue worldwide. CVD, especially acute myocardial infarction (AMI) and stroke, is the leading contributor to morbidity and mortality in Korea. We aimed to develop algorithms for identifying AMI and stroke events from the National Health Insurance Service (NHIS) database and validate these algorithms through medical record review.
METHODS
We first established a concept and definition of “hospitalization episode,” taking into account the unique features of health claims-based NHIS database. We then developed first and recurrent event identification algorithms, separately for AMI and stroke, to determine whether each hospitalization episode represents a true incident case of AMI or stroke. Finally, we assessed our algorithms’ accuracy by calculating their positive predictive values (PPVs) based on medical records of algorithm-identified events.
RESULTS
We developed identification algorithms for both AMI and stroke. To validate them, we conducted retrospective review of medical records for 3,140 algorithm-identified events (1,399 AMI and 1,741 stroke events) across 24 hospitals throughout Korea. The overall PPVs for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.
CONCLUSIONS
We successfully developed algorithms for identifying AMI and stroke events. The algorithms demonstrated high accuracy, with PPVs of approximately 90% for first events and 80% for recurrent events. These findings indicate that our algorithms hold promise as an instrumental tool for the consistent and reliable production of national CVD statistics in Korea.
Summary
Key Message
In this study, we developed algorithms to identify acute myocardial infarction (AMI) and stroke events from the Korean National Health insurance Service database. To validate them, we conducted retrospective review of medical records across 24 hospitals throughout Korea. The overall positive predictive values for the first and recurrent AMI events were around 92% and 78%, respectively, while those for the first and recurrent stroke events were around 88% and 81%, respectively.

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  • Incidence and case fatality rates of stroke in Korea, 2011-2020
    Jenny Moon, Yeeun Seo, Hyeok-Hee Lee, Hokyou Lee, Fumie Kaneko, Sojung Shin, Eunji Kim, Kyu Sun Yum, Young Dae Kim, Jang-Hyun Baek, Hyeon Chang Kim
    Epidemiology and Health.2023; : e2024003.     CrossRef
Original Articles
Validation of the Korean Academy of Geriatric Dentistry screening questionnaire and oral frailty diagnostic criteria in community-dwelling older adults
Jeong-Hyun Kang, Seong-Chan Park, Hoi-In Jung, Sun Jae Jung, Hye-Jin Park, Soo-Min Kim, Min-Ji Jo, Yun-Seon Lee, Sun-Young Han
Epidemiol Health. 2024;46:e2024008.   Published online December 11, 2023
DOI: https://doi.org/10.4178/epih.e2024008
  • 3,863 View
  • 224 Download
  • 1 Web of Science
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study aimed to establish the validity—specifically, the sensitivity and specificity—of the screening questionnaire and diagnostic criteria for oral frailty proposed by the Korean Academy of Geriatric Dentistry (KAGD) among community-dwelling older adults.
METHODS
This study enrolled 100 participants. Among various definitions of oral frailty, this study used the criteria proposed by Tanaka as the reference test. The screening questionnaire consisted of 11 items for screening physical frailty, chewing ability, swallowing difficulties, oral dryness, and tongue and lip motor function. Each question had a different scoring weight, and if the total score was 1 or higher, an oral frailty diagnostic examination proposed by the KAGD would be recommended. The diagnostic test was the oral frailty diagnostic criteria proposed by the KAGD including 6 measures: chewing ability, occlusal force, tongue pressure, oral dryness, swallowing difficulty, and oral hygiene. If a participant exhibited 2 or more positive measures, this participant was classified as “oral frail.” The screening questionnaire was analyzed using a cut-off value of 1 or higher, while the diagnostic criteria utilized a cut-off of 2 or more positive measures. Sensitivity and specificity were calculated.
RESULTS
The screening questionnaire showed significant power for screening oral frailty (area under the receiver operating characteristic curve, 0.783; sensitivity, 87.8%; specificity, 52.5%). The diagnostic accuracy of the newly proposed diagnostic criteria was acceptable (sensitivity, 95.1%; specificity, 42.4%).
CONCLUSIONS
The newly proposed screening questionnaire and diagnostic criteria in Korea appear to be a useful tool to identify oral frailty in community-dwelling older adults.
Summary
Korean summary
본 연구는 지역사회에 거주하는 노인들의 구강 노쇠에 대한 선별검사 설문지와 진단 기준을 검증하는 것을 목표로 했습니다. 민감도와 특이도가 계산되었으며, 스크리닝 설문지는 구강 노쇠를 식별하는 데 상당한 힘을 보여주었고(민감도 87.8%, 특이도 52.5%), 진단 기준은 수용 가능한 정확도(민감도 95.1%, 특이도 42.4%)를 나타냈습니다. 연구 결과는 제안된 선별 설문지와 진단 기준이 한국 지역사회에 거주하는 노인들의 구강 노쇠를 식별하는 데 유용한 도구임을 시사합니다.
Key Message
This study aimed to validate a screening questionnaire and diagnostic criteria for oral frailty among older adults living in the community. Sensitivity and specificity were calculated, with the screening questionnaire demonstrating a significant power for identifying oral frailty (sensitivity 87.8%, specificity 52.5%) and the diagnostic criteria showing acceptable accuracy (sensitivity 95.1%, specificity 42.4%). The findings suggest that the proposed screening questionnaire and diagnostic criteria are valuable tools for identifying oral frailty in community-dwelling older adults in Korea.
Associations between digital media use and lack of physical exercise among middle-school adolescents in Korea
Gyeongmin Kim, Hyunsuk Jeong, Hyeon Woo Yim
Epidemiol Health. 2023;45:e2023012.   Published online January 10, 2023
DOI: https://doi.org/10.4178/epih.e2023012
  • 7,365 View
  • 251 Download
  • 5 Web of Science
  • 4 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The reported effects of digital media overuse on physical activity among adolescents are inconsistent. This study examined the association between hours of digital media use and lack of moderate-intensity physical exercise (mPE) according to the type of digital media.
METHODS
This study included 1,837 middle school students from the iCURE (Internet user Cohort for Unbiased Recognition of gaming disorder in Early Adolescence) study conducted in Korea. Hours spent using digital media were measured by self-reported daily usage time for Internet games, messengers, social media, and watching game streaming on weekdays. Lack of mPE was defined as performing a minimum of 30 minutes at a time less than twice weekly. Multivariable logistic regression analysis stratified by sex was performed.
RESULTS
Among male students, the group with the highest hours of using either Internet games or watching game streaming was more likely to lack mPE than each non-user group. In contrast, among male students, the group using either messengers or social media had a higher rate of mPE compared to each non-user group. Female students showed no association between hours spent using Internet games, messengers, social media, or watching game streaming and a lack of mPE.
CONCLUSIONS
Among male middle school students in Korea, the excessive use of Internet games or watching game streaming was associated with a lack of mPE. Thus, guidelines should be established regarding adolescent use of internet games and watching game streaming.
Summary
Korean summary
한국에서 남, 여 중학생을 대상으로 4개 인터넷 매체(인터넷 게임, 메신저, 소셜미디어, 게임 스트리밍 시청) 과다사용과 신체 운동 부재와의 연관성을 알아보기 위한 단면조사 연구를 시행하였다. 남자 중학생에서 인터넷 게임 사용 또는 게임 스트리밍 시청 시간이 가장 높은 사분위 그룹은 비이용 그룹보다 중간 강도의 신체운동 부재율이 유의하게 높았다.
Key Message
A cross-sectional study was conducted to find out the relationship between excessive use of four Internet media (internet games, messengers, social media, and game streaming) and lack of physical exercise targeting male and female middle school students in Korea. Among male middle school students, the upper quartile group with the highest Internet game use or game streaming viewing time had a significantly higher moderate-intensity physical exercise absence rate than the non-use group.

Citations

Citations to this article as recorded by  
  • ‘We wanted to spend more time with each other than with our phones’. Relationship between digital disconnection and physical activity of family members
    Katarzyna Kopecka-Piech
    Cogent Arts & Humanities.2024;[Epub]     CrossRef
  • Social Media Addiction and Cognitive Behavioral Physical Activity Among Adolescent Girls: A Cross‐Sectional Study
    Ebru Sönmez Sari, Handan Terzi, Didem Şahin
    Public Health Nursing.2024;[Epub]     CrossRef
  • Cyber Sex Crimes Targeting Children and Adolescents in South Korea: Incidents and Legal Challenges
    Yujin Jang, Youngmeen Suh
    Social Sciences.2024; 13(11): 596.     CrossRef
  • Trends in the effects of socioeconomic position on physical activity levels and sedentary behavior among Korean adolescents
    Hunju Lee, Hyowon Choi, Sang Baek Koh, Hyeon Chang Kim
    Epidemiology and Health.2023; 45: e2023085.     CrossRef
Brief Communication
Prospective cohort data quality assurance and quality control strategy and method: Korea HIV/AIDS Cohort Study
Soo Min Kim, Yunsu Choi, Bo Youl Choi, Minjeong Kim, Sang Il Kim, Jun Young Choi, Shin-Woo Kim, Joon Young Song, Youn Jeong Kim, Mee-Kyung Kee, Myeongsu Yoo, Jeong Gyu Lee, Bo Young Park
Epidemiol Health. 2020;42:e2020063.   Published online September 4, 2020
DOI: https://doi.org/10.4178/epih.e2020063
  • 13,895 View
  • 220 Download
  • 3 Web of Science
  • 3 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
The aim of effective data quality control and management is to minimize the impact of errors on study results by identifying and correcting them. This study presents the results of a data quality control system for the Korea HIV/AIDS Cohort Study that took into account the characteristics of the data.
METHODS
The HIV/AIDS Cohort Study in Korea conducts repeated measurements every 6 months using an electronic survey administered to voluntarily consenting participants and collects data from 21 hospitals. In total, 5,795 sets of data from 1,442 participants were collected from the first investigation in 2006 to 2016. The data refining results of 2015 and 2019 were converted into the data refining rate and compared.
RESULTS
The quality control system involved 3 steps at different points in the process, and each step contributed to data quality management and results. By improving data quality control in the pre-phase and the data collection phase, the estimated error value in 2019 was 1,803, reflecting a 53.9% reduction from 2015. Due to improvements in the stage after data collection, the data refining rate was 92.7% in 2019, a 24.21%p increase from 2015.
CONCLUSIONS
Despite this quality management strategy, errors may still exist at each stage. Logically possible errors for the post-review refining of downloaded data should be actively identified with appropriate consideration of the purpose and epidemiological characteristics of the study data. To improve data quality and reliability, data management strategies should be systematically implemented.
Summary
Korean summary
이 연구는 한국 에이즈 코호트 자료의 연구 목적과 역학적 특성을 고려한 체계적인 질 관리 방법과 결과를 제시한다. 시간적 선후 관계를 고려한 로직을 활용한 자료정제 과정을 비롯한 3단계의 체계적인 질 관리 방법은 이제껏 없었던 국내 코호트 자료 질 관리에 도움이 될 것으로 사료된다.

Citations

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  • Adopting Data to Care to Identify and Address Gaps in Services for Children and Adolescents Living With HIV in Mozambique
    Belmiro Sousa, Sergio Chiale, Hayley Bryant, Lisa Dulli, Tanya Medrano
    Global Health: Science and Practice.2024; 12(2): e2300130.     CrossRef
  • Effect of characteristics on the clinical course at the initiation of treatment for human immunodeficiency virus infection using dimensionality reduction
    Yunsu Choi, Bo Youl Choi, Sang Il Kim, Jungsoon Choi, Jieun Kim, Bo Young Park, Soo Min Kim, Shin-Woo Kim, Jun Yong Choi, Joon Young Song, Youn Jeong Kim, Hyo Youl Kim, Jin-Soo Lee, Jung Ho Kim, Yoon Hee Jun, Myungsun Lee, Jaehyun Seong
    Scientific Reports.2023;[Epub]     CrossRef
  • A Nationwide Evaluation of the Prevalence of Human Papillomavirus in Brazil (POP-Brazil Study): Protocol for Data Quality Assurance and Control
    Jaqueline Driemeyer Correia Horvath, Marina Bessel, Natália Luiza Kops, Flávia Moreno Alves Souza, Gerson Mendes Pereira, Eliana Marcia Wendland
    JMIR Research Protocols.2022; 11(1): e31365.     CrossRef
Original Article
Epidemiological characteristics of HIV infected Korean: Korea HIV/AIDS Cohort Study
Yunsu Choi, Bo Youl Choi, Soo Min Kim, Sang Il Kim, June Kim, Jun Young Choi, Shin-Woo Kim, Joon Young Song, Youn Jeong Kim, Dae Won Park, Hyo Youl Kim, Hee-Jung Choi, Mee-Kyung Kee, Young Hyun Shin, Myeongsu Yoo
Epidemiol Health. 2019;41:e2019037.   Published online September 3, 2019
DOI: https://doi.org/10.4178/epih.e2019037
  • 18,494 View
  • 355 Download
  • 24 Web of Science
  • 20 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
To manage evidence-based diseases, it is important to identify the characteristics of patients in each country.
METHODS
The Korea HIV/AIDS Cohort Study seeks to identify the epidemiological characteristics of 1,442 Korean individuals with human immunodeficiency virus (HIV) infection (12% of Korean individuals with HIV infection in 2017) who visited 21 university hospitals nationwide. The descriptive statistics were presented using the Korea HIV/AIDS cohort data (2006-2016).
RESULTS
Men accounted for 93.3% of the total number of respondents, and approximately 55.8% of respondents reported having an acute infection symptom. According to the transmission route, infection caused by sexual contact accounted for 94.4%, of which 60.4% were caused by sexual contact with the same sex or both males and females. Participants repeatedly answered the survey to decrease depression and anxiety scores. Of the total participants, 89.1% received antiretroviral therapy (ART). In the initial ART, 95.3% of patients were treated based on the recommendation. The median CD4 T-cell count at the time of diagnosis was 229.5 and improved to 331 after the initial ART. Of the patients, 16.6% and 9.4% had tuberculosis and syphilis, respectively, and 26.7% had pneumocystis pneumonia. In the medical history, sexually transmitted infectious diseases showed the highest prevalence, followed by endocrine diseases. The main reasons for termination were loss to follow-up (29.9%) and withdrawal of consent (18.7%).
CONCLUSIONS
Early diagnosis and ART should be performed at an appropriate time to prevent the development of new infection.
Summary
Korean summary
국내 감염인은 대부분 성 접촉으로 인해 감염되었고, 감염인의 약 90%가 치료를 경험하였다. 하지만 여전히 결핵, 매독, 주폐포자충 폐렴 등과 같은 HIV 관련 질환의 유병률이 높았고, 치료를 통해 수명이 연장되어 노화 혹은 치료 약제 부작용과 관련된 HIV 비 관련 만성 질환의 유병률도 높았다. 향후 감염인의 HIV/AIDS 비 관련 질환에 대한 연구 및 사망 원인 등에 대한 후속 연구가 필요하겠다.

Citations

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  • Factors associated with health-related quality of life among people living with HIV in South Korea: Tobit regression analysis
    Gwang Suk Kim, Layoung Kim, SangA Lee, Mi-So Shim, Youngjin Lee, Seoyoung Baek, Claus Kadelka
    PLOS ONE.2024; 19(5): e0303568.     CrossRef
  • Smoothed quantile residual life regression analysis with application to the Korea HIV/AIDS cohort study
    Soo Min Kim, Yunsu Choi, Sangwook Kang, Korea HIV/AIDS cohort study
    BMC Medical Research Methodology.2024;[Epub]     CrossRef
  • Epidemiological and Clinical Characteristics of Women Living with HIV in Korea
    Sang Min Ahn, Yong Seop Lee, Min Han, Jung Ah Lee, Jae Eun Seong, Yae Jee Baek, JongHoon Hyun, Jung Ho Kim, Jin Young Ahn, Dong Hyun Oh, Su Jin Jeong, Ji Hyeon Baek, Nam Su Ku, Hee Kyoung Choi, Yoonseon Park, BumSik Chin, Young Keun Kim, Joon Sup Yeom, Yo
    Infection & Chemotherapy.2024; 56(3): 369.     CrossRef
  • Distribution of Opportunistic Pathogens in People Living with HIV at a University Hospital in Istanbul over a One-Year Treatment Period and Its Association with CD4 T Cell Counts
    Hayriye Kirkoyun Uysal, Muammer Osman Koksal, Kutay Sarsar, Pinar Soguksu, Gonca Erkose Genc, Gizem Yapar, Evrim Ozdemir, Mustafa Onel, Sevim Mese, Mehmet Demirci, Zayre Erturan, Eray Yurtseven, Omer Haluk Eraksoy, Ali Agacfidan
    Pathogens.2023; 12(10): 1226.     CrossRef
  • Effect of characteristics on the clinical course at the initiation of treatment for human immunodeficiency virus infection using dimensionality reduction
    Yunsu Choi, Bo Youl Choi, Sang Il Kim, Jungsoon Choi, Jieun Kim, Bo Young Park, Soo Min Kim, Shin-Woo Kim, Jun Yong Choi, Joon Young Song, Youn Jeong Kim, Hyo Youl Kim, Jin-Soo Lee, Jung Ho Kim, Yoon Hee Jun, Myungsun Lee, Jaehyun Seong
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  • Epidemiological Analysis of HIV/AIDS in Kazakhstan During 2018-2020
    Galiya Bilibayeva, Dinara Ospanova, Anarkhan Nurkerimova, Farida Kussainova, Marat Tukeev, Moldir Shokybaeva, Shynar Tanabayeva, Ildar Fakhradiyev, Timur Saliev
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  • Nationwide population-based incidence of cancer among patients with HIV/AIDS in South Korea
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    Wonjeong Chae, Seung Yeon Kang, Sung-In Jang, Yoon Dae Han
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    Boyoung Park, Kyoung Hwan Ahn, Yunsu Choi, Jung Ho Kim, Hye Seong, Youn Jeong Kim, Jun Young Choi, Joon Young Song, Eunjung Lee, Yoon Hee Jun, Young Kyung Yoon, Won Suk Choi, Myungsun Lee, Jaehyun Seong, Shin-Woo Kim
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  • Comparison of Three Cardiovascular Risk Scores among HIV-Infected Patients in Korea: The Korea HIV/AIDS Cohort Study
    Ji Yun Bae, Soo Min Kim, Yunsu Choi, Jun Yong Choi, Sang Il Kim, Shin-Woo Kim, Bo Young Park, Bo Youl Choi, Hee Jung Choi
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    Sangmi Ryou, Myeongsu Yoo, Kisoon Kim, Sangsoo Kim, Sang Il Kim, Youn Jeong Kim, Dae Won Park, Jun Yong Choi, Hyo Youl Kim, Jung Ho Kim, Joon Young Song, Shin-Woo Kim, Hyun-Ha Chang, Bo Youl Choi, Mee-Kyung Kee
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    Yoon-Min Cho, BumSik Chin
    Infection & Chemotherapy.2021; 53(3): 477.     CrossRef
  • Prevalence of Multidrug-Resistant Tuberculosis in HIV/Tuberculosis Co-Infected Patients
    Chan Mi Lee, Eunyoung Lee, Ji Hwan Bang, Sang-Won Park, Wan Beom Park, Myoung-don Oh, Nam Joong Kim
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  • Trends of Cause of Death among Human Immunodeficiency Virus Patients and the Impact of Low CD4 Counts on Diagnosis to Death: a Retrospective Cohort Study
    Yoonjung Kim, Shin-Woo Kim, Hyun-Ha Chang, Ki Tae Kwon, Sohyun Bae, Soyoon Hwang
    Journal of Korean Medical Science.2020;[Epub]     CrossRef
MERS-Epidemiologic Investigation
The first case of the 2015 Korean Middle East Respiratory Syndrome outbreak
Yong-Shik Park, Changhwan Lee, Kyung Min Kim, Seung Woo Kim, Keon-Joo Lee, Jungmo Ahn, Moran Ki
Epidemiol Health. 2015;37:e2015049.   Published online November 14, 2015
DOI: https://doi.org/10.4178/epih/e2015049
  • 19,907 View
  • 187 Download
  • 23 Web of Science
  • 29 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
This study reviewed problems in the prevention of outbreak and spread of Middle East Respiratory Syndrome (MERS) and aimed to provide assistance in establishing policies to prevent and manage future outbreaks of novel infectious diseases of foreign origin via in-depth epidemiological investigation of the patient who initiated the MERS outbreak in Korea, 2015. Personal and phone interviews were conducted with the patient and his guardians, and his activities in Saudi Arabia were investigated with the help of the Saudi Arabian Ministry of Health. Clinical courses and test results were confirmed from the medical records. The patient visited 4 medical facilities and contacted 742 people between May 11, 2015, at symptom onset, and May 20, at admission to the National Medical Center; 28 people were infected and diagnosed with MERS thereafter. Valuable lessons learned included: (1) epidemiological knowledge on the MERS transmission pattern and medical knowledge on its clinical course; (2) improvement of epidemiological investigative methods via closed-circuit television, global positioning system tracking, and review of Health Insurance Review and Assessment Service records; (3) problems revealed in the existing preventive techniques, including early determination of the various people contacted; (4) experiences with preventive methods used for the first time in Korea, including cohort quarantine; (5) reconsideration of the management systems for infectious disease outbreaks across the country, such as this case, at the levels of central government, local government, and the public; (6) reconsideration of hospital infectious disease management systems, culture involving patient visitation, and emergency room environments.
Summary
Korean summary
2015년 한국 메르스 유행의 발단이 된 첫 번째 환자의 역학조사를 통해 신종감염병의 국내 유입 경위 및 유행확산을 막기 위한 대응 과정의 문제점을 되짚어 보았다. 이를 통해 향후 신종감염병의 국내유입을 막기 위한 대비, 대응 정책 수립에 도움이 되길 바라며 이번 메르스 유행이 한국의 병원감염 관리 수준이 향상되는 계기가 되어야 할 것이다.

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MERS-Original Article
Epidemiologic features of the first MERS outbreak in Korea: focus on Pyeongtaek St. Mary’s Hospital
Kyung Min Kim, Moran Ki, Sung-il Cho, Minki Sung, Jin Kwan Hong, Hae-Kwan Cheong, Jong-Hun Kim, Sang-Eun Lee, Changhwan Lee, Keon-Joo Lee, Yong-Shik Park, Seung Woo Kim, Bo Youl Choi
Epidemiol Health. 2015;37:e2015041.   Published online September 17, 2015
DOI: https://doi.org/10.4178/epih/e2015041
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AbstractAbstract AbstractSummary PDFSupplementary Material
Abstract
OBJECTIVES
This study investigated the epidemiologic features of the confirmed cases of Middle East Respiratory Syndrome (MERS) in Pyeongtaek St. Mary’s Hospital, where the outbreak first began, in order to identify lessons relevant for the prevention and control of future outbreaks.
METHODS
The patients’ clinical symptoms and test results were collected from their medical records. The caregivers of patients were identified by phone calls.
RESULTS
After patient zero (case #1) was admitted to Pyeongtaek St. Mary’s Hospital (May 15-May 17), an outbreak occurred, with 36 cases between May 18 and June 4, 2015. Six patients died (fatality rate, 16.7%). Twenty-six cases occurred in the first-generation, and 10 in the second-generation. The median incubation period was five days, while the median period from symptom onset to death was 12.5 days. While the total attack rate was 3.9%, the attack rate among inpatients was 7.6%, and the inpatients on the eighth floor, where patient zero was hospitalized, had an 18.6% attack rate. In contrast, caregivers and medical staff showed attack rates of 3.3% and 1.1%, respectively.
CONCLUSIONS
The attack rates were higher than those of the previous outbreaks in other countries. The outbreak spread beyond Pyeongtaek St. Mary’s Hospital when four of the patients were moved to other hospitals without appropriate quarantine. The best method of preventing future outbreaks is to overcome the vulnerabilities observed in this outbreak, such as ward crowding, patient migration without appropriate data sharing, and the lack of an initial broad quarantine.
Summary
Korean summary
평택성모병원에서는 총 36명의 메르스 환자가 발생하여 이중 6명이 사망하였다. 또한 평택성모병원 유행의 발병률은 기존에 알려진 것보다 높았다. 한국의 메르스 유행이 시작된 평택성모병원에서 나타난 초기 방역 부족, 적절한 정보공유 없이 환자들이 병원간에 이동하는 것, 혼잡한 병동 문제 등의 감염병 전파 취약점을 극복하는 것이 향후 새로운 감염병 유행을 막을 수 있는 최선의 방법이 될 것이다.

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Original Article
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
<sec><title>OBJECTIVES</title><p>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.</p></sec><sec><title>METHODS</title><p>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.</p></sec><sec><title>RESULTS</title><p>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.</p></sec><sec><title>CONCLUSION</title><p>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.</p></sec>
Summary

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Editorial
Comments on Jo and Colleagues' Paper (2010) "Association of Subway Driver's Depressive Symptoms and Experience of Work-Related Problems"
Jae-Min Kim
Epidemiol Health. 2011;33:e2011002.   Published online April 25, 2011
DOI: https://doi.org/10.4178/epih/e2011002
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Abstract
Summary
Multicenter Study
Characteristics of major depressive disorder according to family history of depression : A CRESCEND-K (Clinical Research Center for Depression in Korea) study.
Seunghee Jeong, Hyeon Woo Yim, Youngeun Jung, Sunjin Jo, Taeyoun Jun, Sung Won Jung, Minsoo Lee, Jaemin Kim
Korean J Epidemiol. 2008;30(2):272-280.   Published online December 31, 2008
DOI: https://doi.org/10.4178/kje.2008.30.2.272
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AbstractAbstract PDF
Abstract
PURPOSE
People with a family history of mood disorder are more likely to have depression. This study compared the characteristics of non-psychotic major depression disorder according to family history of depression.
METHOD
Subjects were total of 817 persons recruited for the CRESCEND-K multicenter trial. Characteristics of depression and suicide history of patients with and without a family history of depression were assessed. Family history was determined through self-report.
RESULTS
Of 817 participants, 12.4% had a positive family history of depression. Those with family history of depression reported an earlier age at onset of MDD, and more psychiatric comorbidity. Severity of depression and anxiety were not different according to family history of depression. There were no difference in attempted suicide history, number of attempted suicide and age at onset of 1st attempted suicide according to such a family history.
CONCLUSION
Patients with family history of depression reported earlier onset of MDD and more history of psychiatric comorbidity.
Summary

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  • The Associations between Social Support, Health-Related Behaviors, Socioeconomic Status and Depression in Medical Students
    Yoolwon Jeong, Jin Young Kim, Jae Seon Ryu, Ko eun Lee, Eun Hee Ha, Hyesook Park
    Epidemiology and Health.2010; 32: e2010009.     CrossRef
Original Article
Effect of anti-smoking education on male high school students.
Tack Min Kim, Sun Ha Jee, Heechoul Ohr
Korean J Epidemiol. 1992;14(2):175-183.
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Abstract
In order to examine the effect of an anti - smoking education method on smoking, a untreated control group design with pretest and posttest study were conducted with self - completing questionnaire in 1990 and 1991. A total of 247 male students from one high school in Wonju made the experimental group and another 236 students made the comparison group in this study. Anti - smoking education, with a forty - minute demonstration about danger of smoking and a twenty - minute - long video tape education, was given to the experiment group. The results were as follows : 1. The smoking prevalence of the experiment group and the comparision group were 11.5% and 14.5% respectively at baseline. Smoking prevalence of the experiment group increased to 16.0% and that of comparison group increased to 16.4% respectively after one year interval of antismoking education to the experiment group. 2. The baseline smoking knowlege score of experiment group was 29.7 and that of comparison group was 31.9. Those scores collected after one year interval ware 31.9 and 33.2 respectively. 3. The odds ratios for smoking estimated from a unconditional logistic regression analysis were 4.8 (p<0.01) for students with a smoking friends as the best friend, 1.02 (p<0.05) for one score increase in knowledge of smoking health hazard and 0.8 (p<0.05) for anti - smoking education. This study implicates it is unlikely that a common anti - smoking programme would be effective for male high school students. To devlelop effective measures for preventing high school boys’ smoking it is highly recommended to carry out further researches in details of anti - smoking education.
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Epidemiol Health : Epidemiology and Health
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