1.Maintenance of pegylated liposomal doxorubicin/carboplatin in patients with advanced ovarian cancer: randomized study of an Asian Gynecologic Oncology Group
Chyong Huey LAI ; Elizabeth VALLIKAD ; Hao LIN ; Lan Yan YANG ; Shih Ming JUNG ; Hsueh Erh LIU ; Yu Che OU ; Hung Hsueh CHOU ; Cheng Tao LIN ; Huei Jean HUANG ; Kuan Gen HUANG ; Jiantai QIU ; Yao Ching HUNG ; Tzu I WU ; Wei Yang CHANG ; Kien Thiam TAN ; Chiao Yun LIN ; Angel CHAO ; Chee Jen CHANG
Journal of Gynecologic Oncology 2020;31(1):5-
2.Diagnostic Accuracy of a Novel On-site Virtual Fractional Flow Reserve Parallel Computing System
Hyung Bok PARK ; Yeonggul JANG ; Reza ARSANJANI ; Minh Tuan NGUYEN ; Sang Eun LEE ; Byunghwan JEON ; Sunghee JUNG ; Youngtaek HONG ; Seongmin HA ; Sekeun KIM ; Sang Wook LEE ; Hyuk Jae CHANG
Yonsei Medical Journal 2020;61(2):137-144
bias of 0.005 (95% CI −0.011 to 0.021) with 95% limits of agreement of −0.16 to 0.17 between vFFR and FFR. The accuracy, sensitivity, specificity, positive predictive value, and negative predictive value were 78.0%, 87.1%, 72.5%, 58.7%, and 92.6%, respectively, using the FFR cutoff of 0.80. They were 87.0%, 95.0%, 80.0%, 54.3%, and 98.5%, respectively, with the FFR cutoff of 0.75. The area under the receiver-operating characteristics curve of vFFR versus obstructive CTA stenosis was 0.88 versus 0.61 for the FFR cutoff of 0.80, respectively; it was 0.94 versus 0.62 for the FFR cutoff of 0.75.CONCLUSION: Our novel, fully automated, on-site vFFR technology showed excellent diagnostic performance for the detection of lesion-specific ischemia.]]>
Angiography
;
Bias (Epidemiology)
;
Constriction, Pathologic
;
Coronary Angiography
;
Fractional Flow Reserve, Myocardial
;
Humans
;
Ischemia
;
Patient-Specific Modeling
;
Sensitivity and Specificity
3.Incidence of Hypotension after Discontinuation of Norepinephrine or Arginine Vasopressin in Patients with Septic Shock: a Systematic Review and Meta-Analysis
Jae Uk SONG ; Jonghoo LEE ; Hye Kyeong PARK ; Gee Young SUH ; Kyeongman JEON
Journal of Korean Medical Science 2020;35(1):8-
bias. In addition, there were no significant differences in intensive care unit (ICU) mortality, in-hospital mortality, 28-day mortality, or ICU length of stay between the groups.CONCLUSION: Discontinuing NE prior to AVP was associated with a lower incidence of hypotension in patients recovering from septic shock. However, our results should be interpreted with caution, due to the considerable between-study heterogeneity.]]>
Arginine Vasopressin
;
Arginine
;
Bias (Epidemiology)
;
Consensus
;
Hospital Mortality
;
Humans
;
Hypotension
;
Incidence
;
Intensive Care Units
;
Length of Stay
;
Mortality
;
Norepinephrine
;
Odds Ratio
;
Population Characteristics
;
Sepsis
;
Shock, Septic
;
Treatment Outcome
;
Vasoconstrictor Agents
4.Precision Medicine and Cardiovascular Health: Insights from Mendelian Randomization Analyses
Wes SPILLER ; Keum Ji JUNG ; Ji Young LEE ; Sun Ha JEE
Korean Circulation Journal 2020;50(2):91-111
Cardiovascular disease (CVD) is considered a primary driver of global mortality and is estimated to be responsible for approximately 17.9 million deaths annually. Consequently, a substantial body of research related to CVD has developed, with an emphasis on identifying strategies for the prevention and effective treatment of CVD. In this review, we critically examine the existing CVD literature, and specifically highlight the contribution of Mendelian randomization analyses in CVD research. Throughout this review, we assess the extent to which research findings agree across a range of studies of differing design within a triangulation framework. If differing study designs are subject to non-overlapping sources of bias, consistent findings limit the extent to which results are merely an artefact of study design. Consequently, broad agreement across differing studies can be viewed as providing more robust causal evidence in contrast to limiting the scope of the review to a single specific study design. Utilising the triangulation approach, we highlight emerging patterns in research findings, and explore the potential of identified risk factors as targets for precision medicine and novel interventions.
Artifacts
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Bias (Epidemiology)
;
Cardiovascular Diseases
;
Mendelian Randomization Analysis
;
Mortality
;
Precision Medicine
;
Random Allocation
;
Risk Factors
6.Effectiveness of Acceptance and Commitment Therapy for Chronic Pain Patients: A Systematic Review and Meta-Analysis
Hee Sook KANG ; Sung Dong HWANG ; Sang Eun JUN
Journal of Korean Academy of Psychiatric and Mental Health Nursing 2019;28(3):271-285
PURPOSE: The aims of this study was to evaluate the effects of acceptance and commitment therapy (ACT) for chronic pain patients. METHODS: Based on the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-analyses, we searched the Cochrane Library, CINAHL, EMBASE, OVID, PubMed and Korean databases to identify randomized controlled trials published through May 2019. To estimate the effect size, a meta-analysis of the studies was performed using the R program, and the risk of bias was assessed using the Cochrane's Risk of Bias tool for randomized studies. RESULTS: A total of 11 studies were included in this study. Studies were heterogeneous, and random effects models were used in the analyses. ACT was effective for improving pain (g=−0.40, 95%CI:−0.69~−1.12, p<.001, I2=80%), pain acceptance (g=1.24, 95% CI:0.41~2.05, p<.001, I²=95%), anxiety (g=−0.47, 95% CI:−0.81~−0.13, p<.001, I²=84%), depression (g=−0.52, 95% CI:−0.85~−0.19, p<.001, I²=85%), and quality of life (g=1.14, 95% CI:0.11~2.17, p<.001, I²=95%). CONCLUSION: Our study findings of the ACT seems to be effective for improving pain, pain acceptance, anxiety, depression, and quality of life in patients with chronic pain. Additionally, ACT may be useful for reducing barriers to therapy, and various studies should be attempted.
Acceptance and Commitment Therapy
;
Anxiety
;
Bias (Epidemiology)
;
Chronic Pain
;
Depression
;
Humans
;
Quality of Life
7.Comparative Analysis of Phase Lag Entropy and Bispectral Index as Anesthetic Depth Indicators in Patients Undergoing Thyroid Surgery with Nerve Integrity Monitoring
Kwon Hui SEO ; Kyung Mi KIM ; Soo Kyung LEE ; Hyunji JOHN ; Junsuck LEE
Journal of Korean Medical Science 2019;34(20):e151-
BACKGROUND: Most depth of anesthesia (DOA) monitors rely on the temporal characteristics of a single-channel electroencephalogram (EEG) and cannot provide spatial or connectivity information. Phase lag entropy (PLE) reflects DOA by calculating diverse connectivity from temporal patterns of phase relationships. The aim of this study was to compare the performance of PLE and bispectral index (BIS) monitors for assessing DOA during anesthesia induction, nerve integrity monitoring (NIM), and anesthesia emergence. METHODS: Thirty-five patients undergoing elective thyroid surgery with recurrent laryngeal nerve NIM received propofol and remifentanil via target-controlled infusion. After applying PLE and BIS monitors, propofol infusion was initiated at a calculated effect site concentration (Ce) of 2 µg/mL and then increased in 1-µg/mL Ce increments. After propofol Ce reached 5 μg/mL, a remifentanil infusion was begun, and anesthesia induction was considered complete. During NIM, PLE and BIS values were compared at a specific time points from platysma muscle exposure to subcutaneous tissue closure. PLE and BIS values were recorded continuously from preanesthetic state to full recovery of orientation; bias and limits of agreement between monitors were calculated. RESULTS: PLE and BIS values decreased progressively with increasing propofol Ce during anesthetic induction and increased by stages during emergence. The prediction probabilities of PLE and BIS for detecting propofol Ce changes were 0.750 and 0.756, respectively, during induction and 0.749 and 0.746, respectively, during emergence. No aberrant PLE or BIS values occurred during NIM. Correlation coefficients for BIS and PLE were 0.98 and 0.92 during induction and emergence, respectively. PLE values were significantly higher than BIS values at full recovery of orientation. Estimated bias between monitors was −4.16 ± 8.7, and 95% limits of agreement were −21.21 to 12.89. CONCLUSION: PLE is a reasonable alternative to BIS for evaluating consciousness and DOA during general anesthesia and during NIM. TRIAL REGISTRATION: Clinical Research Information Service Identifier: KCT0003490
Anesthesia
;
Anesthesia, General
;
Bias (Epidemiology)
;
Consciousness
;
Consciousness Monitors
;
Electroencephalography
;
Entropy
;
Humans
;
Information Services
;
Propofol
;
Recurrent Laryngeal Nerve
;
Subcutaneous Tissue
;
Superficial Musculoaponeurotic System
;
Thyroid Gland
8.Report of Korean Association of External Quality Assessment Service on the Accuracy-Based Lipid Proficiency Testing (2016–2018)
Jeong Ho KIM ; Yonggeun CHO ; Sang Guk LEE ; Yeo Min YUN
Journal of Laboratory Medicine and Quality Assurance 2019;41(3):121-129
The accuracy-based lipid (ABL) proficiency testing (PT) program was started in 2016 by the Korean External Quality Assessment Service to minimize the matrix effect. We analyzed 3 years of the program. We made or purchased six kinds of commutable frozen sera based on the Clinical and Laboratory Standards Institute 37A guideline and distributed it in two rounds per year from 2016 to 2018. We obtained reference values for levels of total cholesterol (TC), high-density lipoprotein cholesterol (HDLC), low-density lipoprotein cholesterol (LDLC), total glycerides, and triglycerides in each fresh frozen pool at the reference-measurement laboratories. We evaluated the average percent bias of the participating laboratories based on the National Cholesterol Education Program (NCEP) bias limit. The number of participating laboratories evaluating TC, HDLC, LDLC, total glycerides, and triglycerides increased from 164 to 223, 163 to 223, 158 to 214, 98 to 139, and 61 to 82, respectively. The average percent bias of all participating laboratories for TC, HDLC, LDLC, total glycerides, and triglycerides was +0.14%, −0.54%, +2.9%, −1.08%, and −1.32%, respectively. The average percent bias exceeded the NCEP bias limit only once or twice for TC, HDLC, and total glycerides but frequently for LDLC (eight out of 18 pools). The manufacturer-specific bias estimation report seemed useful for traceability. Although the average percent bias of participating laboratories for TC, HDLC, LDLC, total glycerides, and triglycerides was mostly within the bias limit provided by NCEP, cases of bias limit exceeding the NCEP bias limit occurred occasionally, especially for LDLC during the 3 years of the ABL PT program in Korea, suggesting that ABL PT can be used to keep maintaining traceability.
Bias (Epidemiology)
;
Cholesterol
;
Education
;
Glycerides
;
Korea
;
Laboratory Proficiency Testing
;
Lipoproteins
;
Reference Values
;
Triglycerides
9.Mendelian Randomization Analysis in Observational Epidemiology
Journal of Lipid and Atherosclerosis 2019;8(2):67-77
Mendelian randomization (MR) in epidemiology is the use of genetic variants as instrumental variables (IVs) in non-experimental design to make causality of a modifiable exposure on an outcome or disease. It assesses the causal effect between risk factor and a clinical outcome. The main reason to approach MR is to avoid the problem of residual confounding. There is no association between the genotype of early pregnancy and the disease, and the genotype of an individual cannot be changed. For this reason, it results with randomly assigned case-control studies can be set by regressing the measurements. IVs in MR are used genetic variants for estimating the causality. Usually an outcome is a disease and an exposure is risk factor, intermediate phenotype which may be a biomarker. The choice of the genetic variable as IV (Z) is essential to a successful in MR analysis. MR is named ‘Mendelian deconfounding’ as it gives to estimate of the causality free from biases due to confounding (C). To estimate unbiased estimation of the causality of the exposure (X) on the clinically relevant outcome (Y), Z has the 3 core assumptions (A1-A3). A1) Z is independent of C; A2) Z is associated with X; and A3) Z is independent of Y given X and C; The purpose of this review provides an overview of the MR analysis and is to explain that using an IV is proposed as an alternative statistical method to estimate causal effect of exposure and outcome under controlling for a confounder.
Bias (Epidemiology)
;
Case-Control Studies
;
Epidemiology
;
Genotype
;
Mendelian Randomization Analysis
;
Methods
;
Molecular Epidemiology
;
Phenotype
;
Pregnancy
;
Random Allocation
;
Risk Factors
10.Association Between Dental Implants and Cognitive Function in Community-dwelling Older Adults in Korea
Seungkook KI ; Jihye YUN ; Jinhee KIM ; Yunhwan LEE
Korean Journal of Preventive Medicine 2019;52(5):333-343
OBJECTIVES: This study aimed to evaluate the association between dental implants and cognitive function in community-dwelling older adults. METHODS: Data were collected from the baseline survey (2016–2017) of the Korean Frailty and Aging Cohort Study. The study sample comprised 1115 community-dwelling people aged 70 years to 84 years who had 0-19 natural teeth. Dental implants and natural teeth were identified by panoramic radiography, while the cognitive function was assessed by the Korean version of the Mini-Mental State Examination (MMSE-KC). The association between dental implants and cognitive function was analyzed by multiple linear regression. Sensitivity analysis was performed to test for potential bias. RESULTS: The mean number of natural teeth in the study population was 9.50 (standard deviation [SD], 6.42), and the mean MMSE-KC score was 24.93 (SD, 3.55). In the simple univariate analysis, tooth replacement, age, sex, smoking status, alcohol consumption, body mass index, osteoporosis, number of natural teeth, periodontitis, chewing discomfort, tooth-brushing frequency, education level, monthly household income, participation in economic activity, living alone, and marital status had a significant impact on the association. After adjusting for confounders, the association between dental implants and cognitive function remained significant (B, 0.85; standard error, 0.40; p<0.05). Age, body mass index, periodontitis, tooth-brushing frequency, and education level were also significantly associated with cognitive function. The results of the sensitivity analyses were consistent with those of the primary analysis. CONCLUSIONS: Dental implants were associated with cognitive function in older adults living in the community. Dental implants as tooth replacements may play a role in preserving cognitive function.
Adult
;
Aging
;
Alcohol Drinking
;
Bias (Epidemiology)
;
Body Mass Index
;
Cognition
;
Cognitive Reserve
;
Cohort Studies
;
Dental Implants
;
Education
;
Family Characteristics
;
Humans
;
Korea
;
Linear Models
;
Marital Status
;
Mastication
;
Osteoporosis
;
Periodontitis
;
Prostheses and Implants
;
Radiography, Panoramic
;
Smoke
;
Smoking
;
Surveys and Questionnaires
;
Tooth

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