We investigated the incidence of diagnosed diabetes in South Korean adults (aged ≥20 years) by analyzing data for the National Health Insurance Service–National Sample Cohort. From 2006 to 2015, the overall incidence rate of diagnosed diabetes decreased by approximately 0.1% per year until 2015. Although, this trend was observed in individuals aged 40 years or over, the rate increased slightly in the 20–29 and 30–39 years age groups, from 0.5 to 0.7 and 2.0 to 2.6 per 1,000 individuals, respectively. The proportion of obese young adults with diabetes increased remarkably, from 51.4% in 2006 to 72.4% in 2015. Thus, young adults need early identification and weight-control strategies to prevent diabetes.

BACKGROUND/AIMS: Olmesartan, a widely used angiotensin II receptor blocker (ARB), has been linked to sprue-like enteropathy. No cases of olmesartan-associated enteropathy have been reported in Northeast Asia. We investigated the associations between olmesartan and other ARBs and the incidence of enteropathy in Korea. METHODS: Our retrospective cohort study used data from the Korean National Health Insurance Service to identify 108,559 patients (58,186 females) who were initiated on angiotensin converting enzyme inhibitors (ACEis), olmesartan, or other ARBs between January 2005 and December 2012. The incidences of enteropathy were compared among drug groups. Changes in body weight were compared after propensity score matching of patients in the ACEis and olmesartan groups. RESULTS: Among 108,559 patients, 31 patients were diagnosed with enteropathy. The incidences were 0.73, 0.24, and 0.37 per 1,000 persons, in the ACEis, olmesartan, and other ARBs groups, respectively. Adjusted rate ratios for enteropathy were: olmesartan, 0.33 (95% confidential interval [CI], 0.10 to 1.09; p = 0.070) and other ARBs, 0.34 (95% CI, 0.14 to 0.83; p = 0.017) compared to the ACEis group after adjustment for age, sex, income level, and various comorbidities. The post hoc analysis with matched cohorts revealed that the proportion of patients with significant weight loss did not differ between the ACEis and olmesartan groups. CONCLUSIONS: Olmesartan was not associated with intestinal malabsorption or significant body weight loss in the general Korean population. Additional large-scale prospective studies of the relationship between olmesartan and the incidence of enteropathy in the Asian population are needed.
Angiotensin Receptor Antagonists ; Angiotensin-Converting Enzyme Inhibitors ; Asia ; Asian Continental Ancestry Group ; Body Weight ; Cohort Studies* ; Comorbidity ; Drug-Related Side Effects and Adverse Reactions ; Humans ; Incidence ; Insurance Claim Review ; Intestinal Diseases ; Korea ; National Health Programs ; Propensity Score ; Prospective Studies ; Receptors, Angiotensin ; Retrospective Studies ; Weight Loss

OBJECTIVES: Electrocardiogram (ECG) data are important for the study of cardiovascular disease and adverse drug reactions. Although the development of analytical techniques such as machine learning has improved our ability to extract useful information from ECGs, there is a lack of easily available ECG data for research purposes. We previously published an article on a database of ECG parameters and related clinical data (ECG-ViEW), which we have now updated with additional 12-lead waveform information. METHODS: All ECGs stored in portable document format (PDF) were collected from a tertiary teaching hospital in Korea over a 23-year study period. We developed software which can extract all ECG parameters and waveform information from the ECG reports in PDF format and stored it in a database (meta data) and a text file (raw waveform). RESULTS: Our database includes all parameters (ventricular rate, PR interval, QRS duration, QT/QTc interval, P-R-T axes, and interpretations) and 12-lead waveforms (for leads I, II, III, aVR, aVL, aVF, V1, V2, V3, V4, V5, and V6) from 1,039,550 ECGs (from 447,445 patients). Demographics, drug exposure data, diagnosis history, and laboratory test results (serum calcium, magnesium, and potassium levels) were also extracted from electronic medical records and linked to the ECG information. CONCLUSIONS: Electrocardiogram information that includes 12 lead waveforms was extracted and transformed into a form that can be analyzed. The description and programming codes in this case report could be a reference for other researchers to build ECG databases using their own local ECG repository.
Calcium ; Cardiovascular Diseases ; Demography ; Diagnosis ; Drug-Related Side Effects and Adverse Reactions ; Electrocardiography* ; Electronic Health Records ; Hospitals, Teaching ; Korea ; Machine Learning ; Magnesium ; Potassium

OBJECTIVES: A distributed research network (DRN) has the advantages of improved statistical power, and it can reveal more significant relationships by increasing sample size. However, differences in data structure constitute a major barrier to integrating data among DRN partners. We describe our experience converting Electronic Health Records (EHR) to the Observational Health Data Sciences and Informatics (OHDSI) Common Data Model (CDM). METHODS: We transformed the EHR of a hospital into Observational Medical Outcomes Partnership (OMOP) CDM ver. 4.0 used in OHDSI. All EHR codes were mapped and converted into the standard vocabulary of the CDM. All data required by the CDM were extracted, transformed, and loaded (ETL) into the CDM structure. To validate and improve the quality of the transformed dataset, the open-source data characterization program ACHILLES was run on the converted data. RESULTS: Patient, drug, condition, procedure, and visit data from 2.07 million patients who visited the subject hospital from July 1994 to November 2014 were transformed into the CDM. The transformed dataset was named the AUSOM. ACHILLES revealed 36 errors and 13 warnings in the AUSOM. We reviewed and corrected 28 errors. The summarized results of the AUSOM processed with ACHILLES are available at http://ami.ajou.ac.kr:8080/. CONCLUSIONS: We successfully converted our EHRs to a CDM and were able to participate as a data partner in an international DRN. Converting local records in this manner will provide various opportunities for researchers and data holders.
Clinical Coding ; Data Accuracy* ; Dataset ; Electronic Health Records* ; Epidemiologic Methods ; Hospitals, Teaching* ; Humans ; Informatics ; Sample Size ; Vocabulary

This report examines a patient with pulmonary adenocarcinoma that developed on a previous lesion from microscopic polyangiitis. A 59-year-old woman had been diagnosed with microscopic polyangiitis in October of 1988 based on her clinical symptoms and serological tests, which were positive for anti-neutrophil cytoplasmic antibodies. Her glomerulonephritis had been well controlled with low-dose prednisolone. She presented in October of 2005 with vague chest discomfort and dyspnea on exertion. Physical examination was unremarkable. A non-contrast computed tomography (CT) scan of the chest showed patch ground-glass opacity at the right lower lobe of the lung. Because we did not believe the lesion to be a definite malignancy, we decided to follow up with chest images over a short interval. During the 18 months following the images, the lesion did not change. However, the opacity of the lesion increased slightly over the last two months, and a non-contrast CT scan of the chest was therefore performed. A CT scan showed persistent ground-glass opacity with a slightly solid portion. To diagnose the previous finding and possibly to provide treatment, a right lower lobectomy of the lung via video-assisted thoracoscopic surgery was performed. The pathologic review of the resected lung revealed an adenocarcinoma, stage pT1N0. After one year, fluorodeoxyglucose positron emission tomography was performed, and no evidence of a recurrent malignancy was found.
Adenocarcinoma ; Antibodies, Antineutrophil Cytoplasmic ; Dyspnea ; Female ; Follow-Up Studies ; Glomerulonephritis ; Humans ; Lung ; Microscopic Polyangiitis ; Middle Aged ; Physical Examination ; Positron-Emission Tomography ; Prednisolone ; Serologic Tests ; Thoracic Surgery, Video-Assisted ; Thorax