No abstract available.
Abstracting and Indexing as Topic* ; Evidence-Based Medicine* ; Methods*

BACKGROUND: As modern epidemiologic studies began to identify obesity as a risk factor for cardiovascular disease, diabetes, hypertension, and cancer, measuring the degree of excess body fat is important on epidemiologic surveys. The evaluation of obesity level in epidemiologic surveys has been mostly done indirectly by measuring patient's height and weight. But, the anthropometry could not be done to respondents of recalling past anthropometric values or to proxy respondents. This study was attempted to elucidate usefulness of a somatotype drawing as a measuring instrument of obesity level in epidemiologic surveys in Korea. METHOD: The inclusion criteria of subjects were (1) members of the Seoul Cohort Study, who were recruited by self-administered structured questionnaire survey through mailing to the healthy men between the ages of 40 and 59 years through the program of a biennial health checkup offered by the Korean Medical Insurance Corporation (KMIC), and (2) volunteers for cancer screening program offered by KMIC. For assessing usefulness of the instrument, measurement of status/weight and self-administered questionnaire survey were done separately through the program of a biennial health checkup and of cancer screening. RESULTS: The data were collected from 138 subjects, whose Body Mass Index (kg/M2) was 23.58+/-1.46 (mean+/-SD). When the validity was measured through correlation with BMI, Spearman's correlation coefficient (rs) was 0.72 (p<0.05), that remained statistically significant after adjusting age, education level, and monthly income and occupation. And, the grades of somatotypo drawing were grouped as 1-3, 4-6, 7-8 by ANOVA and Tukey test. CONCLUSIONS: Instrument using somatotype drawing is applicable to screen degree of body fat in self-administered questionnaire surveys in Korea.
Adipose Tissue ; Anthropometry ; Body Mass Index ; Cardiovascular Diseases ; Cohort Studies ; Surveys and Questionnaires ; Early Detection of Cancer ; Education ; Epidemiologic Studies ; Humans ; Hypertension ; Insurance ; Korea* ; Male ; Obesity* ; Occupations ; Postal Service ; Proxy ; Risk Factors ; Seoul ; Somatotypes* ; Volunteers

The aim of this study was to assess the degree of association between individual stress and the amount of smoking among male senior students of a medical college. The questionnaire survey was conducted twice for collecting the data on stress level in terms of BEPSl score, smoking amounts, alcohol intake, and residence type in 1992 and 1993. Among the 223 responders, 39.9% were smokers. In the smokers, the association between stress level and smoking amount was significant after controlling for alcohol intake and residence type (P < 0.l). Especially in the group of living without family, the association was more significant (p=0.06). Therefore, it is recommendable that the stress management program is called upon for the student smokers to reduce smoking amount.
Humans ; Male ; Surveys and Questionnaires ; Smoke* ; Smoking*

After publishing results of a study that revealed diarrheagenic and emetic activity in 4-5-day old mice infected with Kudoa septempunctata (K. septempunctata) spores, the Korea Centers for Disease Control and Prevention reported 11 events of “Kudoa food poisoning” in 2015. The epidemiological design of the previous study was descriptive rather than analytical; therefore, this study aimed to further investigate the pathogenicity of K. septempunctata. Academic articles showing evidence of the pathogenicity of K. septempunctata were searched via PubMed using the citation discovery tool. Information regarding the kinds of experimental animals and inoculum spores used, as well as study results were extracted. Four articles evaluating the pathogenicity of Myxospran parasites were selected; the first article suggested the pathogenicity of K. septempunctata, while the remaining three articles reported no abnormal symptoms or histopathologic changes. Our findings indicate that there is weak evidence supporting the pathogenicity of K. septempunctata. Further studies evaluating the pathogenicity of K. septempunctata are needed urgently.
Animals ; Centers for Disease Control and Prevention (U.S.) ; Food Parasitology ; Foodborne Diseases* ; Intestinal Diseases, Parasitic ; Korea ; Mice ; Myxozoa ; Parasites ; Spores ; Virulence

After publishing results of a study that revealed diarrheagenic and emetic activity in 4-5-day old mice infected with Kudoa septempunctata (K. septempunctata) spores, the Korea Centers for Disease Control and Prevention reported 11 events of “Kudoa food poisoning” in 2015. The epidemiological design of the previous study was descriptive rather than analytical; therefore, this study aimed to further investigate the pathogenicity of K. septempunctata. Academic articles showing evidence of the pathogenicity of K. septempunctata were searched via PubMed using the citation discovery tool. Information regarding the kinds of experimental animals and inoculum spores used, as well as study results were extracted. Four articles evaluating the pathogenicity of Myxospran parasites were selected; the first article suggested the pathogenicity of K. septempunctata, while the remaining three articles reported no abnormal symptoms or histopathologic changes. Our findings indicate that there is weak evidence supporting the pathogenicity of K. septempunctata. Further studies evaluating the pathogenicity of K. septempunctata are needed urgently.
Animals ; Centers for Disease Control and Prevention (U.S.) ; Food Parasitology ; Foodborne Diseases ; Intestinal Diseases, Parasitic ; Korea ; Mice ; Myxozoa ; Parasites ; Spores ; Virulence

While Korea had the highest rate of increase in per capita health expenditures from 1997 to 2007 among The Organization for Economic Cooperation and Development (OECD) countries, it is necessary in all countries to establish sustainable health care systems that efficiently use the existing effective treatment methods. For dealing with the overwhelming health care crisis, the European Union and the United States (US) have launched Health Technology Assessment (HTA) and Comparative Effectiveness Research (CER) programs, respectively. Further, the Federal Coordinating Council for Comparative Effectiveness Research in US has considered the development of the CER data infrastructure to be the primary investment needed in order to reform the national health care system. The main reason is that investment in data infrastructure can potentially generate significant additional investment in CER. In addition, the Council stressed the need for coordination between CER and health information technology through a distributed network of electronic health records. These directions and decisions on driving CER in the US may provide an invaluable lesson on solving some healthcare problems in Korea. However, barriers to the potential contribution of the existing databases to CER must be overcome, including interoperability, privacy protection and confidentiality, and active participation of the holders of the related databases.
Biomedical Technology ; Comparative Effectiveness Research ; Confidentiality ; Delivery of Health Care* ; Electronic Health Records ; European Union ; Health Expenditures ; Investments ; Korea ; Medical Informatics ; Medical Record Linkage ; Medical Records Systems, Computerized ; Privacy ; United States

Quaternary prevention should be implemented to minimize harm to patients because the ultimate goal of medicine is to prevent disease and promote health. Primary care physicians have a major responsibility in quaternary prevention, and the establishment of clinical epidemiology as a distinct field of study would create a role charged with minimizing patient harm arising from over-medicalization.
Coronavirus Infections/epidemiology/*prevention & control ; *Delivery of Health Care ; Disease Outbreaks ; Health Promotion ; Humans ; Public Health Administration ; Republic of Korea/epidemiology

In spite of being several results of efficacy obtained by randomized controlled trials about new health technologies, evidences related to real effectiveness confirmed by head-to-head direct comparison should be needed in order to improve qualities of healthcare. The comparative effectiveness evaluation (CEE) as outcomes research have suggested as the important tool for developing evidence-based information to patients, clinicians, and other decision makers about which technologies are most effective for which patients under specific circumstances. Four major methods of outcomes research are applied as systematic reviews and meta-analyses, cohort studies using registries, linkage of large databases, and pragmatic clinical trials. Through activating the CEE, the best and most effective technologies should be adopted rapidly in routine clinical practices.
Cohort Studies ; Comparative Effectiveness Research ; Delivery of Health Care ; Humans ; Outcome Assessment (Health Care) ; Registries ; Technology Assessment, Biomedical

In terms of years of life lost to premature mortality, cancer imposes the highest burden in Korea. In order to reduce the burden of cancer, the Korean government has implemented cancer control programs aiming to reduce cancer incidence, to increase survival rates, and to decrease cancer mortality. However, these programs may paradoxically increase the cost burden. For examples, a cancer screening program for early detection could bring about over-diagnosis and over-treatment, and supplying medical services in a paternalistic manner could lead to defensive medicine or futile care. As a practical measure to reduce the cost burden of cancer, appropriate cancer care should be established. Ensuring appropriateness requires patient-doctor communication to ensure that utility values are shared and that autonomous decisions are made regarding medical services. Thus, strategies for reducing the cost burden of cancer through ensuring appropriate patient-centered care include introducing value-based medicine, conducting cost-utility studies, and developing patient decision aids.
Cost of Illness ; Decision Support Techniques ; Defensive Medicine ; Early Detection of Cancer ; Humans ; Incidence ; Korea* ; Mortality ; Mortality, Premature ; Patient-Centered Care* ; Practice Valuation and Purchase ; Quality of Health Care ; Survival Rate ; Tumor Burden

A main aim of the Evidence-based Medicine is to make the best decision by related evidence in supplying healthcare services. To apply evidence-practice gap (EPG) is very helpful to scan for what evidence is necessary. EPG gave 4 parts depending on the existence of evidence and practice. Comparative effectiveness research could be suggested in the part on conducting a practice with evidence. Translational research would be applied in the part on no practice without evidence. The adaptation of previously clinical practice guideline (CPG) should be conducted in the part on treating patients without evidence. Finally, de novo development of CPG would be undertaken in the situation of not applying the known evidence for clinical practice. These trials would bring us to a new level in improving the level of quality in the nationwide healthcare system as well as to progress achievements in the Korean medical academy.
Comparative Effectiveness Research ; Delivery of Health Care ; Evidence-Based Medicine ; Evidence-Based Practice ; Humans ; Practice Guidelines as Topic ; Translational Medical Research