1.Digital Biomarkers in Living Labs for Vulnerable and Susceptible Individuals: An Integrative Literature Review
YouHyun PARK ; Tae-Hwa GO ; Se Hwa HONG ; Sung Hwa KIM ; Jae Hun HAN ; Yeongsil KANG ; Dae Ryong KANG
Yonsei Medical Journal 2022;63(S1):43-55
Purpose:
The study aimed to identify which digital biomarkers are collected and which specific devices are used according to vulnerable and susceptible individual characteristics in a living-lab setting.
Materials and Methods:
A literature search, screening, and appraisal process was implemented using the Web of Science, Pubmed, and Embase databases. The search query included a combination of terms related to “digital biomarkers,” “devices that collect digital biomarkers,” and “vulnerable and susceptible groups.” After the screening and appraisal process, a total of 37 relevant articles were obtained.
Results:
In elderly people, the main digital biomarkers measured were values related to physical activity. Most of the studies used sensors. The articles targeting children aimed to predict diseases, and most of them used devices that are simple and can induce some interest, such as wearable device-based smart toys. In those who were disabled, digital biomarkers that measured location-based movement for the purpose of diagnosing disabilities were widely used, and most were measured by easy-to-use devices that did not require detailed explanations. In the disadvantaged, digital biomarkers related to health promotion were measured, and various wearable devices, such as smart bands and headbands were used depending on the purpose and target.
Conclusion
As the digital biomarkers and devices that collect them vary depending on the characteristics of study subjects, researchers should pay attention not only to the purpose of the study but also the characteristics of study subjects when collecting and analyzing digital biomarkers from living labs.
2.Evaluation of an air quality warning system for vulnerable and susceptible individuals in Korea: an interrupted time series analysis
YouHyun PARK ; Jun Hyuk KOO ; Hoyeon JEONG ; Ji Ye JUNG ; Changsoo KIM ; Dae Ryong KANG
Epidemiology and Health 2023;45(1):e2023020-
OBJECTIVES:
This study was conducted to elucidate the effects of an air quality warning system (AQWS) implemented in January 2015 in Korea by analyzing changes in the incidence and exacerbation rates of environmental diseases.
METHODS:
Data from patients with environmental diseases were extracted from the National Health Insurance Service-National Sample Cohort database from 2010 to 2019, and data on environmental risk factors were acquired from the AirKorea database. Patient and meteorological data were linked based on residential area. An interrupted time series analysis with Poisson segmented regression was used to compare the rates before and after AQWS introduction. Adjustment variables included seasonality, air pollutants (carbon monoxide, nitrogen dioxide, sulfur dioxide, particulate matter less than 10 μm in diameter, and ozone), temperature, and humidity.
RESULTS:
After AQWS implementation, the incidence of asthma gradually decreased by 20.5%. Cardiovascular disease and stroke incidence also significantly decreased (by 34.3 and 43.0%, respectively). However, no immediate or gradual decrease was identified in the exacerbation rate of any environmental disease after AQWS implementation. Sensitivity analyses were performed according to age, disability, and health insurance coverage type. Overall, the AQWS effectively mitigated the occurrence of most environmental diseases in Korea. However, the relationships between alarm system implementation and reduced incidence differed among diseases based on the characteristics of vulnerable and sensitive individuals.
CONCLUSIONS
Our results suggest that by tailoring the AQWS to demographic and sociological characteristics and providing enhanced education about the warning system, interventions can become an efficient policy tool to decrease air pollution-related health risks.
3.Clinical Practice Guideline for Care in the Last Days of Life
Jinyoung SHIN ; Yoon Jung CHANG ; So-Jung PARK ; Jin Young CHOI ; Sun-Hyun KIM ; Youn Seon CHOI ; Nam Hee KIM ; Ho-Kee YUM ; Eun Mi NAM ; Myung Hee PARK ; Nayeon MOON ; Jee Youn MOON ; Hee-Taik KANG ; Jung Hun KANG ; Jae-Min PARK ; Chung-Woo LEE ; Seon-Young KIM ; Eun Jeong LEE ; Su-Jin KOH ; Yonghwan KIM ; Myongjin AGNES CHO ; Youhyun SONG ; Jae Yong SHIM
Korean Journal of Hospice and Palliative Care 2020;23(3):103-113
A clinical practice guideline for patients in the dying process in general wards and their families, developed through an evidence-based process, is presented herein. The purpose of this guideline is to enable a peaceful death based on an understanding of suitable management of patients’ physical and mental symptoms, psychological support, appropriate deci-sion-making, family care, and clearly-defined team roles. Although there are limits to the available evidence regarding medical issues in patients facing death, the final recommendations were determined from expert advice and feedback, considering values and preferences related to medical treatment, benefits and harms, and applicability in the real world. This guideline should be applied in a way that takes into account specific health care environments, including the resources of medical staff and differences in the available resources of each institution. This guideline can be used by all medical institutions in South Korea.