Objective: There has been a rapid increase in the utilization of emergency departments (EDs), especially for non-emergent cases. The challenges of accessing medical services at night cause disparities in ED utilization between the day and night. Additionally, the coronavirus disease-2019 (COVID-19) pandemic has had a notable impact on ED visits. This study aimed to compare the characteristics of patients visiting the EDs in the daytime and at night before and after COVID-19. Methods: A retrospective observational study was conducted on adults (≥18 years) at three metropolitan EDs from January 1, 2019 to December 31, 2020. Data, including the Korean Triage Acuity System, Tenth Revision (ICD-10) codes, and ICU admissions, were collected. Characteristics of patients visiting the ED during the day (06:00-18:00) and night (18:00-06:00) periods before and after COVID-19 were analyzed. Results: During the pre-COVID-19 and COVID-19 periods, 117,896 and 92,915 patients visited the ED, respectively. Non-emergency nighttime visits were increased than daytime visits during both the pre-COVID-19 period (37.9% vs. 30.9%) and the COVID-19 period (35.4% vs. 28.8%) (P<0.01). During COVID-19, non-emergency patient visits to the ED during the nighttime decreased compared to those during the day (odds ratio, 0.96; 95% confidence interval [CI], 0.93-0.99, P=0.01). Among the top five diagnoses, the number of patients declined during the COVID-19 pandemic in most categories, except for the category of “Fever of other and unknown origin,” which saw an increase both during the day (incident rate ratio [IRR], 1.10; 95% CI, 1.05-1.17) and night (IRR, 1.23; 95% CI, 1.17-1.30). Conclusion The COVID-19 pandemic significantly influenced ED visit patterns, particularly by reducing non-emergent visits during nighttime.

Objectives: This study aimed to comprehensively outline the methodological approaches used in published research comparing the vaccine effectiveness (VE) of coronavirus disease 2019 (COVID-19) vaccines. Methods: A systematic search was conducted on June 13, 2024, to identify comparative studies evaluating the effectiveness of mRNA versus non-mRNA and monovalent versus bivalent COVID-19 vaccines. We screened titles, abstracts, and full texts, collecting data on publication year, country, sample size, study population composition, study design, VE estimates, outcomes, and covariates. Studies that reported relative VE (rVE) were analyzed separately from those that did not. Results: We identified 25 articles comparing rVE between mRNA and non-mRNA COVID-19 vaccines, as well as between monovalent and bivalent formulations. Among the studies assessing VE by vaccine type, 126 did not provide rVE estimates. Comparative VE studies frequently employed retrospective cohort designs. Among the definitions of rVE used, the most common were hazard ratio and absolute VE, calculated as (1−odds ratio)×100. Studies were most frequently conducted in the United Kingdom and the United States, and the most common outcome was infection. Most targeted the general population and assessed the VE of mRNA vaccines using the AstraZeneca vaccine as a reference. A small proportion, 7.3% (n=11), did not adjust for any variables. Only 3 studies (2.0%) adjusted for all core confounding variables recommended by the World Health Organization. Conclusion Few comparative studies of COVID-19 vaccines have incorporated rVE methodologies. Reporting rVE and employing a consistent set of covariates can broaden our understanding of COVID-19 vaccines.

Objectives: This study aimed to comprehensively outline the methodological approaches used in published research comparing the vaccine effectiveness (VE) of coronavirus disease 2019 (COVID-19) vaccines. Methods: A systematic search was conducted on June 13, 2024, to identify comparative studies evaluating the effectiveness of mRNA versus non-mRNA and monovalent versus bivalent COVID-19 vaccines. We screened titles, abstracts, and full texts, collecting data on publication year, country, sample size, study population composition, study design, VE estimates, outcomes, and covariates. Studies that reported relative VE (rVE) were analyzed separately from those that did not. Results: We identified 25 articles comparing rVE between mRNA and non-mRNA COVID-19 vaccines, as well as between monovalent and bivalent formulations. Among the studies assessing VE by vaccine type, 126 did not provide rVE estimates. Comparative VE studies frequently employed retrospective cohort designs. Among the definitions of rVE used, the most common were hazard ratio and absolute VE, calculated as (1−odds ratio)×100. Studies were most frequently conducted in the United Kingdom and the United States, and the most common outcome was infection. Most targeted the general population and assessed the VE of mRNA vaccines using the AstraZeneca vaccine as a reference. A small proportion, 7.3% (n=11), did not adjust for any variables. Only 3 studies (2.0%) adjusted for all core confounding variables recommended by the World Health Organization. Conclusion Few comparative studies of COVID-19 vaccines have incorporated rVE methodologies. Reporting rVE and employing a consistent set of covariates can broaden our understanding of COVID-19 vaccines.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.

Objective: There has been a rapid increase in the utilization of emergency departments (EDs), especially for non-emergent cases. The challenges of accessing medical services at night cause disparities in ED utilization between the day and night. Additionally, the coronavirus disease-2019 (COVID-19) pandemic has had a notable impact on ED visits. This study aimed to compare the characteristics of patients visiting the EDs in the daytime and at night before and after COVID-19. Methods: A retrospective observational study was conducted on adults (≥18 years) at three metropolitan EDs from January 1, 2019 to December 31, 2020. Data, including the Korean Triage Acuity System, Tenth Revision (ICD-10) codes, and ICU admissions, were collected. Characteristics of patients visiting the ED during the day (06:00-18:00) and night (18:00-06:00) periods before and after COVID-19 were analyzed. Results: During the pre-COVID-19 and COVID-19 periods, 117,896 and 92,915 patients visited the ED, respectively. Non-emergency nighttime visits were increased than daytime visits during both the pre-COVID-19 period (37.9% vs. 30.9%) and the COVID-19 period (35.4% vs. 28.8%) (P<0.01). During COVID-19, non-emergency patient visits to the ED during the nighttime decreased compared to those during the day (odds ratio, 0.96; 95% confidence interval [CI], 0.93-0.99, P=0.01). Among the top five diagnoses, the number of patients declined during the COVID-19 pandemic in most categories, except for the category of “Fever of other and unknown origin,” which saw an increase both during the day (incident rate ratio [IRR], 1.10; 95% CI, 1.05-1.17) and night (IRR, 1.23; 95% CI, 1.17-1.30). Conclusion The COVID-19 pandemic significantly influenced ED visit patterns, particularly by reducing non-emergent visits during nighttime.

Objective: There has been a rapid increase in the utilization of emergency departments (EDs), especially for non-emergent cases. The challenges of accessing medical services at night cause disparities in ED utilization between the day and night. Additionally, the coronavirus disease-2019 (COVID-19) pandemic has had a notable impact on ED visits. This study aimed to compare the characteristics of patients visiting the EDs in the daytime and at night before and after COVID-19. Methods: A retrospective observational study was conducted on adults (≥18 years) at three metropolitan EDs from January 1, 2019 to December 31, 2020. Data, including the Korean Triage Acuity System, Tenth Revision (ICD-10) codes, and ICU admissions, were collected. Characteristics of patients visiting the ED during the day (06:00-18:00) and night (18:00-06:00) periods before and after COVID-19 were analyzed. Results: During the pre-COVID-19 and COVID-19 periods, 117,896 and 92,915 patients visited the ED, respectively. Non-emergency nighttime visits were increased than daytime visits during both the pre-COVID-19 period (37.9% vs. 30.9%) and the COVID-19 period (35.4% vs. 28.8%) (P<0.01). During COVID-19, non-emergency patient visits to the ED during the nighttime decreased compared to those during the day (odds ratio, 0.96; 95% confidence interval [CI], 0.93-0.99, P=0.01). Among the top five diagnoses, the number of patients declined during the COVID-19 pandemic in most categories, except for the category of “Fever of other and unknown origin,” which saw an increase both during the day (incident rate ratio [IRR], 1.10; 95% CI, 1.05-1.17) and night (IRR, 1.23; 95% CI, 1.17-1.30). Conclusion The COVID-19 pandemic significantly influenced ED visit patterns, particularly by reducing non-emergent visits during nighttime.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.

Objectives: This study aimed to comprehensively outline the methodological approaches used in published research comparing the vaccine effectiveness (VE) of coronavirus disease 2019 (COVID-19) vaccines. Methods: A systematic search was conducted on June 13, 2024, to identify comparative studies evaluating the effectiveness of mRNA versus non-mRNA and monovalent versus bivalent COVID-19 vaccines. We screened titles, abstracts, and full texts, collecting data on publication year, country, sample size, study population composition, study design, VE estimates, outcomes, and covariates. Studies that reported relative VE (rVE) were analyzed separately from those that did not. Results: We identified 25 articles comparing rVE between mRNA and non-mRNA COVID-19 vaccines, as well as between monovalent and bivalent formulations. Among the studies assessing VE by vaccine type, 126 did not provide rVE estimates. Comparative VE studies frequently employed retrospective cohort designs. Among the definitions of rVE used, the most common were hazard ratio and absolute VE, calculated as (1−odds ratio)×100. Studies were most frequently conducted in the United Kingdom and the United States, and the most common outcome was infection. Most targeted the general population and assessed the VE of mRNA vaccines using the AstraZeneca vaccine as a reference. A small proportion, 7.3% (n=11), did not adjust for any variables. Only 3 studies (2.0%) adjusted for all core confounding variables recommended by the World Health Organization. Conclusion Few comparative studies of COVID-19 vaccines have incorporated rVE methodologies. Reporting rVE and employing a consistent set of covariates can broaden our understanding of COVID-19 vaccines.

Objectives: This study aimed to comprehensively outline the methodological approaches used in published research comparing the vaccine effectiveness (VE) of coronavirus disease 2019 (COVID-19) vaccines. Methods: A systematic search was conducted on June 13, 2024, to identify comparative studies evaluating the effectiveness of mRNA versus non-mRNA and monovalent versus bivalent COVID-19 vaccines. We screened titles, abstracts, and full texts, collecting data on publication year, country, sample size, study population composition, study design, VE estimates, outcomes, and covariates. Studies that reported relative VE (rVE) were analyzed separately from those that did not. Results: We identified 25 articles comparing rVE between mRNA and non-mRNA COVID-19 vaccines, as well as between monovalent and bivalent formulations. Among the studies assessing VE by vaccine type, 126 did not provide rVE estimates. Comparative VE studies frequently employed retrospective cohort designs. Among the definitions of rVE used, the most common were hazard ratio and absolute VE, calculated as (1−odds ratio)×100. Studies were most frequently conducted in the United Kingdom and the United States, and the most common outcome was infection. Most targeted the general population and assessed the VE of mRNA vaccines using the AstraZeneca vaccine as a reference. A small proportion, 7.3% (n=11), did not adjust for any variables. Only 3 studies (2.0%) adjusted for all core confounding variables recommended by the World Health Organization. Conclusion Few comparative studies of COVID-19 vaccines have incorporated rVE methodologies. Reporting rVE and employing a consistent set of covariates can broaden our understanding of COVID-19 vaccines.

Rare endocrine diseases are complex conditions that require lifelong specialized care due to their chronic nature and associated long-term complications. In Korea, a lack of nationwide data on clinical practice and outcomes has limited progress in patient care. Therefore, the Multicenter Networks for Ideal Outcomes of Pediatric Rare Endocrine and Metabolic Disease (OUTSPREAD) study was initiated. This study involves 30 centers across Korea. The study aims to improve the long-term prognosis of Korean patients with rare endocrine diseases by collecting comprehensive clinical data, biospecimens, and patient-reported outcomes to identify complications and unmet needs in patient care. Patients with childhood-onset pituitary, adrenal, or gonadal disorders, such as craniopharyngioma, congenital adrenal hyperplasia (CAH), and Turner syndrome were prioritized. The planned enrollment is 1,300 patients during the first study phase (2022–2024). Clinical, biochemical, and imaging data from diagnosis, treatment, and follow-up during 1980–2023 were retrospectively reviewed. For patients who agreed to participate in the prospective cohort, clinical data and biospecimens will be prospectively collected to discover ideal biomarkers that predict the effectiveness of disease control measures and prognosis. Patient-reported outcomes, including quality of life and depression scales, will be evaluated to assess psychosocial outcomes. Additionally, a substudy on CAH patients will develop a steroid hormone profiling method using liquid chromatography-tandem mass spectrometry to improve diagnosis and monitoring of treatment outcomes. This study will address unmet clinical needs by discovering ideal biomarkers, introducing evidence-based treatment guidelines, and ultimately improving long-term outcomes in the areas of rare endocrine and metabolic diseases.