1.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
2.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
3.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
4.Cost-effectiveness of Fractional Flow Reserve Versus Intravascular Ultrasound to Guide Percutaneous Coronary Intervention: Results From the FLAVOUR Study
Doyeon HWANG ; Hea-Lim KIM ; Jane KO ; HyunJin CHOI ; Hanna JEONG ; Sun-ae JANG ; Xinyang HU ; Jeehoon KANG ; Jinlong ZHANG ; Jun JIANG ; Joo-Yong HAHN ; Chang-Wook NAM ; Joon-Hyung DOH ; Bong-Ki LEE ; Weon KIM ; Jinyu HUANG ; Fan JIANG ; Hao ZHOU ; Peng CHEN ; Lijiang TANG ; Wenbing JIANG ; Xiaomin CHEN ; Wenming HE ; Sung Gyun AHN ; Ung KIM ; You-Jeong KI ; Eun-Seok SHIN ; Hyo-Soo KIM ; Seung-Jea TAHK ; JianAn WANG ; Tae-Jin LEE ; Bon-Kwon KOO ;
Korean Circulation Journal 2025;55(1):34-46
Background and Objectives:
The Fractional Flow Reserve and Intravascular UltrasoundGuided Intervention Strategy for Clinical Outcomes in Patients with Intermediate Stenosis (FLAVOUR) trial demonstrated non-inferiority of fractional flow reserve (FFR)-guided percutaneous coronary intervention (PCI) compared with intravascular ultrasound (IVUS)-guided PCI. We sought to investigate the cost-effectiveness of FFR-guided PCI compared to IVUS-guided PCI in Korea.
Methods:
A 2-part cost-effectiveness model, composed of a short-term decision tree model and a long-term Markov model, was developed for patients who underwent PCI to treat intermediate stenosis (40% to 70% stenosis by visual estimation on coronary angiography).The lifetime healthcare costs and quality-adjusted life-years (QALYs) were estimated from the healthcare system perspective. Transition probabilities were mainly referred from the FLAVOUR trial, and healthcare costs were mainly obtained through analysis of Korean National Health Insurance claims data. Health utilities were mainly obtained from the Seattle Angina Questionnaire responses of FLAVOUR trial participants mapped to EQ-5D.
Results:
From the Korean healthcare system perspective, the base-case analysis showed that FFR-guided PCI was 2,451 U.S. dollar lower in lifetime healthcare costs and 0.178 higher in QALYs compared to IVUS-guided PCI. FFR-guided PCI remained more likely to be cost-effective over a wide range of willingness-to-pay thresholds in the probabilistic sensitivity analysis.
Conclusions
Based on the results from the FLAVOUR trial, FFR-guided PCI is projected to decrease lifetime healthcare costs and increase QALYs compared with IVUS-guided PCI in intermediate coronary lesion, and it is a dominant strategy in Korea.
5.Hospital life experience of older patients hospitalized for a long time in long-term care hospitals without visitors: A phenomenological study
Hanna JEONG ; Suhye KWON ; Yu Jin JUNG
Journal of Korean Gerontological Nursing 2024;26(2):191-202
This study aimed to explore older patients’ experiences of hospital life in long-term care hospitals without visitors. Methods: Data were collected through individual in-depth interviews with eight older patients hospitalized in long-term care hospitals and were analyzed using Colaizzi’s phenomenological method. Results: Four theme clusters extracted from older patients’ experiences were shabby oneself cut off from the outside world, a hospital that eventually became home, fear of death that will come one day, a self-reliant daily life with gathering body and mind. Conclusion: Through the results of this study, it was possible to deeply understand the experiences of older patients living in long-term care hospitals for a long time without visitors. Based on this, it is necessary to develop nursing interventions that can effectively support them, and active strategies are required to prevent their social disconnection and expand various social networks inside and outside the hospital.
6.Structural Equation Modeling of Health Promotion Behavior on Migrant Workers: A Multi-Group Analysis Based on the Period of Residence
Journal of Korean Academy of Nursing 2024;54(1):73-92
Purpose:
This study developed and tested a hypothetical model of health promotion behavior on migrant workers based on the Health Promotion Model and the Health Literacy Skills Framework.
Methods:
Data were collected from 298 migrant workers in 9 regions across the country from December 2020 to March 2021. The exogenous variables were e-health literacy, occupational stress, acculturation, and social support. The endogenous variables were perceived benefits of action, self-efficacy, and health promotion behavior. Data were analyzed using SPSS/WIN 25.0, AMOS 20.0, and R-4.0.3 program.
Results:
The model fit was appropriate. Social support had the most significant direct impact on the health promotion behavior of migrant workers. Perceived benefits of action and self-efficacy played a mediating role in the relationship among e-health literacy, social support, and health promotion behavior. Based on multi-group analysis, the migrant worker group with less than 5 years of residency had a more statistically significant effect on the relationship between perceived benefits of action and health promotion behavior than those with over 5 years.
Conclusion
Providing social support as a critical administrative strategy to enhance the health promotion behavior of migrant workers is necessary. Furthermore, when developing an intervention program utilizing the internal mechanism between social support and health promotion behavior, a self-efficacy-enhancing strategy is considered to be more effective. Additionally, educating migrant workers with short-term residence of less than 5 years about the benefits of health behaviors is essential.
7.Promising Therapeutic Effectsof Embryonic Stem Cells-Origin Mesenchymal Stem Cells in Experimental Pulmonary Fibrosis Models: Immunomodulatory and Anti-Apoptotic Mechanisms
Hanna LEE ; Ok-Yi JEONG ; Hee Jin PARK ; Sung-Lim LEE ; Eun-yeong BOK ; Mingyo KIM ; Young Sun SUH ; Yun-Hong CHEON ; Hyun-Ok KIM ; Suhee KIM ; Sung Hak CHUN ; Jung Min PARK ; Young Jin LEE ; Sang-Il LEE
Immune Network 2023;23(6):e45-
Interstitial lung disease (ILD) involves persistent inflammation and fibrosis, leading to respiratory failure and even death. Adult tissue-derived mesenchymal stem cells (MSCs) show potential in ILD therapeutics but obtaining an adequate quantity of cells for drug application is difficult. Daewoong Pharmaceutical’s MSCs (DW-MSCs) derived from embryonic stem cells sustain a high proliferative capacity following long-term culture and expansion. The aim of this study was to investigate the therapeutic potential of DW-MSCs in experimental mouse models of ILD. DW-MSCs were expanded up to 12 passages for in vivo application in bleomycin-induced pulmonary fibrosis and collagen-induced connective tissue diseaseILD mouse models. We assessed lung inflammation and fibrosis, lung tissue immune cells, fibrosis-related gene/protein expression, apoptosis and mitochondrial function of alveolar epithelial cells, and mitochondrial transfer ability. Intravenous administration of DWMSCs consistently improved lung fibrosis and reduced inflammatory and fibrotic markers expression in both models across various disease stages. The therapeutic effect of DW-MSCs was comparable to that following daily oral administration of nintedanib or pirfenidone.Mechanistically, DW-MSCs exhibited immunomodulatory effects by reducing the number of B cells during the early phase and increasing the ratio of Tregs to Th17 cells during the late phase of bleomycin-induced pulmonary fibrosis. Furthermore, DW-MSCs exhibited antiapoptotic effects, increased cell viability, and improved mitochondrial respiration in alveolar epithelial cells by transferring their mitochondria to alveolar epithelial cells. Our findings indicate the strong potential of DW-MSCs in the treatment of ILD owing to their high efficacy and immunomodulatory and anti-apoptotic effects.
8.Analysis of YouTube Content on Oral Disease Information about the Elderly
Ji-Won KIM ; Hanna GU ; Hye-Jin KWON ; Jeong-Hyun LIM ; Hee-Jung LIM
Journal of Dental Hygiene Science 2022;22(1):1-8
Background:
The elderly have, a higher disease morbidity than other age groups due to a decrease in resistance to the diseaseand have complex diseases, so care should be taken. Accordingly, it is considered important to provide information for improving the health of the elderly. Health information plays an important role in individual health promotion and education, so the degree of exposure to information about oral health of the elderly is expected to have a significant impact on understanding and acquiring information on oral content videos on the importance, prevention, and management of oral health of the elderly in the future.
Methods:
This study analyzed video content related to oral diseases of the elderly in a total of 150 videos uploaded on YouTubefrom January 1, 2012 to May 13, 2021, using a total of three books of dental hygiene for the elderly.
Results:
Forty-nine broadcasters accounted for the most of this information. Among the information providers, there were twodental hygienists. They accounted for 1.3% of all the information providers. The highest number of dental hygienists who broadcasted information was 42 in 2019. The average number of views was 37,303 periodontal diseases, the highest. Among the videos, dry mouth was the most common with 34 oral diseases.
Conclusion
The number of images for each disease varies, so it seems that information should be provided in various ways. Dentalhygienists should widely improve oral health knowledge by providing various dental hygiene management images for each oral disease to improve the oral health of the general public. In addition, based on the information of the Health Insurance Review and Assessment Service, the development and provision of content should be actively carried out so that people can obtain the information they desire.
9.A Study of the Educational Needs of Clinical Nurses Based on the Experiences in Training Programs for Nursing COVID-19 Patients
Jeong-Won HAN ; Jaewon JOUNG ; Ji-Soon KANG ; Hanna LEE
Asian Nursing Research 2022;16(2):63-72
Purpose:
This study aimed to explore the experience of clinical nurses regarding training programs for critically ill patients with coronavirus disease 2019 (COVID-19) and their educational needs.
Methods:
Qualitative data were analyzed using content analysis, and quantitative data were analyzed according to Borich's formula. Data for the study were collected in March 2021 from 16 nurses who had completed a nursing program for critically ill patients with COVID-19 and were working at three hospitals designated for COVID-19.
Results:
Participants' experiences were classified into three major categories, namely “Participation experiences and perceptions of the training program,” “Recommendations for improving the training program,” and “Perceptions of working in an infectious environment,” and 10 subcategories. According to Borich's formula, the most pressing educational needs in respiratory and non-respiratory nursing, respectively, were for “nursing care for patients on extracorporeal membrane oxygenation” and “application of continuous renal replacement therapy and caring for patients.”
Conclusion
To prepare for the periodic emergence of communicable infectious diseases throughout the world and cultivate nursing staff to care for critically ill patients, it is necessary to develop nursing education programs with content corresponding to nurses' needs. This study can be used as base data for cultivating nursing staff for critically ill patients with communicable infectious diseases in keeping with clinical nurses’ educational needs and basic educational materials for nursing students.
10.Importation and Transmission of SARS-CoV-2 B.1.1.529 (Omicron) Variant of Concern in Korea, November 2021
Ji Joo LEE ; Young June CHOE ; Hyeongseop JEONG ; Moonsu KIM ; Seonggon KIM ; Hanna YOO ; Kunhee PARK ; Chanhee KIM ; Sojin CHOI ; JiWoo SIM ; Yoojin PARK ; In Sil HUH ; Gasil HONG ; Mi Young KIM ; Jin Su SONG ; Jihee LEE ; Eun-Jin KIM ; Jee Eun RHEE ; Il-Hwan KIM ; Jin GWACK ; Jungyeon KIM ; Jin-Hwan JEON ; Wook-Gyo LEE ; Suyeon JEONG ; Jusim KIM ; Byungsik BAE ; Ja Eun KIM ; Hyeonsoo KIM ; Hye Young LEE ; Sang-Eun LEE ; Jong Mu KIM ; Hanul PARK ; Mi YU ; Jihyun CHOI ; Jia KIM ; Hyeryeon LEE ; Eun-Jung JANG ; Dosang LIM ; Sangwon LEE ; Young-Joon PARK
Journal of Korean Medical Science 2021;36(50):e346-
In November 2021, 14 international travel-related severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) B.1.1.529 (omicron) variant of concern (VOC) patients were detected in South Korea. Epidemiologic investigation revealed community transmission of the omicron VOC. A total of 80 SARS-CoV-2 omicron VOC-positive patients were identified until December 10, 2021 and 66 of them reported no relation to the international travel.There may be more transmissions with this VOC in Korea than reported.

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