1.Differences in perceptions of medical artificial intelligence between medical and non-medical professionals in Korea: a qualitative study
Jeonghoon HA ; Hakyoung PARK ; Jiwon SHINN ; Hun-Sung KIM
Journal of the Korean Medical Association 2026;69(3):281-293
Purpose: Medical artificial intelligence (AI) is rapidly being integrated into clinical practice and healthcare systems, raising concerns regarding safety, accountability, and governance. Despite its increasing importance, empirical comparative studies examining differences in perceptions of medical AI among key expert groups remain limited. This study aimed to compare and analyze perceptions of medical AI among medical and non-medical professionals and to systematically identify commonalities and differences across policy- and governance-relevant domains. Methods: Focus group interviews using open-ended questions were conducted with 30 experts (15 medical and 15 non-medical professionals) who had direct experience with medical AI. Data were analyzed using inductive thematic analysis combined with qualitative comparative analysis. Analytical rigor was strengthened through independent coding and consensus-based discussions. Results: Both groups recognized the potential of medical AI to bring meaningful changes to healthcare systems. However, medical professionals primarily evaluated medical AI in terms of clinical applicability, patient safety, explainability, and accountability. In contrast, non-medical professionals emphasized technological maturity, scalability, data infrastructure, standardization, and system-integration potential. Group-specific patterns also emerged regarding perceived limitations, autonomy, educational priorities, and classification frameworks, particularly in relation to clinical risk management versus system-level design and governance considerations. Conclusion: Differences in perceptions of medical AI are systematically associated with distinct interpretive frames shaped by professional roles and responsibility structures. Effective implementation and policy design for medical AI therefore require an integrated approach that accounts for these structural differences. This study provides empirical evidence and a conceptual foundation for future quantitative and mixed-methods research on medical AI governance.
3.Long-Term Efficacy and Safety of Denosumab: Insights beyond 10 Years of Use
Jeonghoon HA ; Youn-Ju LEE ; Jinyoung KIM ; Chaiho JEONG ; Yejee LIM ; Jeongmin LEE ; Ki-Hyun BAEK ;
Endocrinology and Metabolism 2025;40(1):47-56
Osteoporosis management in post-menopausal women focuses on fracture prevention, with denosumab as a key therapeutic option. Despite its proven efficacy in reducing fracture risk and increasing bone mineral density (BMD) over 10 years, its long-term impact remains uncertain. We evaluated the literature on its efficacy and safety beyond the initial decade. Clinical trials and real-world studies confirm denosumab’s sustained efficacy, especially in lumbar spine BMD, with hip BMD stabilizing. Concerns about adverse events (AEs) like hypocalcemia and osteonecrosis of the jaw necessitate vigilant monitoring. Risks of atypical femoral fractures and malignancies also require attention, despite unclear links to treatment duration. Clinical guidelines for denosumab beyond 10 years are limited, emphasizing the need for careful monitoring. In certain scenarios, such as advanced chronic kidney disease, prolonged denosumab may be required to balance AE risks with fracture prevention benefits. Denosumab shows potential for long-term efficacy in augmenting BMD; however, monitoring for AEs is crucial to guide clinical decision-making effectively.
4.Long-Term Efficacy and Safety of Denosumab: Insights beyond 10 Years of Use
Jeonghoon HA ; Youn-Ju LEE ; Jinyoung KIM ; Chaiho JEONG ; Yejee LIM ; Jeongmin LEE ; Ki-Hyun BAEK ;
Endocrinology and Metabolism 2025;40(1):47-56
Osteoporosis management in post-menopausal women focuses on fracture prevention, with denosumab as a key therapeutic option. Despite its proven efficacy in reducing fracture risk and increasing bone mineral density (BMD) over 10 years, its long-term impact remains uncertain. We evaluated the literature on its efficacy and safety beyond the initial decade. Clinical trials and real-world studies confirm denosumab’s sustained efficacy, especially in lumbar spine BMD, with hip BMD stabilizing. Concerns about adverse events (AEs) like hypocalcemia and osteonecrosis of the jaw necessitate vigilant monitoring. Risks of atypical femoral fractures and malignancies also require attention, despite unclear links to treatment duration. Clinical guidelines for denosumab beyond 10 years are limited, emphasizing the need for careful monitoring. In certain scenarios, such as advanced chronic kidney disease, prolonged denosumab may be required to balance AE risks with fracture prevention benefits. Denosumab shows potential for long-term efficacy in augmenting BMD; however, monitoring for AEs is crucial to guide clinical decision-making effectively.
5.Long-Term Efficacy and Safety of Denosumab: Insights beyond 10 Years of Use
Jeonghoon HA ; Youn-Ju LEE ; Jinyoung KIM ; Chaiho JEONG ; Yejee LIM ; Jeongmin LEE ; Ki-Hyun BAEK ;
Endocrinology and Metabolism 2025;40(1):47-56
Osteoporosis management in post-menopausal women focuses on fracture prevention, with denosumab as a key therapeutic option. Despite its proven efficacy in reducing fracture risk and increasing bone mineral density (BMD) over 10 years, its long-term impact remains uncertain. We evaluated the literature on its efficacy and safety beyond the initial decade. Clinical trials and real-world studies confirm denosumab’s sustained efficacy, especially in lumbar spine BMD, with hip BMD stabilizing. Concerns about adverse events (AEs) like hypocalcemia and osteonecrosis of the jaw necessitate vigilant monitoring. Risks of atypical femoral fractures and malignancies also require attention, despite unclear links to treatment duration. Clinical guidelines for denosumab beyond 10 years are limited, emphasizing the need for careful monitoring. In certain scenarios, such as advanced chronic kidney disease, prolonged denosumab may be required to balance AE risks with fracture prevention benefits. Denosumab shows potential for long-term efficacy in augmenting BMD; however, monitoring for AEs is crucial to guide clinical decision-making effectively.
6.Long-Term Efficacy and Safety of Denosumab: Insights beyond 10 Years of Use
Jeonghoon HA ; Youn-Ju LEE ; Jinyoung KIM ; Chaiho JEONG ; Yejee LIM ; Jeongmin LEE ; Ki-Hyun BAEK ;
Endocrinology and Metabolism 2025;40(1):47-56
Osteoporosis management in post-menopausal women focuses on fracture prevention, with denosumab as a key therapeutic option. Despite its proven efficacy in reducing fracture risk and increasing bone mineral density (BMD) over 10 years, its long-term impact remains uncertain. We evaluated the literature on its efficacy and safety beyond the initial decade. Clinical trials and real-world studies confirm denosumab’s sustained efficacy, especially in lumbar spine BMD, with hip BMD stabilizing. Concerns about adverse events (AEs) like hypocalcemia and osteonecrosis of the jaw necessitate vigilant monitoring. Risks of atypical femoral fractures and malignancies also require attention, despite unclear links to treatment duration. Clinical guidelines for denosumab beyond 10 years are limited, emphasizing the need for careful monitoring. In certain scenarios, such as advanced chronic kidney disease, prolonged denosumab may be required to balance AE risks with fracture prevention benefits. Denosumab shows potential for long-term efficacy in augmenting BMD; however, monitoring for AEs is crucial to guide clinical decision-making effectively.
7.Complete Blood Count Parameters and Bone Health: Clinical and Experimental Evidence
Jeonghoon HA ; Mayo ONO ; Hui ZHU ; Caroline CENCER ; Xiyu GE ; Joy Y. WU
Endocrinology and Metabolism 2025;40(6):811-820
Osteoporotic fractures pose a significant burden in aging populations, yet current assessment strategies may overlook systemic factors influencing bone health. Emerging evidence suggests that complete blood count (CBC) parameters, including red blood cell indices, white blood cell (WBC) counts and subtypes, and platelet counts, are associated with skeletal fragility and fracture risk. Anemia has been consistently linked to reduced bone mineral density and increased fracture susceptibility, potentially due to impaired oxygen delivery and osteoblast dysfunction. Elevated red cell distribution width may reflect oxidative stress and has been associated with bone loss. Inflammatory markers such as high WBC count and neutrophil-to-lymphocyte ratio are implicated in enhanced osteoclast activity, while platelet abnormalities may influence bone remodeling and fracture healing. These associations suggest that CBC-derived markers could serve as accessible and cost-effective indicators to support osteoporosis evaluation. However, important limitations remain, including undefined clinical thresholds, limited longitudinal evidence, and uncertain causality. Further research is needed to clarify underlying mechanisms and determine whether correcting hematological abnormalities can improve skeletal outcomes. A cautious, evidence-based approach is warranted to define the role of CBC parameters in the clinical assessment of bone health.
8.Low Serum 25-Hydroxyvitamin D as a Risk Factor for Frailty in Community-Dwelling Older Men: A Korean Nationwide Study
Jeongmin LEE ; Min-gu KANG ; Jeonghoon HA ; Yunju JO ; Dongryeol RYU ; Hee-Won JUNG ; Ki-Hyun BAEK ; Beom-Jun KIM
Endocrinology and Metabolism 2025;40(6):961-973
Background:
Despite the critical role of vitamin D in various biological processes, its impact on frailty—a condition closely linked to biological age—remains inconclusive. This study aimed to explore the association between serum 25-hydroxyvitamin D (25[OH] D) levels and frailty status in older Korean adults, utilizing a comprehensive frailty index (FI) and a nationally representative dataset.
Methods:
This cross-sectional study included 6,589 participants aged ≥65 years from the Korea National Health and Nutrition Examination Survey (2008–2012). Frailty was assessed using a deficit accumulation FI based on 38 physical, cognitive, psychological, and social items.
Results:
After adjusting for potential confounders, frail men showed 6.8% lower serum 25(OH)D concentrations compared to nonfrail controls (P=0.007). Men in the lowest serum 25(OH)D quartile (≤39.3 nmol/L) exhibited a 5.3% higher FI (P=0.047) and 1.71-fold increased odds of frailty (P=0.005), compared to those in the highest quartile (>63.3 nmol/L). Similarly, men with vitamin D deficiency (<30 nmol/L) exhibited a 9.6% higher FI compared to those with sufficient vitamin D levels (≥50 nmol/L; P=0.004). However, no significant association between serum 25(OH)D concentration and frailty was observed in women across any analysis.
Conclusion
These findings suggest that low serum 25(OH)D concentrations are a potential risk factor for frailty, particularly in men. Further research is warranted to determine whether vitamin D supplementation in such high-risk older adults could help mitigate frailty.
9.Platelet Count Normalization Following Romosozumab Treatment for Osteoporosis in Patient with Immune Thrombocytopenic Purpura: A Case Report and Literature Review
Journal of Bone Metabolism 2024;31(4):335-339
Romosozumab, which is approved for the treatment of osteoporosis, has a dual-action mechanism that promotes bone formation and inhibits bone resorption. However, its association with an increased risk of major adverse cardiovascular events, as highlighted in the ARCH I study, raises concerns. The underlying pathophysiological mechanisms, possibly involving changes in platelet dynamics, are yet to be fully elucidated. Herein, we present a case of a 60-year-old Korean woman diagnosed with immune thrombocytopenic purpura and new-onset osteoporosis, who was treated with romosozumab. Subsequent to the administration of romosozumab, there was a notable elevation in her platelet count. This observation warrants further investigation into the off-target effects of romosozumab, especially its impact on hematopoietic stem cell function and platelet dynamics. This case accentuates the imperative for more comprehensive research into the systemic effects of romosozumab, particularly its involvement in hematopoiesis and cardiovascular risk, to thoroughly understand its extensive implications for patient health.
10.Platelet Count Normalization Following Romosozumab Treatment for Osteoporosis in Patient with Immune Thrombocytopenic Purpura: A Case Report and Literature Review
Journal of Bone Metabolism 2024;31(4):335-339
Romosozumab, which is approved for the treatment of osteoporosis, has a dual-action mechanism that promotes bone formation and inhibits bone resorption. However, its association with an increased risk of major adverse cardiovascular events, as highlighted in the ARCH I study, raises concerns. The underlying pathophysiological mechanisms, possibly involving changes in platelet dynamics, are yet to be fully elucidated. Herein, we present a case of a 60-year-old Korean woman diagnosed with immune thrombocytopenic purpura and new-onset osteoporosis, who was treated with romosozumab. Subsequent to the administration of romosozumab, there was a notable elevation in her platelet count. This observation warrants further investigation into the off-target effects of romosozumab, especially its impact on hematopoietic stem cell function and platelet dynamics. This case accentuates the imperative for more comprehensive research into the systemic effects of romosozumab, particularly its involvement in hematopoiesis and cardiovascular risk, to thoroughly understand its extensive implications for patient health.

Result Analysis
Print
Save
E-mail