1.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
2.Symptom and Sentiment Analysis of Older People with Cancer and Caregivers: A Text Mining Approach Using Korean Social Media Data
Healthcare Informatics Research 2025;31(2):175-188
Objectives:
This study examined the symptoms and emotions expressed by older adults with cancer and their caregivers in South Korean online cancer communities. It aimed to identify narrative patterns and provide insights to inform personalized care strategies.
Methods:
We analyzed 6,908 user-generated posts collected from major online cancer communities in South Korea. Keyword frequency analysis, term frequency-inverse document frequency, 2-gram analysis, and latent Dirichlet allocation-based topic modeling were applied to explore language patterns. Sentiment analysis identified 12 emotional categories, and Pearson correlation coefficients were calculated to examine associations between symptoms and emotional expressions. All data were cleaned and standardized prior to analysis.
Results:
Many users expressed anxiety (20.63%) and depression (19.59%), frequently associated with chemotherapy and sleep disturbances. Among reported symptoms, sleep problems carried the highest negative sentiment (79.81%), underscoring their profound impact on well-being. Topic modeling consistently revealed seven recurring themes, including treatment decision-making, symptom management, and concerns about family, demonstrating the layered and personalized experiences of older cancer patients and their caregivers.
Conclusions
This study explored treatment-related and symptom-related difficulties faced by older adults with cancer. Many reported significant emotional strain, especially anxiety, depression, and sleep disturbances. These findings highlight the necessity for supportive strategies addressing both psychological and physical aspects of care. Future research could investigate the utility of large language models in analyzing these narratives, provided the data is ethically managed and appropriate for such use.
3.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
4.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
5.Symptom and Sentiment Analysis of Older People with Cancer and Caregivers: A Text Mining Approach Using Korean Social Media Data
Healthcare Informatics Research 2025;31(2):175-188
Objectives:
This study examined the symptoms and emotions expressed by older adults with cancer and their caregivers in South Korean online cancer communities. It aimed to identify narrative patterns and provide insights to inform personalized care strategies.
Methods:
We analyzed 6,908 user-generated posts collected from major online cancer communities in South Korea. Keyword frequency analysis, term frequency-inverse document frequency, 2-gram analysis, and latent Dirichlet allocation-based topic modeling were applied to explore language patterns. Sentiment analysis identified 12 emotional categories, and Pearson correlation coefficients were calculated to examine associations between symptoms and emotional expressions. All data were cleaned and standardized prior to analysis.
Results:
Many users expressed anxiety (20.63%) and depression (19.59%), frequently associated with chemotherapy and sleep disturbances. Among reported symptoms, sleep problems carried the highest negative sentiment (79.81%), underscoring their profound impact on well-being. Topic modeling consistently revealed seven recurring themes, including treatment decision-making, symptom management, and concerns about family, demonstrating the layered and personalized experiences of older cancer patients and their caregivers.
Conclusions
This study explored treatment-related and symptom-related difficulties faced by older adults with cancer. Many reported significant emotional strain, especially anxiety, depression, and sleep disturbances. These findings highlight the necessity for supportive strategies addressing both psychological and physical aspects of care. Future research could investigate the utility of large language models in analyzing these narratives, provided the data is ethically managed and appropriate for such use.
6.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
7.Symptom and Sentiment Analysis of Older People with Cancer and Caregivers: A Text Mining Approach Using Korean Social Media Data
Healthcare Informatics Research 2025;31(2):175-188
Objectives:
This study examined the symptoms and emotions expressed by older adults with cancer and their caregivers in South Korean online cancer communities. It aimed to identify narrative patterns and provide insights to inform personalized care strategies.
Methods:
We analyzed 6,908 user-generated posts collected from major online cancer communities in South Korea. Keyword frequency analysis, term frequency-inverse document frequency, 2-gram analysis, and latent Dirichlet allocation-based topic modeling were applied to explore language patterns. Sentiment analysis identified 12 emotional categories, and Pearson correlation coefficients were calculated to examine associations between symptoms and emotional expressions. All data were cleaned and standardized prior to analysis.
Results:
Many users expressed anxiety (20.63%) and depression (19.59%), frequently associated with chemotherapy and sleep disturbances. Among reported symptoms, sleep problems carried the highest negative sentiment (79.81%), underscoring their profound impact on well-being. Topic modeling consistently revealed seven recurring themes, including treatment decision-making, symptom management, and concerns about family, demonstrating the layered and personalized experiences of older cancer patients and their caregivers.
Conclusions
This study explored treatment-related and symptom-related difficulties faced by older adults with cancer. Many reported significant emotional strain, especially anxiety, depression, and sleep disturbances. These findings highlight the necessity for supportive strategies addressing both psychological and physical aspects of care. Future research could investigate the utility of large language models in analyzing these narratives, provided the data is ethically managed and appropriate for such use.
8.Development and Application of New Risk-Adjustment Models to Improve the Current Model for Hospital Standardized Mortality Ratio in South Korea
Hyeki PARK ; Ji-Sook CHOI ; Min Sun SHIN ; Soomin KIM ; Hyekyoung KIM ; Nahyeong IM ; Soon Joo PARK ; Donggyo SHIN ; Youngmi SONG ; Yunjung CHO ; Hyunmi JOO ; Hyeryeon HONG ; Yong-Hwa HWANG ; Choon-Seon PARK
Yonsei Medical Journal 2025;66(3):179-186
Purpose:
This study assessed the validity of the hospital standardized mortality ratio (HSMR) risk-adjusted model by comparing models that include clinical information and the current model based on administrative information in South Korea.
Materials and Methods:
The data of 53976 inpatients were analyzed. The current HSMR risk-adjusted model (Model 1) adjusts for sex, age, health coverage, emergency hospitalization status, main diagnosis, surgery status, and Charlson Comorbidity Index (CCI) using administrative data. As candidate variables, among clinical information, the American Society of Anesthesiologists score, Acute Physiology and Chronic Health Evaluation (APACHE) II, Simplified Acute Physiology Score (SAPS) 3, present on admission CCI, and cancer stage were collected. Surgery status, intensive care in the intensive care unit, and CCI were selected as proxy variables among administrative data. In-hospital death was defined as the dependent variable, and a logistic regression analysis was performed. The statistical performance of each model was compared using C-index values.
Results:
There was a strong correlation between variables in the administrative data and those in the medical records. The C-index of the existing model (Model 1) was 0.785; Model 2, which included all clinical data, had a higher C-index of 0.857. In Model 4, in which APACHE II and SAPS 3 were replaced with variables recorded in the administrative data from Model 2, the C-index further increased to 0.863.
Conclusion
The HSMR assessment model improved when clinical data were adjusted. Simultaneously, the validity of the evaluation method could be secured even if some of the clinical information was replaced with the information in the administrative data.
9.Non-Invasive Radiofrequency Hyperthermia Attenuates HMGB1/TLR4/NF-κB Inflammatory Axis in a Chronic Prostatitis/Chronic Pelvic Pain Syndrome Rat Model
Soomin KIM ; Jun Jie PIAO ; Seokhwan BANG ; Hyong Woo MOON ; Hyuk Jin CHO ; U-Syn HA ; Sung-Hoo HONG ; Ji Youl LEE ; Hae Hoon KIM ; Ha Nul KIM ; Kyung-Hwa JEON ; Mahadevan Raj RAJASEKARAN ; Sae Woong KIM ; Woong Jin BAE
The World Journal of Men's Health 2024;42(4):855-864
Purpose:
The primary goal of this study is to evaluate the effect of the non-invasive radiofrequency hyperthermia (RFHT) device on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) rat model and investigate the underlying mechanism.
Materials and Methods:
In this study, Sprague-Dawley rats were randomly distributed into three groups: (1) normal control group, (2) CP/CPPS group, and (3) RFHT group. CP/CPPS rat models were induced by 17β-estradiol and dihydrotestosterone for 4 weeks and RFHT was administered for 5 weeks after model establishment. During RFHT administration, core body temperatures were continuously monitored with a rectal probe. After administering RFHT, we assessed pain index for all groups and collected prostate tissues for Western blot analysis, immunofluorescence, and immunohistochemistry. We also collected adjacent organs to the prostate including urinary bladder, testes, and rectum for safety assessment via H&E staining along with a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay.
Results:
After administering RFHT, pain in rats was significantly alleviated compared to the CP/CPPS group. RFHT reduced high-mobility group box 1 (HMGB1) expression and improved inflammation by downregulating subsequent proinflammatory cytokines through inhibition of the toll-like receptor 4 (TLR4)-nuclear factor kappa B (NF-κB) pathway. In prostate-adjacent organs, no significant histological alteration or inflammatory infiltration was detected. The area of cell death also did not increase significantly after RFHT.
Conclusions
In conclusion, RFHT demonstrated anti-inflammatory effects by inhibiting the HMGB1-TLR4-NF-κB pathway in CP/CPPS rat models. This suggests that RFHT could serve as a safe and promising therapeutic strategy for CP/CPPS.
10.Non-Invasive Radiofrequency Hyperthermia Attenuates HMGB1/TLR4/NF-κB Inflammatory Axis in a Chronic Prostatitis/Chronic Pelvic Pain Syndrome Rat Model
Soomin KIM ; Jun Jie PIAO ; Seokhwan BANG ; Hyong Woo MOON ; Hyuk Jin CHO ; U-Syn HA ; Sung-Hoo HONG ; Ji Youl LEE ; Hae Hoon KIM ; Ha Nul KIM ; Kyung-Hwa JEON ; Mahadevan Raj RAJASEKARAN ; Sae Woong KIM ; Woong Jin BAE
The World Journal of Men's Health 2024;42(4):855-864
Purpose:
The primary goal of this study is to evaluate the effect of the non-invasive radiofrequency hyperthermia (RFHT) device on chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS) rat model and investigate the underlying mechanism.
Materials and Methods:
In this study, Sprague-Dawley rats were randomly distributed into three groups: (1) normal control group, (2) CP/CPPS group, and (3) RFHT group. CP/CPPS rat models were induced by 17β-estradiol and dihydrotestosterone for 4 weeks and RFHT was administered for 5 weeks after model establishment. During RFHT administration, core body temperatures were continuously monitored with a rectal probe. After administering RFHT, we assessed pain index for all groups and collected prostate tissues for Western blot analysis, immunofluorescence, and immunohistochemistry. We also collected adjacent organs to the prostate including urinary bladder, testes, and rectum for safety assessment via H&E staining along with a terminal deoxynucleotidyl transferase-mediated deoxyuridine triphosphate nick end labeling assay.
Results:
After administering RFHT, pain in rats was significantly alleviated compared to the CP/CPPS group. RFHT reduced high-mobility group box 1 (HMGB1) expression and improved inflammation by downregulating subsequent proinflammatory cytokines through inhibition of the toll-like receptor 4 (TLR4)-nuclear factor kappa B (NF-κB) pathway. In prostate-adjacent organs, no significant histological alteration or inflammatory infiltration was detected. The area of cell death also did not increase significantly after RFHT.
Conclusions
In conclusion, RFHT demonstrated anti-inflammatory effects by inhibiting the HMGB1-TLR4-NF-κB pathway in CP/CPPS rat models. This suggests that RFHT could serve as a safe and promising therapeutic strategy for CP/CPPS.

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