• Journal of Society of Preventive Korean Medicine
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• v.28 no.1
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• pp.69-87
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• 2024

Objectives : This study is to investigate the current National Health Insurance Database cohort studies related to complications of Parkinson's Disease (PD) and suggest the design of Korean medical epidemiological studies of PD. Methods : Nationwide longitudinal studies of PD patients in South Korea were collected through Pubmed and the Korea Citation Index (KCI). We selected cohort studies that used the National Health Insurance Database in Korea and targeted Parkinson's disease patients. Studies published before February 2024 were categorized according to study designs. We examined variables and covariates, enroll dates and matching methods. Results : Of a total of 536 studies, 18 studies met the inclusion criteria. All studies used the National Health Insurance (NHI) Research Database and among them, 5 used sample data and one senior database. Studies can be classified into two types. 11 cohort studies were comparing PD patients and non-PD patients. Another type was 4 PD patients cohort studies. Most studies used two diagnostic codes (G20 and V124) for inclusion criteria. Enroll periods were from 2002 to 2017, and follow-up periods were from 7 to 14 years. 16 studies considered age and sex as covariates. 15 studies used the propensity score matching method to increase the level of causality. There was only one study related to the Korean medical treatment. Conclusion : In future cohort studies on Korean medical treatment, more attempts should be made to reveal the effect of the treatments on PD patients by defining inclusion criteria for patient groups, covariates, exposure variables, and assessment indicators more operatively.

• Annals of Occupational and Environmental Medicine
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• v.35
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• pp.26.1-26.15
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• 2023

Background: The objective of this study is to investigate the differences in incidence rates of targeted diseases by classification of occupations among construction workers in Korea. Methods: In a subject-based cohort of the Korean Construction Worker's Cohort, we surveyed a total of 1,027 construction workers. As occupational exposure, the classification of occupations was developed using two axes: construction business and job type. To analyze disease incidence, we linked survey data with National Health Insurance Service data. Eleven target disease categories with high prevalence or estimated work-relatedness among construction workers were evaluated in our study. The average incidence rates were calculated as cases per 1,000 person-years (PY). Results: Injury, poisoning, and certain other consequences of external causes had the highest incidence rate of 344.08 per 1,000 PY, followed by disease of the musculoskeletal system and connective tissue for 208.64 and diseases of the skin and subcutaneous tissue for 197.87 in our cohort. We especially found that chronic obstructive pulmonary disease was more common in construction painters, civil engineering welders, and civil engineering frame mold carpenters, asthma in construction painters, landscape, and construction water proofers, interstitial lung diseases in construction water proofers. Conclusions: This is the first study to systematically classify complex construction occupations in order to analyze occupational diseases in Korean construction workers. There were differences in disease incidences among construction workers based on the classification of occupations. It is necessary to develop customized occupational safety and health policies for high-risk occupations for each disease in the construction industry.

• Analyses & Alternatives
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• v.8 no.2
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• pp.31-64
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• 2024

The recent trend of declining consciousness regarding the necessity of unification among South Korean citizens is evident. Does a cohort effect exist in this downward trend in the perception of the necessity of unification? The purpose of this study is to analyze whether birth cohorts statistically significantly influence the consciousness of the necessity of unification. To this end, the hierarchical age-period-cohort (HAPC) model was employed as the analytical model, and data from the Unification Consciousness Survey conducted by Seoul National University's Institute for Peace and Unification Studies from 2007 to 2021 was used. The analysis results showed evidence that the progress of economic inequality at the birth cohort level affected the decline in the perception of the necessity of unification. The 1980s birth cohort, which faced socioeconomic difficulties during their social advancement due to income and wealth polarization, is observed to have a distinctly negative perception of unification requiring massive financial resources, compared to the 1960s and 1970s birth cohorts.

• Journal of Preventive Medicine and Public Health
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• v.27 no.1 s.45
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• pp.117-134
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• 1994

The effects of regional medical insurance on utilization of medical care in urban population was examined in this study. The data was collected in a 2-year follow-up household survey conducted at Taegu city before and after implementation of the regional medical insurance. The study population was divided into 2 groups. Cohort I was the uninsured in 1989 and cohort II was the insured in 1989. After the coverage of medical insurance, physician visit rate per 1,000 population, use-disability ratio and use-restricted activity ratio in cohort I were increased compared to cohort II in both of acute and chronically ill people. The use-disability ratio and use-restricted activity ratio of the insured poor were lower than those of the insured nonpoor in both of cohort I and cohort II. The major reasons for pharmacy use were accessibility and affordability before the coverage of medical insurance in cohort I, however, after the coverage of medical insurance, the important reason was accessibility rather than affordability. In logistic regression analysis of physician visit, the significant independent variables were acute illness episode (+), chronic illness episode (+) and income (+) in both of cohort I and cohort II. In cohort I, after the coverage of medical insurance, more people replied that the medical cost of hospital and clinic was reasonable. The people who covered by the regional medical insurance were more dissatisfied with the imposed premium than those who covered by other types of medical insurance in both of cohort I and cohort II. More people in cohort II than cohort I were dissatisfied with the services from hospitals and clinics after implementation of the regional medical insurance. In conclusion. after the coverage of medical insurance, the gap between the poor and the nonpoor still exists in terms of medical care utilization.

• Journal of the Korean Geographical Society
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• v.46 no.2
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• pp.212-232
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• 2011

The main objective of this study is to establish a population projection method based on the biregional cohort-component method and to apply it to population projections for Busan. Some drawbacks of using the net migration cohort-component method in a regional or local level population projection are demonstrated. A biregional cohort-component method, a variant of the interregional cohort-component method, is established as an alternative where in-migration and out-migration are separately considered and then are combined to produce a projection for the migration component. Predicated on the established method, population projections for Busan are undertaken for the period of 2005~2030 under three different scenarios. Considerably different projection results are obtained between the net migration and biregional methods; among others, the trend of population decline is more severe in the former than in the latter. An investigation of the temporal trend of the projected population shows that the proposed method is highly reasonable. In conclusion, the proposed method based on the biregional cohort-component method seems not only to be theoretically more robust than the net migration cohort-component method but also to be very effective in the real world application.

• Korean Journal of Radiology
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• v.24 no.4
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• pp.274-283
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• 2023

Objective: To compare the outcomes of digital breast tomosynthesis (DBT) screening combined with ultrasound (US) with those of digital mammography (DM) combined with US in women with dense breasts. Materials and Methods: A retrospective database search identified consecutive asymptomatic women with dense breasts who underwent breast cancer screening with DBT or DM and whole-breast US simultaneously between June 2016 and July 2019. Women who underwent DBT + US (DBT cohort) and DM + US (DM cohort) were matched using 1:2 ratio according to mammographic density, age, menopausal status, hormone replacement therapy, and a family history of breast cancer. The cancer detection rate (CDR) per 1000 screening examinations, abnormal interpretation rate (AIR), sensitivity, and specificity were compared. Results: A total of 863 women in the DBT cohort were matched with 1726 women in the DM cohort (median age, 53 years; interquartile range, 40-78 years) and 26 breast cancers (9 in the DBT cohort and 17 in the DM cohort) were identified. The DBT and DM cohorts showed comparable CDR (10.4 [9 of 863; 95% confidence interval {CI}: 4.8-19.7] vs. 9.8 [17 of 1726; 95% CI: 5.7-15.7] per 1000 examinations, respectively; P = 0.889). DBT cohort showed a higher AIR than the DM cohort (31.6% [273 of 863; 95% CI: 28.5%-34.9%] vs. 22.4% [387 of 1726; 95% CI: 20.5%-24.5%]; P < 0.001). The sensitivity for both cohorts was 100%. In women with negative findings on DBT or DM, supplemental US yielded similar CDRs in both DBT and DM cohorts (4.0 vs. 3.3 per 1000 examinations, respectively; P = 0.803) and higher AIR in the DBT cohort (24.8% [188 of 758; 95% CI: 21.8%-28.0%] vs. 16.9% [257 of 1516; 95% CI: 15.1%-18.9%; P < 0.001). Conclusion: DBT screening combined with US showed comparable CDR but lower specificity than DM screening combined with US in women with dense breasts.

• The Korean Journal of Applied Statistics
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• v.28 no.4
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• pp.703-719
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• 2015

We propose an extension of the Lee and Jho (2015) mean reverting the two factor mortality model by incorporating a period-specific cohort effect. We found that the consideration of cohort effect improves the mortality fit of Korea male data above age 65. Parameters are estimated by the weighted least squares method and Metropolis algorithm. We also emphasize that the cohort effect is necessary to choose the base survival index to calculate longevity bond issue price. A key contribution of the article is the proposal and development of a method to calculate the longevity bond price to hedge the longevity risk exposed to Korea National Pension Services.

• Journal of Preventive Medicine and Public Health
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• v.48 no.6
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• pp.280-286
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• 2015

Objectives: Approximately 10% to 15% of lung cancer cases occur in never-smokers. Hormonal factors have been suggested to lead to an elevated risk of lung cancer in women. This systematic review (SR) aimed to investigate the association between hormonal replacement therapy (HRT) and the risk of lung cancer in women using cohort studies. Methods: We first obtained previous SR articles on this topic. Based on these studies we made a list of refereed, cited, and related articles using the PubMed and Scopus databases. All cohort studies that evaluated the relative risk of HRT exposure on lung cancer occurrence in women were selected. Estimate of summary effect size (sES) with 95% confidence intervals (CIs) were calculated. Results: A total of 14 cohort studies were finally selected. A random effect model was applied due to heterogeneity (I-squared, 64.3%). The sES of the 14 articles evaluating the impact of HRT exposure on lung cancer occurrence in women indicated no statistically significant increase in lung cancer risk (sES, 0.99; 95% CI, 0.90 to 1.09). Conclusions: These results showed that HRT history had no effect on the risk of lung cancer in women, even though the sES of case-control studies described in previous SR articles indicated that HRT had a protective effect against lung cancer. It is necessary to conduct a pooled analysis of cohort studies.

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.10
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• pp.6185-6187
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• 2013

Cervical cancer has emerged as a major public health problem in Lucknow and New York in the $21^{st}$ century. Cancer genetic studies are essential to identify/stratify disease-susceptible individuals in a population-based cohort. Sample size homogeneity and North Indian caste in female urology genetic-studies are significant issues in meaningful interpretation of data. A review of scientific literature using Pubmed database was conducted, including an assessment of cervical cancer genetic studies conducted as part of the author's doctoral dissertation at a premier Lucknow-based medical research Institute. Sample size numbers and caste criteria in the North Indian cohort ($N{\leq}400$ subjects) were evaluated with homogeneity in the sample cohort data set(s). Subgroup caste-stratification of North Indian cohort is equally essential, for instance, Brahmin (e.g. Pandey), Vaishya (e.g. Mittal), Rajput (e.g. Singh) and Kshudra (e.g. Yadav) during the conception and design of genetics-based studies. Sample size homogeneity in histopathologically confirmed case and control numbers and caste-based stratification in a North Indian cohort is essential in single nucleotide polymorphism (SNP) studies in cervical cancer susceptible populations to draw more definitive conclusions.

• Journal of agricultural medicine and community health
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• v.31 no.2
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• pp.119-144
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• 2006

The Korea rural health study, a large prospective cohort study, the objectives of this study are exploration for potential causes of agricultural injuries and diseases among farmers. Current medical research suggests that they may have higher rates of some traumatic injuries, pesticide poisoning, infectious diseases, musculoskeletal diseases, asthma and other respiratory diseases. This study is designed to identify occupational, lifestyle, and environmental factors of workplace that may affect the rate of diseases in farming population. Round 1, initial cohort recruitment, will begin in 2006 and conclude in 2009. Round 2, follow-up will begin in 2010 and conclude in 2014. Approximately 54,000 persons will be selected to study population. Nested case-control studies and case-crossover studies will be conducted for getting to the bottom of agriculture-related diseases. Recruitment and follow-up are conducted in collaboration with multi-centers. As data on the exposures and health outcomes of this study population are collected and analyzed in 2014. This study will be evaluated by public health experts for effort, achievement, adequacy of performance, efficacy, process of study and so on. The author expects that this cohort study may reduce agricultural injuries and diseases and will provide information that agricultural workers can use in making decisions about their health. Also, this study will be significant basis for strengthening the competitiveness of agriculture in Korea.