• Title/Summary/Keyword: cohort

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Analyzing Cancer Incidence among Korean Workers and Public Officials Using Big Data from National Health Insurance Service (건강보험 빅데이터를 통한 전체 근로자 및 공무원 근로자의 암 발생률 분석)

  • Baek, Seong-Uk;Lee, Wanhyung;Yoo, Ki-Bong;Lee, Woo-Ri;Lee, Won-Tae;Kim, Min-Seok;Lim, Sung-Shil;Kim, Jihyun;Choi, Jun-Hyeok;Lee, Kyung-Eun;Yoon, Jin-Ha
    • Journal of Korean Society of Occupational and Environmental Hygiene
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    • v.32 no.3
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    • pp.268-278
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    • 2022
  • Objectives: This study aimed to establish a control group based on the big data from National Health Insurance Service. We also presented presented the number of incidences for each cancer, and analyzed the cancer incidence rate among Korean workers. Methods: The cohort definition was separated by 'baseline cohort', 'dynamic cohort', and 'fixed- industry cohort' according to the definition. Cancer incidence was calculated based on the Korean Standard Classification of Disease code. Incidence rate was calculated among the group of all workers and public officials. Based on the study subjects and each cohort definition, the number of observations, incidences, and the incidence rate according to sex and age groups was calculated. The incidence rate was estimated based on the incidence per 100,000 person-year, and 95% confidence intervals calculated according to the Poisson distribution. Results: The result shows that the number of cancer cases in the all-worker group decreases after the age of 55, but the incidence rate tends to increase, which is attributed to the retirement of workers over 55 years old. Despite the specific characteristics of the workers, the trend and figures of cancer incidence revealed in this study are similar to those reported in previous studies of the overall South Korean population. When comparing the incidence rates of all workers and the control group of public officials, the incidence rate of public officials is generally observed to be higher in the age group under the age of 55. On the other hand, for workers aged 60 or older, the incidence rates were 1,065.4 per 100,000 person-year for all workers and 1,023.7 per 100,000 person-year for civil servants. Conclusions: This study analyzed through health insurance data including all workers in Korea, and analyzed the incidence of cancer of workers by sex and age. In addition, further in-depth researches are needed to determine the incidence of cancer by industry.

Development and Validation of a Simple Index Based on Non-Enhanced CT and Clinical Factors for Prediction of Non-Alcoholic Fatty Liver Disease

  • Yura Ahn;Sung-Cheol Yun;Seung Soo Lee;Jung Hee Son;Sora Jo;Jieun Byun;Yu Sub Sung;Ho Sung Kim;Eun Sil Yu
    • Korean Journal of Radiology
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    • v.21 no.4
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    • pp.413-421
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    • 2020
  • Objective: A widely applicable, non-invasive screening method for non-alcoholic fatty liver disease (NAFLD) is needed. We aimed to develop and validate an index combining computed tomography (CT) and routine clinical data for screening for NAFLD in a large cohort of adults with pathologically proven NAFLD. Materials and Methods: This retrospective study included 2218 living liver donors who had undergone liver biopsy and CT within a span of 3 days. Donors were randomized 2:1 into development and test cohorts. CTL-S was measured by subtracting splenic attenuation from hepatic attenuation on non-enhanced CT. Multivariable logistic regression analysis of the development cohort was utilized to develop a clinical-CT index predicting pathologically proven NAFLD. The diagnostic performance was evaluated by analyzing the areas under the receiver operating characteristic curve (AUC). The cutoffs for the clinical-CT index were determined for 90% sensitivity and 90% specificity in the development cohort, and their diagnostic performance was evaluated in the test cohort. Results: The clinical-CT index included CTL-S, body mass index, and aspartate transaminase and triglyceride concentrations. In the test cohort, the clinical-CT index (AUC, 0.81) outperformed CTL-S (0.74; p < 0.001) and clinical indices (0.73-0.75; p < 0.001) in diagnosing NAFLD. A cutoff of ≥ 46 had a sensitivity of 89% and a specificity of 41%, whereas a cutoff of ≥ 56.5 had a sensitivity of 57% and a specificity of 89%. Conclusion: The clinical-CT index is more accurate than CTL-S and clinical indices alone for the diagnosis of NAFLD and may be clinically useful in screening for NAFLD.

Development and Validation of a Prognostic Nomogram Based on Clinical and CT Features for Adverse Outcome Prediction in Patients with COVID-19

  • Yingyan Zheng;Anling Xiao;Xiangrong Yu;Yajing Zhao;Yiping Lu;Xuanxuan Li;Nan Mei;Dejun She;Dongdong Wang;Daoying Geng;Bo Yin
    • Korean Journal of Radiology
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    • v.21 no.8
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    • pp.1007-1017
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    • 2020
  • Objective: The purpose of our study was to investigate the predictive abilities of clinical and computed tomography (CT) features for outcome prediction in patients with coronavirus disease (COVID-19). Materials and Methods: The clinical and CT data of 238 patients with laboratory-confirmed COVID-19 in our two hospitals were retrospectively analyzed. One hundred sixty-six patients (103 males; age 43.8 ± 12.3 years) were allocated in the training cohort and 72 patients (38 males; age 45.1 ± 15.8 years) from another independent hospital were assigned in the validation cohort. The primary composite endpoint was admission to an intensive care unit, use of mechanical ventilation, or death. Univariate and multivariate Cox proportional hazard analyses were performed to identify independent predictors. A nomogram was constructed based on the combination of clinical and CT features, and its prognostic performance was externally tested in the validation group. The predictive value of the combined model was compared with models built on the clinical and radiological attributes alone. Results: Overall, 35 infected patients (21.1%) in the training cohort and 10 patients (13.9%) in the validation cohort experienced adverse outcomes. Underlying comorbidity (hazard ratio [HR], 3.35; 95% confidence interval [CI], 1.67-6.71; p < 0.001), lymphocyte count (HR, 0.12; 95% CI, 0.04-0.38; p < 0.001) and crazy-paving sign (HR, 2.15; 95% CI, 1.03-4.48; p = 0.042) were the independent factors. The nomogram displayed a concordance index (C-index) of 0.82 (95% CI, 0.76-0.88), and its prognostic value was confirmed in the validation cohort with a C-index of 0.89 (95% CI, 0.82-0.96). The combined model provided the best performance over the clinical or radiological model (p < 0.050). Conclusion: Underlying comorbidity, lymphocyte count and crazy-paving sign were independent predictors of adverse outcomes. The prognostic nomogram based on the combination of clinical and CT features could be a useful tool for predicting adverse outcomes of patients with COVID-19.