• 제목/요약/키워드: confounding method

검색결과 79건 처리시간 0.022초

황련해독탕약침 치료에 대한 임상 논문 고찰: 국내 학술지의 증례보고와 대조군 연구 중심으로 (An Intensive Review On Clinical Thesis about Hwangryunhaedok-tang Pharmacopuncture Treatment: Focused on Case Reports and Controlled Studies in Korean Academic Journals)

  • 이수환;김순중
    • 한방재활의학과학회지
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    • 제29권2호
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    • pp.171-188
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    • 2019
  • Objectives The purpose of this thesis is to compare and analyze outcomes of case studies and controlled studies about Hwangryunhaedok-tang (HHT) pharmacopuncture in clinical studies. Based on these studies reporting clinical effects by using HHT pharmacopuncture, we object to deduct the comparative review in applying clinical disorders limitedly. And conclusionally, by using this comparative review, we aim to make the fine evidence in treating clinical specific diseases. Methods We searched 106 studies about HHT pharmacopuncture from 6 Korean web databases by using in Korean word 'Hwangryunhaedok-tang pharmacopuncture'. This search had been progressed throughout 1 month (January, 2019). There was 106 thesis and we excluded studies that are not related to HHT pharmacopuncture, experimental research, not the case report or randomized controlled trials, non-randomized controlled trials, not using HHT pharmacopuncture, not using only one pharmacopuncture, and not using HHT pharmacopuncture for major treating method. As a result, 39 thesis are selected as a population. Results We analyzed 34 case reports and 5 controlled studies. As the final outcome, HHT pharmacopuncture was used in musculoskeletal diseases, dermatopathy, and 32 specific diseases. Conclusions After analyzing 39 studies, effective symptom changes clinically and statistically by using HHT pharmacopuncture herbal acupuncture were identified. However, these thesis designs were reported deficiently in many parts such as not excluding other confounding variables. After modifying defects of thesis design and conduct study, it can play a role as the evidence using HHT pharmacopuncture more precisely.

Evaluation of malnutrition status and related risk factors in geriatric outpatient clinic

  • Cin, Pelin;Tanriover, Ozlem;Yavuzer, Hakan;Erdincler, Deniz Suna
    • Nutrition Research and Practice
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    • 제15권4호
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    • pp.504-515
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    • 2021
  • BACKGROUND/OBJECTIVES: Malnutrition risk and malnutrition among the elderly is a public health concern. In combating this health-related problem, it is critically important to evaluate the risk factors in a multidimensional way and to apply appropriate nutrition intervention based on the results. SUBJECTS/METHODS: A cross-sectional study was conducted on 215 elderly patients (32.6% male, 67.4% female) in a geriatric outpatient clinic of a hospital in Turkey. Nutritional questionnaires that incorporated the 24-h recall method were applied to determine general characteristics of patients, their health status, nutritional habits, and daily energy and nutrient intakes. Mini Nutritional Assessment was used to determine nutritional status. Relevant anthropometric measurements were obtained. RESULTS: The subjects' mean age was 76.1 ± 7.0 years, and the prevalence of malnutrition (n = 7) and risk of malnutrition (n = 53) among the 215 subjects was 3.2% and 24.7%, respectively. Patients with malnutrition or risk of malnutrition were found to be single, have a depression diagnosis, in an older age group, have less appetite, more tooth loss, have more frequent swallowing/chewing difficulty, and have more frequent meal skipping. In addition, mean daily energy, carbohydrate, fat, fiber, vitamin E, vitamin B1, vitamin B2, vitamin B6, vitamin C, folates, potassium, magnesium, phosphorus, iron intake, and water consumption were found to be statistically significantly low in subjects with malnutrition or risk of malnutrition. After performing regression analysis to determine confounding factors, malnutrition risk was significantly associated with marital status, loss of teeth, appetite status, and depression. CONCLUSIONS: Routine nutritional screening and assessment of the elderly should be performed. If nutritional deficiencies cannot be diagnosed early and treated, self-sufficiency in the elderly may deteriorate, resulting in increased institutionalization.

아토피 피부염 심각도에 따른 빈혈 유병률 비교 분석 (Analysis of Prevalence of Anemia according to Severity of Atopic Dermatitis)

  • 윤다이;장지은;유기연
    • 한국임상약학회지
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    • 제30권4호
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    • pp.264-269
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    • 2020
  • Background: Inflammatory diseases can increase the prevalence of anemia. Recent studies confirmed that the prevalence of anemia is increased by atopic dermatitis (AD), a chronic inflammatory disease. Therefore, we aimed to elucidate the correlation between AD severity and prevalence of anemia. Methods: We used data of pediatric patients from the Health Insurance Review and Assessment Service (HIRA-PPS-2016). We included pediatric patients (<18 years) with AD diagnosis who were prescribed medications for AD. We applied a propensity score method with inverse probability of treatment weighting (IPTW) adjusting for differences in prevalence of confounders and performed IPTW logistic regression to evaluate associations between the anemia and severity of AD. Results: In total, 91,501 patients (mild AD: 47,054 patients; moderate-to-severe AD: 44,447 patients) <18 years who were prescribed drugs for AD were analyzed. Analysis of the probability of patients with mild AD and prevalence of anemia as a reference revealed an odds ratio (OR) of 1.159 (95% CI, 1.109-1.212; p<0.001) in moderate-to-severe AD patients, indicating a correlation between anemia prevalence and AD severity. Subgroup analysis according to gender, age group, and type of health insurance revealed there was an association between AD severity and anemia except in patients equal or older than 7 years. Conclusion: The prevalence of anemia increased with AD severity despite adjusting for confounding factors. Our results support the hypothesis that AD can cause anemia, and anemia prevalence could be increased in severe AD patients. Further studies are needed to establish a pathological basis.

한국 성인에서 안질환과 영양소 섭취와의 관련성에 관한 연구: 2015, 2016년 국민건강영양조사 자료를 이용하여 (A Study on the Relationship between Eye Disease and Nutrient Intake in Korean Adults: Data from Korean National Health and Nutrition Examination Survey 2015, 2016)

  • 황효정;신경옥;신승주
    • 대한영양사협회학술지
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    • 제27권2호
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    • pp.77-91
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    • 2021
  • This study was conducted to investigate the effect of the differences in nutrient intakes on the onset of eye disease in the ophthalmic disease group vs. the normal group. The analysis method of this study was performed by adjusting age and gender. The daily caloric intake was 1,672.1±26.4 kcal in the ophthalmic disease group which was significantly lower than the 2,041.5±13.6 kcal intake in the normal group (P=0.006). The intake of proteins (P=0.015) and carbohydrates (P=0.000) was significantly lower in the ophthalmic disease group than in the normal group. The incidence of eye diseases was found to decrease by about 0.79 (95% CI: 0.74~0.83) times as the NAR index of protein was increased, followed by 0.79 (95% CI: 0.64~0.98) times with an increase in niacin consumption. In this study, income, BMI, smoking, alcohol consumption, and quality of life were considered as the confounding variables related to eye disease, along with age and gender, but did not lead to show significant results. It was found that the ophthalmic disease group had an unbalanced nutritional intake compared to the normal group. Therefore, we conclude that nutrition education is necessary to ensurebalanced eating habits for management and prevention of degeneration after the onset of eye diseases.

The Association Between Dietary Diversity Score and Cardiovascular Risk Factors Among Patients With Pemphigus Vulgaris: A Cross Sectional Study

  • Atefeh Seifollahi;Mahboubeh Rezaei Fazl;Leila Setayesh;Mohammad Hassan Javanbakht;Maryam Daneshpazhooh;Sakineh Shab-Bidar;Mehdi Yaseri
    • Clinical Nutrition Research
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    • 제11권4호
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    • pp.289-301
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    • 2022
  • This study was conducted to evaluate the associations between dietary diversity score (DDS) and cardiovascular risk factors in this population. In this cross-sectional study, 187 patients, aged 18-65 years with pemphigus vulgaris were included. DDS was assessed by a 24-hour dietary recall method. Anthropometric measures and biochemical parameters assessed according to standard protocols. Multivariate linear regression analyses used for detecting any associations between DDS and cardiovascular risk factors. The mean ± standard deviation age and body mass index of studied participants were (46.71 ± 11.49 years) and (27.83 ± 4.39 kg/m2) respectively. Our findings showed that a higher DDS intake was related with higher consumption of vegetables (p = 0.001), dairy products (p < 0.001), cereals (p = 0.002), red and processed meat (p < 0.001), sweets and desserts (p < 0.001). After controlling for confounding variables, the results showed positive associations between DDS and high-density lipoprotein cholesterol (HDL-C, β = 1.87, 95% confidence interval [CI], 0.30-3.45, p = 0.02) and total cholesterol (TC) levels (β = 6.41, 95% CI, 1.62-11.03, p = 0.02) (β = 1.75, 95% CI, 0.20-3.30, p = 0.02). However, there were no associations between DDS and prevalence of obesity and glucose homeostasis. The results of this cross-sectional study showed that DDS might be associated with increased HDL-C and TC. However, further prospective studies are needed to prove these findings.

임상에서 발생할 수 있는 문제 상황에서의 성향 점수 가중치 방법에 대한 비교 모의실험 연구 (A simulation study for various propensity score weighting methods in clinical problematic situations)

  • 정시성;민은정
    • 응용통계연구
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    • 제36권5호
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    • pp.381-397
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    • 2023
  • 대부분의 임상시험에서 가장 대표적으로 사용되는 실험설계는 무작위화로, 치료 효과를 정확하게 추정하기 위해 이용된다. 그러나 무작위화가 이루어지지 않은 관찰연구의 경우 치료군과 대조군의 비교로 얻는 치료효과에는 환자 간의 특성 등 여러 조정되지 않은 차이로 인해 편향이 발생한다. 성향 점수 가중치는 이러한 문제점을 해결하기 위해 널리쓰이는 방법으로 치료 효과를 추정하는데에 있어 교란요인을 조정하여 편향을 최소화하도록 하는 방법이다. 성향 점수를 이용한 가중치 방법 중 가장 널리 알려진 역확률 가중치는 관찰된 공변량이 주어졌을 때 특정 치료에 할당될 조건부 확률의 역에 비례하는 가중치를 할당한다. 그러나 이 방법은 극단적인 성향 점수에 의해 종종 방해 받아 편향된 추정치와 과도한 분산을 초래한다는 점이 알려져있어 이러한 문제를 완화하기 위해 절사 역확률 가중치, 중복 가중치, 일치 가중치를 포함한 여러 가지 대안 방법이 제안되었다. 본 논문에서는 제한된 중복, 잘못 지정된 성향 점수 모델 및 예측과 반대되는 치료 등 다양한 문제상황에서 여러 성향 점수 가중치 방법의 성능을 비교하는 시뮬레이션 비교연구를 수행하였다. 비교연구의 결과 중복 가중치와 일치 가중치는 편향, 제곱근평균제곱오차 및 포함 확률 측면에서 역확률 가중치와 절사역확률 가중치에 비에 우월한 성능을 보임을 확인하였다.

성인 남녀에서 라면 섭취에 따른 대사적 지표 평가 : 2013~2014 국민건강영양조사 자료를 이용하여 (Association of instant noodle intake with metabolic factors in Korea: Based on 2013~2014 Korean National Health and Nutrition Examination Survey)

  • 연지영;배윤정
    • Journal of Nutrition and Health
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    • 제49권4호
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    • pp.247-257
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    • 2016
  • 본 연구에서 2013~2014 국민건강영양조사 중 정량적 식품섭취빈도조사로 분석된 라면의 섭취 빈도 및 섭취량에 근거하여, 성인 남녀의 라면 섭취 실태 및 라면 섭취 정도에 따른 영양소 섭취 상태, 대사적 지표를 비교하고 이들과의 관련성을 분석하였으며, 그 결과는 다음과 같다. 우리나라 성인에서 라면의 섭취 빈도는 주당 1.2회 (남성 1.4회, 여성 0.9회)였으며, 섭취량은 주당 1.2개 (남성 1.5개, 여성 0.8개)로 나타났다. 주당 1개 이상의 라면을 섭취하는 군 (라면 고섭취군)과 미만으로 섭취하는 군 (라면 저섭취군)으로 분류하여 분석시, 라면 고섭취군의 경우 라면 저섭취군에 비해 연령은 유의적으로 낮았고, 허리둘레, 혈중 중성지방, 총 콜레스테롤 및 HDL-콜레스테롤 수준이 유의적으로 높았다. 또한 영양소 섭취에서 라면 고섭취군은 라면 저섭취군에 비해 총 열량 및 지방, 나트륨 및 비타민 $B_2$의 섭취 밀도는 유의적으로 높은 반면, 탄수화물, 인, 철, 칼륨, 비타민 A, 비타민 $B_1$, 나이아신 및 비타민 C의 섭취 밀도는 유의적으로 낮은 결과를 보였다. 또한 전체 대상자에서 교란인자의 보정 후 라면 섭취가 가장 높은 Q4군은 라면 섭취 정도가 가장 낮은 Q1군에 비해 고혈당의 odds ratio가 1.4 (95% CI: 1.1~1.8)였으며 (p for trend = 0.003), 여성에서는 라면 섭취 정도가 가장 높은 Q4군에서 Q1군에 비해 복부비만의 위험률이 60% (95% CI: 1.2~2.2) 높은 것으로 나타났다 (p for trend = 0.03). 이와 같은 결과는 라면의 섭취가 상대적으로 높은 우리나라에서 라면의 질적, 양적 섭취와 대사적 위험성을 의미하는 지표와의 관련성을 제안할 수 있는 근거자료가 될 수 있으며, 향후 라면 섭취가 건강상태에 미치는 영향에 관한 영양교육시 활용할 수 있는 기초자료가 될 수 있을 것으로 생각된다.

정상 성인에서 자극추구 기질에 따른 우측 편도체의 측기저 세부구조의 차이 (Right Amygdalar Laterobasal Subregional Differences in Healthy Adults with Different Novelty Seeking Tendencies)

  • 조한별;김빈나;최지혜;전유진;김지현;정지영;임주연;이선혜
    • 생물정신의학
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    • 제19권2호
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    • pp.71-76
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    • 2012
  • Objectives : Novelty seeking (NS) represents a dopaminergically modulated tendency toward frequent exploratory activity. Considering the reports showing the relationship between exploratory activity and amygdalar function and structure, and the fact that amygdala is one of the key structures that constitute the dopaminergic pathway in the brain, amygdala might be closely related to NS tendencies. Amygdalar subregional analysis method, which has the enhanced sensitivity compared to the volumteric approach would be appropriate in investigating the subtle differences of amygdalar structures among healthy individuals. The aim of the current study was to examine whether amygdalar subregional morphometric characteristics are associated with the NS tendencies in healthy adults using the amygdalar subregional analysis method. Methods : Twenty-six healthy adults (12 males, 14 females ; mean age $29.8{\pm}6.2$ years) were screened for eligibility. All subjects completed the Korean version of the Temperament and Character Inventory (TCI) and underwent high-resolution brain magnetic resonance imaging. Individuals were divided into 2 groups according to NS scores of the TCI. Results : Individuals of the high NS group had significantly larger laterobasal subregions in right amygdala, after adjustment with the brain parenchymal volumes. Sensitivity analyses for each potential confounding factor such as age, education years and Hamilton Depression Rating Scale (HDRS) scores demonstrated consistent results. Conclusions : This study suggests that NS differences are associated with the laterobasal subregion of the amygdala.

산모혈액 및 태아 제대혈액의 수은 농도에 따른 출생 시 체중에 관한 연구 (Birth Weight of Mercury Concentrations of Maternal and Umbilical Cord Blood in Pregnant Women)

  • 김병미;김대선;이종화;박혜숙;김영주;서주희;장문희;하은희
    • 한국환경보건학회지
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    • 제34권1호
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    • pp.12-19
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    • 2008
  • We evaluated the relationship between birth weight and mercury exposure levels in Seoul, Korea, by following a cohort of pregnant women and the outcomes of their pregnancies between 2001-2005. Eighty-five pregnant women were recruited into this study after obtaining informed consent. Samples were collected at delivery from normal pregnant women who were living in the city of Seoul, Korea. Mercury concentrations in 85 sets of maternal and cord blood samples were measured using a gold-amalgam collection method. We used multiple regression analysis to analyze the effect of mercury exposure on birth weight. The mean levels of total mercury concentrations were 5.41(ppb) in maternal blood of pregnant women and 3.58(ppb) in umbilical cord blood. The mean concentration of umbilical cord blood mercury exposures was higher than the level recommended by WHO. There was a significant correlation between maternal and cord blood mercury concentrations. Mercury concentrations of umbilical cord blood was associated with birth weight. In addition, after adjusting for potential confounding factors, we found that mercury exposure may reduce the birth weight. This study suggests that exposure to mercury concentration during pregnancy contributes to the risk of low birth weight. Therefore, prenatal and environmental education for various and possible sources of mercury exposure might be necessary for the good health of babies. The finding of this study supports the construction of national policy for environmental health management.

한국인 제2형 당뇨병 여성환자에서 심혈관질환 위험인자와 과일류 및 생선류 섭취와의 관련성: 제4기와 제5기 국민건강영양조사 자료를 이용하여 (Relationship between fruit and fish intakes and cardiovascular disease risk factors in Korean women with type 2 diabetes mellitus: Based on the 4th and 5th Korea National Health and Nutrition Examination Surveys)

  • 오지수;김혜숙;김기남;장남수
    • Journal of Nutrition and Health
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    • 제49권5호
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    • pp.304-312
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    • 2016
  • 본 연구는 2007~2012년 국민건강영양조사 자료를 이용하여 30세 이상 제2형 당뇨병 여성 환자의 과일류 및 생선류 등의 식품섭취량과 심혈관질환 위험인자와의 관련성을 분석하였다. T2DM군이 NFG군에 비해 과일류 및 생선류의 섭취량이 유의적으로 낮았고 이들의 섭취량이 증가할수록 고중성지방혈증의 위험성이 유의적으로 감소하는 것으로 나타났다. 또한, 과일류와 생선류 섭취량은 각각 중앙값 이상으로 많이 섭취한 군 (FF3)이 각각 중앙값 이하로 섭취한 군 (FF1)에의 비해 TG 농도가 높을 위험이 유의적으로 낮았다. 이러한 결과는 과일류에 김치를 제외한 채소류, 버섯류, 해조류의 섭취량을 포함시켜 분석했을 때에도 같은 결과를 나타내었다. 따라서, 한국인 제2형 당뇨병여성 환자의 과일류 및 생선류의 섭취가 심혈관질환에 긍적적인 영향을 미치는 것으로 보이며, 과일류나 생선류 중 어느 한 종류만 많이 섭취하기보다는 두 종류를 모두 적절히 섭취하는 것이 심혈관 질환 위험성을 낮추는데 효과적일 것으로 사료된다.