• Clinical and Experimental Pediatrics
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• 제64권7호
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• pp.313-321
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• 2021

Here we describe the neurodevelopmental outcomes of very low birth weight (VLBW) infants (birth weight ≤1,500 g) at 3 years of age in the Neonatal Research Network of Japan (NRNJ) database in the past decade and review the methodological issues identified in follow-up studies. The follow-up protocol for children at 3 years of chronological age in the NRNJ consists of physical and comprehensive neurodevelopmental assessments in each participating center. Neurodevelopmental impairment (NDI)-moderate to severe neurological disability-is defined as cerebral palsy (CP) with a Gross Motor Function Classification System score ≥2, visual impairment such as uni- or bilateral blindness, hearing impairment requiring hearing amplification, or cognitive impairment with a developmental quotient (DQ) of Kyoto Scale of Psychological Development score <70 or judgment as delayed by pediatricians. We used death or NDI as an unfavorable outcome in all study subjects and NDI in survivors using number of assessed infants as the denominator. Follow-up data were collected from 49% of survivors in the database. Infants with follow-up data had lower birth weights and were of younger gestational age than those without follow-up data. Mortality rates of 40,728 VLBW infants born between 2003 and 2012 were 8.2% before discharge and 0.7% after discharge. The impairment rates in the assessed infants were 7.1% for CP, 1.8% for blindness, 0.9% for hearing impairment, 15.9% for a DQ <70, and 19.1% for NDI. The mortality or NDI rate in all study subjects, including infants without follow-up data, was 17.4%, while that in the subjects with outcome data was 32.5%. The NRNJ follow-up study results suggested that children born with a VLBW remained at high risk of NDI in early childhood. It is important to establish a network follow-up protocol and complete assessments with fewer dropouts to enable clarification of the outcomes of registered infants.

• 한국의학물리학회:학술대회논문집
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• 한국의학물리학회 2002년도 Proceedings
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• pp.133-135
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• 2002

We developed a system that can assist to automatically survey survived patients and to lighten the hard work imposed on radiation oncologists employing Radiation Oncology Greater Area Database (ROGAD) and Internet by web mail.

• Journal of Preventive Medicine and Public Health
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• 제40권2호
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• pp.95-101
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• 2007

Focusing on complex diseases of public health significance, strategic issues regarding the on-going Korean Genome Cohort were reviewed: target size and diseases, measurements, study design issues, and follow-up strategy of the cohort. Considering the epidemiologic characteristics of Korean population as well as strengths and drawbacks of current research environment, we tried to tailor the experience of other existing cohorts into proposals for this Korean study. Currently 100,000 individuals have been participating the new Genome Cohort in Korea. Target size of de novo collection is recommended to be set as between 300,000 to 500,000. This target size would allow acceptable power to detect genetic and environmental factors of moderate effect size and possible interactions between them. Family units and/or special subgroups are recommended to parallel main body of adult individuals to increase the overall efficiency of the study. Given that response rate to the conventional re-contact method may not be satisfactory, successful follow-up is the main key to the achievement of the Korean Genome Cohort. Access to the central database such as National Health Insurance data can provide enormous potential for near-complete case detection. Efforts to build consensus amongst scientists from broad fields and stakeholders are crucial to unleash the centralized database as well as to refine the commitment of this national project.

• 보건교육건강증진학회지
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• 제24권1호
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• pp.127-138
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• 2007

Objectives: This study aims to examine if the follow-up management service by National Health Insurance (NHI) for person at health risk leads to significant modification of the lifestyle and change of health status. Methods: Of persons who underwent health screening and were classified as having health risks after periodic health screening by NHI in 2003, persons who took the follow-up management service were selected as case group and persons who took no service were selected as control group. The DW database of NHI was used to explore the effect of the follow-up management service on the modification of health status and lifestyle. Chi-square tests were conducted with SAS 9.1 to examine the differences of health promotion effect between case vs. control group. Results: It was shown that of lifestyle behaviors, only exercise was significantly improved for case group compared with control group as the effect of the follow-up management service by NHI (2.98%p) (p<.0001). Further, morbidity rate for control group was 2% higher than that of case group (p <.0001), which indicates that persons who received the follow-up management service better maintained their health significantly than persons who did not. Conclusions: The present study shows that the appropriate follow-up management services need to be provided for maximizing potential effect of periodic health screening by NHI.

• 보건교육건강증진학회지
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• 제26권3호
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• pp.75-83
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• 2009

Objectives: This study aims to examine if the follow-up management service by National Health Insurance (NHI) for obesity persons leads to significant modification of the lifestyle and change of health status. Methods: Of persons who underwent health screening and were classified as obesity after periodic health screening by NHI in 2004, persons who took the follow-up management service were selected as case group and persons who took no service were selected as control group. The DW database of NHI was used to explore the effect of the follow-up management service on the modification of lifestyle and health status. Chi-square tests and t-tests, pairs t-tests were conducted with SAS 9.1 to examine the differences of health promotion effect between case vs. control group. Results: It was shows that of lifestyle behaviors, only exercise is significantly improved for case group compared with control group as the effect of the follow-up management service by NHI (2.11%p) (p=0.0435). Further, morbidity rate for control group was 2.05% higher than that of case group (p=0.0002). These results indicate that persons who received the follow-up management service better maintained their health significantly than persons who did not. Conclusion: The present study shows that the appropriate follow-up management services need to be provided for maximaizing potential effect of periodic health screening by NHI.

• Journal of Gastric Cancer
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• 제15권2호
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• pp.87-104
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• 2015

Purpose: To assess real-world treatment patterns, health care utilization, costs, and survival among Medicare enrollees with locally advanced/unresectable or metastatic gastric cancer receiving standard first-line chemotherapy. Materials and Methods: This was a retrospective analysis of the Surveillance, Epidemiology, and End Results-Medicare linked database (2000~2009). The inclusion criteria were as follows: (1) first diagnosed with locally advanced/unresectable or metastatic gastric cancer between July 1, 2000 and December 31, 2007 (first diagnosis defined the index date); (2) ${\geq}65$ years of age at index; (3) continuously enrolled in Medicare Part A and B from 6 months before index through the end of follow-up, defined by death or the database end date (December 31, 2009), whichever occurred first; and (4) received first-line treatment with fluoropyrimidine and/or a platinum chemotherapy agent. Results: In total, 2,583 patients met the inclusion criteria. The mean age at index was $74.8{\pm}6.0years$. Over 90% of patients died during follow-up, with a median survival of 361 days for the overall post-index period and 167 days for the period after the completion of first-line chemotherapy. The mean total gastric cancer-related cost per patient over the entire post-index follow-up period was United States dollar (USD) $70,808{\pm}56,620$. Following the completion of first-line chemotherapy, patients receiving further cancer-directed treatment had USD 25,216 additional disease-related costs versus patients receiving supportive care only (P<0.001). Conclusions: The economic burden of advanced gastric cancer is substantial. Extrapolating based on published incidence estimates and staging distributions, the estimated total disease-related lifetime cost to Medicare for the roughly 22,200 patients expected to be diagnosed with this disease in 2014 approaches USD 300 millions.

• 지역사회간호학회지
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• 제15권3호
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• pp.365-375
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• 2004

Purpose: This study intends to make a database for hypertensive patients and middle-aged women who are visiting the Yeojoo County Health Center. While building up the database, the study reviewed the current assessment tools used in the health center, developed appropriate health care programs, and designed a computerized health care system. Method: The modeling of a database for the system was constructed by MS-Access for DBMS (Database Management System) and Visual Basic. The system is to be used only in the health center by being designed as a client server method, making it possible for many public employees to be interconnected, and enables them to retrieve and search data from the database simultaneously. Results: The health management system systematically follows nursing processes including assessment, diagnosis, intervention and evaluation. Diagnosis. once it is done according to the self determined criteria, saves time and provides appropriate health information for the members. Also, the health education program was developed to follow up on the health status of the members on a continuous basis. Conclusion: Based on these results, it is required to evaluate health care programs provided for the members by using the database system and to develop more practical health care programs. It is also necessary to connect the system to other databases. which contain information about members.

• 정보관리연구
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• 제23권1호
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• pp.1-21
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• 1992

컴퓨터 및 정보통신망(情報通信網)의 발전에 따라 데이터베이스의 구축(構築) 및 활용(活用)이 중요해지고 있다. 과학기술분야(科學技術分野)에서 선진국(先進國)은 문헌(文獻)데이터베이스 뿐만 아니라 수치데이터베이스도 구축하여 왔다. 국내(國內)에서는 문헌(文獻)데이터베이스의 구축 및 활용은 정착되는 단계(段階)이나 수치데이터베이스에 대한 연구(硏究)는 매우 미약하였다. 선진국의 지적소유권(知的所有權)에 대응하기 위해서는 우리 고유의 수치데이터베이스를 구축한 다음에 이를 바탕으로 교환사용(交換使用)을 추진하는 것이 가장 적절한 대응책이며, 따라서 수치데이터베이스의 구축은 우리가 선진국(先進國)과 어깨를 나란히 하려면 필수적으로 요구되는 연구분야(硏究分野)이다. 본 연구(硏究)에서는 재료강도(材料强度) 데이터 중에서 고온특성(高溫特性)에 해당하는 크리프강도에 대한 수치데이터베이스를 구축하였다. 대상물질(對象物質)을 25종으로 하였으며, 국내(國內)에서 생산(生産)된 데이터베이스를 대상으로 하였다.

• 응용통계연구
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• 제21권4호
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• pp.639-647
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• 2008

본 연구는 국민건강보험공단의 건강검진데이터, 자격 및 보험료 그리고 진료비 데이터를 활용하여 고혈압 관리를 위한 맞춤형 고혈압 사후관리모형(고혈압 진료예측모형 및 고혈압 진료순응도세분화모형)을 개발하고자 하였다. 모형 개발에는 데이터마이닝의 로지스틱 회귀모형, 의사결정나무 그리고 앙상블 모형을 활용하였다. 고혈압 진료예측모형에서는 3가지 모형 중 로지스틱 회귀모형이 가장 우수한 모형으로 채택되었으며, 고혈압 진료순응도세분화모형은 의사결정나무모형을 통해 개발되었다. 본 연구는 전국 규모의 수년간 축적된 자료를 데이터마이닝을 활용함으로써 고혈압의 진료 및 진료순응도에 이르는 고혈압 사후관리 프로세스 전반에 걸친 결과를 도출함으로써 우리나라 고혈압 사후관리체계 구축에 기여할 것으로 사료된다.

• Asian Pacific Journal of Cancer Prevention
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• 제14권9호
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• pp.5179-5183
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• 2013

The cerebellar hemangioblastoma (CHB) has an abundant blood supply and deep anatomical location. Complete surgical resection is generally very difficult. This study investigated the safety and effectiveness of preoperative embolization followed by surgical resection of CHB in a large cohort of patients. A database of 125 CHB patients with surgical resection in Beijing Tiantan Hospital between July 2006 and July 2012 was reviewed. Of those, 46 cases (experimental group) received preoperative embolization, 79 cases (control group) underwent surgery without embolization. Patient demographics, tumor size, duration of surgery, blood loss, blood transfusion, complications and follow-up results were collected and analyzed retrospectively. In the experimental group, the Kamofsky score (KS) was 80-100 in 40 cases (86.9%), 40-70 in 4 cases (8.7%), and below 40 in 2 cases (4.3%). Among 31 cases with follow-up, KS was 80-100 in 27 cases (87.1%), 40-70 in 2 cases (6.5%), and 0 in 2 cases (6.5%). In control group, KS was 80 -100 in 65 cases (82.2%), 40-70 in 6 cases (7.6%), 10-30 in 3 cases (3.8%), and 0 in 3 cases (3.8%). Among 53 cases with follow-up, KS was 80-100 in 44 cases (83.0%), 40-70 in 4 cases (7.5%), 10-30 in 1 case (1.9%), and 0 in 4 cases (7.5%). There were statistically significant differences between the experimental and control groups in tumor size, duration of surgery, amount of intraoperative blood loss and transfusion (p<0.01). However, complications (p=0.31) and follow-up results (p=0.76) showed no significant differences between groups. Selective preoperative embolization of those CHB patients with richer blood supply, higher hemorrhage risk, is safe and effective, and is a reliable adjuvant therapy for complete surgical resection of CHB.