• Journal of Preventive Medicine and Public Health
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• v.40 no.2
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• pp.108-113
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• 2007

When conducting large-scale cohort studies, numerous statistical issues arise from the range of study design, data collection, data analysis and interpretation. In genomic cohort studies, these statistical problems become more complicated, which need to be carefully dealt with. Rapid technical advances in genomic studies produce enormous amount of data to be analyzed and traditional statistical methods are no longer sufficient to handle these data. In this paper, we reviewed several important statistical issues that occur frequently in large-scale genomic cohort studies, including measurement error and its relevant correction methods, cost-efficient design strategy for main cohort and validation studies, inflated Type I error, gene-gene and gene-environment interaction and time-varying hazard ratios. It is very important to employ appropriate statistical methods in order to make the best use of valuable cohort data and produce valid and reliable study results.

• Journal of Preventive Medicine and Public Health
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• v.55 no.5
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• pp.464-474
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• 2022

Objectives: We introduced the cohort studies included in the Korean Cohort Consortium (KCC), focusing on large-scale cohort studies established in Korea with a prolonged follow-up period. Moreover, we also provided projections of the follow-up and estimates of the sample size that would be necessary for big-data analyses based on pooling established cohort studies, including population-based genomic studies. Methods: We mainly focused on the characteristics of individual cohort studies from the KCC. We developed "PROFAN", a Shiny application for projecting the follow-up period to achieve a certain number of cases when pooling established cohort studies. As examples, we projected the follow-up periods for 5000 cases of gastric cancer, 2500 cases of prostate and breast cancer, and 500 cases of non-Hodgkin lymphoma. The sample sizes for sequencing-based analyses based on a 1:1 case-control study were also calculated. Results: The KCC consisted of 8 individual cohort studies, of which 3 were community-based and 5 were health screening-based cohorts. The population-based cohort studies were mainly organized by Korean government agencies and research institutes. The projected follow-up period was at least 10 years to achieve 5000 cases based on a cohort of 0.5 million participants. The mean of the minimum to maximum sample sizes for performing sequencing analyses was 5917-72 102. Conclusions: We propose an approach to establish a large-scale consortium based on the standardization and harmonization of existing cohort studies to obtain adequate statistical power with a sufficient sample size to analyze high-risk groups or rare cancer subtypes.

• Women's Health Nursing
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• v.27 no.1
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• pp.27-39
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• 2021

Purpose: This study aimed to review recent findings from birth cohort studies on maternal and child environmental health. Methods: Birth cohort studies regarding environmental health outcomes for mothers and their children were investigated through a systematic review. A literature search was conducted in PubMed, CINAHL, the Cochrane Library, Embase, and RISS to identify published studies using the keywords using a combination of the following keywords: maternal exposure, environmental exposure, health, cohort, and birth cohort. Articles were searched and a quality appraisal using the Newcastle-Ottawa Scale for cohort studies was done. Results: A review of the 14 selected studies revealed that prenatal and early life exposure to environmental pollutants had negative impacts on physical, cognitive, and behavioral development among mothers and children up to 12 years later. Environmental pollutants included endocrine disruptors, air pollution (e.g., particulate matter), and heavy metals. Conclusion: This systematic review demonstrated that exposure to environmental pollutants negatively influences maternal and children's environmental health outcomes from pregnancy to the early years of life. Therefore, maternal health care professionals should take steps to reduce mothers' and children's exposure to environmental pollutants.

• Asian Pacific Journal of Cancer Prevention
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• v.13 no.9
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• pp.4677-4681
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• 2012

Objective: Egg consumption has been suggested to increase the risk of colorectal and some other cancers. The present study summarized and quantified the current evidence relating dietary intake of eggs and prostate cancer. Materials and methods: Literature searches were conducted to identify peer-reviewed manuscripts published up to July 2012. Twenty manuscripts from nine cohort studies and 11 case-control studies were identified. Summary risk estimates with 95% confidence intervals (CIs) were calculated for case-control and cohort studies separately. Results: Neither the case-control not the cohort studies showed any association of prostate cancer incidence with egg consumption (case-control studies: odds ratio 1.09, 95% CI 0.86-1.31; cohort studies: relative risk 0.97, 95% CI 0.97-1.07). The results were consistent in subgroup analysis. Furthermore, no association was observed between egg consumption and prostate cancer-specific mortality. Conclusions: Our analyses provided no evidence of a significant influence of egg consumption on prostate cancer incidence and mortality. However, more studies, particularly large prospective studies, are needed.

• Journal of Society of Preventive Korean Medicine
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• v.20 no.1
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• pp.65-73
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• 2016

Objectives : In this study, we investigated the trends of cohort project in domestic and overseas, and suggested the necessity of cohort on korean medicine and the direction of research. Methods : The papers which include cohort in the title and published by 2015 were searched using PubMed. In order to study the history of cohort in domestic and overseas, research trend was investigated based on the websites of each cohort projects and traditional medicine searching engine named OASIS. Results : Using PubMed, 42,802 papers were searched. Most of the studies over 50 % of total articles, however, were conducted in these 6 years. Nevertheless, cohort studies are being actively proceed, the korean medicine based on cohort studies are nonexistent. Therefore, further discussion about cohort study on korean medicine is necessary to gather physiological index and clinical index of korean medicine consistently. Conclusions : Systematically constructed cohort on korean medicine would be the foundation which collects information, such as gene information, bio information, dietary habit, life style, and Pattern identification (辨證), and integrates them. The analysis of massive clinical materials could suggest the basis of Prevention and treatment of korean medicine considering the difference between personal.

• 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.

• Korean Medical Education Review
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• v.25 no.2
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• pp.119-125
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• 2023

Pusan National University School of Medicine (PNUSOM) began analyzing the cohort of pre-medical students admitted in 2015 and has been conducting purposeful analyses for the past 3 years. The aim of this paper is to introduce the process of cohort establishment, cohort composition, and the utilization of cohort analysis results. PNUSOM did not initially form a cohort with a purpose or through a systematic process, but was able to collect longitudinal data on students through the establishment of a Medical Education Information System and an organization that supports medical education. Cohort construction at our university is different in terms of a clear orientation toward research questions, flexibility in cohort composition, and subsequent guideline supplementation. We investigated the relevance of admission factors, performance improvements, satisfaction with the educational environment, and promotion and failure rate in undergraduate students, as well as performance levels and career paths in graduates. The results were presented to the Admissions Committee, Curriculum Committee, Learning Outcomes Committee, and Student Guidance Committee to be used as a basis for innovations and improvements in education. Since cohort studies require long-term efforts, it is necessary to ensure the efficiency of data collection for graduate cohorts, as well as the validity and ethics of the study.

• 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.

• Journal of Preventive Medicine and Public Health
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• v.40 no.2
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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.