• Journal of Preventive Medicine and Public Health
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• v.57 no.5
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• pp.499-507
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• 2024

Objectives: This study aimed to compare the Delta, Greenland, and Monte Carlo methods for estimating 95% confidence intervals (CIs) of the population-attributable fraction (PAF). The objectives were to identify the optimal method and to determine the influence of primary parameters on PAF calculations. Methods: A dataset was simulated using hypothetical values for primary parameters (population, relative risk [RR], prevalence, and variance of the beta estimator ) involved in PAF calculations. Three methods (Delta, Greenland, and Monte Carlo) were used to estimate the 95% CIs of the PAFs. Perturbation analysis was performed to assess the sensitivity of the PAF to changes in these parameters. An R Shiny application, the "GDM-PAF CI Explorer," was developed to facilitate the analysis and visualization of these computations. Results: No significant differences were observed among the 3 methods when both the RR and p-value were low. The Delta method performed well under conditions of low prevalence or minimal RR, while Greenland's method was effective in scenarios with high prevalence. Meanwhile, the Monte Carlo method calculated 95% CIs of PAFs that were stable overall, though it required intensive computational resources. In a novel approach that utilized perturbation for sensitivity analysis, was identified as the most influential parameter in the estimation of CIs. Conclusions: This study emphasizes the necessity of a careful approach for comparing 95% CI estimation methods for PAFs and selecting the method that best suits the context. It provides practical guidelines to researchers to increase the reliability and accuracy of epidemiological studies.

• Journal of Food Hygiene and Safety
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• v.24 no.4
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• pp.378-384
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• 2009

There are differences of Cadmium (Cd) urinary concentration which is considered as indicator of renal tubular dysfunction in other countries, so we have reviewed domestic epidemiological data and suggested Korean health based guidance value (HBGV) for Cd to improve an efficiency of risk management. We decided to apply the WHO calculation model which considered the relationship between dietary intake and Cd concentration in urine sample. It is determined that Cd concentration 2.5 ug/g creatinine in urine as the prevalence of renal tubular dysfunction based on epidemiological data, because there is no renal tubular dysfunction and injury/lesion such as proteinuria at the concentration of 11.63 ug/g creatinine which is the highest Cd concentration in urine from the domestic epidemiological data. It is identified that the ratio between the Cd dietary consumption (8.3~10.4 ug/day) and Cd urinary concentration (0.38 ug/g creatinine) in Korean adult who predicting never been exposed to Cd are 21.8~27.3 and then it is applied to the corresponding model suggested by WHO. Also it is applied that 10% of bioavailability and 50% of excretion rate of absorbed to body (the ratio is 24) were assumed. The estimate of daily Cd consumption level which begins tubular dysfunction is 1 ug/kg bw/day, so we suggest the Korean provisional tolerable weekly intake (PTWI) as 7 ug/kg bw/week.

• The Journal of the Korean Society for Microbiology
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• v.35 no.5_6
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• pp.330-332
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• 2000

• The Korean Journal of Applied Statistics
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• v.9 no.1
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• pp.1-15
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• 1996

This paper discusses the effectiveness of an infection rate under a certain disease on an immunity rate by a protective inoculation. A sequence of dependense models concerning the infection rate is derived by defining conditionally nested binary random variables for the analysis of polytomous data with hierarchical response scale. Maximum likelihood estimates based on the marginal log-likelihood functin are obtained numerically in the Nelder and Mead's(1965) simplex method.

• Journal of Preventive Medicine and Public Health
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• v.54 no.3
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• pp.166-172
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• 2021

Traditional epidemiological assessments, which mainly focused on evaluating the statistical association between two major components-the exposure and outcome-have recently evolved to ascertain the in-between process, which can explain the underlying causal pathway. Mediation analysis has emerged as a compelling method to disentangle the complex nature of these pathways. The statistical method of mediation analysis has evolved from simple regression analysis to causal mediation analysis, and each amendment refined the underlying mathematical theory and required assumptions. This short guide will introduce the basic statistical framework and assumptions of both traditional and modern mediation analyses, providing examples conducted with real-world data.

• Journal of Preventive Medicine and Public Health
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• v.17 no.1
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• pp.5-24
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• 1984

There has been an immense need for elaborate studies on the complications and the neuological sequelae generated by acute carbon monoxide (CO) poisoning which is highly prevalent in Korea due to widespread adoption of the anthracite coal briquette as domestic fuel for heating and for cooking. For this epidemiological study, a total of 444 subjects who received hospital emergency care for acute CO poisoning during the period of March 1982 to February 1983 were randomly selected from the emergency patients's lists of 13 general hospitals in Seoul area. Informations on the neurological sequelae were elucidated by means of home visiting with prearranged questionnaire consisting questions and concise neurological examination. The findings obtained were summarized as follows; 1. The complications were found in 18% of the surveyed and acute decubitus was comprised 67.5% of the complications. 2. The total cumulative incidence of the neurological sequelae was 41.2 per 100 patients and the absolute incidence rate regardless of the duration after poisoning was 40.8%. 3. The incidence of the neurological sequelae was higher in the older age than in the younger and also higher in female than in male. Twice higher incidence was observed in the admitted patients than in the non-admitted patients and the incidence became higher in proportion to the duration of CO exposure, coma and admission. The poorer the consciousness level of patients found, at emergency room and at discharge, the higher the incidence. The incidence of the neurological sequelae by emergency care was higher in hyperbaric oxygen therapy group(51.9%) than in 100% $O_2$ group(38.0%) 4. A total of five variables significantly associated with the occurrence of the neurological sequelae were selected by the stepwise discriminant analysis. The variables were following course of emergency care, age, consciousness level at discharge, admission duration, and consciousness level at emergency room in their sequence of discriminant power. Eight variables were selected as those associated with the degree of the neurological sequelae through the stepwise multiple regression analysis. Of these variables, the acute decubitus alone explained 21.1% of the total variation ana all the eight variables could explain 36.5% of the same. The remaining seven variables listed in the order of their relative importance were: age, consciousness level at discharge, admission duration, coma duration and consciousness level at emergency room. 5. It was postulated that unexpectedly high incidence of the neurological sequelae of the CO poisoning in this epidemiological study was mainly due to the inadequate emergency care and the lack of efficient and sophisticated treatment measure. In the effort to minimize the incidence of grave neurological sequelae of acute CO poisoning, new guidelines for the emergency care and treatment should be pursued with efficient ways.

• Journal of Life Science
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• v.26 no.9
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• pp.999-1006
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• 2016

This paper studies an infection of norovirus and astrovirus in outbreaks in Korea. In March 2016, gastroenteritis outbreaks occurred in Busan. 522 students of three departments at university D had meeting at a restaurant near the university. Some of them had symptom such as diarrhea, vomiting. Epidemiological, laboratory and environmental investigations were performed to identify the agents of the outbreaks. Fecal specimens were collected from 35 students and 7 food handlers to identify causative viral agents. Norovirus genogroup GI and GII were detected from diarrhea patients. Astrovirus was also detected from some of them. In particular, these outbreaks were the first occurrence associated with astrovirus in Busan. Total of 42 samples were collected, and 24 samples resulted in positive to norovirus (16 cases) and astrovirus (8 cases). To identify the molecular genetic information of norovirus, we carried out sequences analysis of the detected strains. Norovirus genotypes were classified into GI.3, GI.4, GII.4, GII.13, GII.17 and GII.21. Astrovirus genotypes were seven astrovirus type 5 and one astrovirus type 2. We performed environmental investigation about water at the kitchen, but norovirus and astrovirus were not detected. The statistical analysis was conducted to evaluate the association between illness and risk factors. The results of this study may contribute to accumulate more the epidemiological data and develop the public health and hygiene.

• Korean Journal of Clinical Laboratory Science
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• v.51 no.4
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• pp.420-427
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• 2019

Scrub typhus is a fever-related disease that is commonly diagnosed during the autumn season. The number of patients affected by this disease continues to increase every year. However, the cause of the disease and the regional differences of its incidence are poorly understood. This study examined the epidemiological features and regional differences in the incidence of scrub typhus. The monthly incidence of cases from all reports rose to more than 90% during the fall season (October~December). Based on the analysis of the 18,851 cases in the epidemiological investigation, 14,777 (78.4%) and 4,074 (21.6%) cases occurred in high and low occurrence areas, respectively. Moreover, there were more female cases than male cases (males: 7,233 [38.4%]; females: 11,618 [61.6%]; P< 0.001). The clinical symptoms, including fever, chills, myalgia, and eschar of the body, were noted in 16,688 (89.1%), 11,533 (61.2%),11,439 (60.7%), and 6,005 (45.4%) cases, respectively. The incidence rates were higher for Gyeongnam, Jeonam, Jeonbuk, and Chungnam provinces. The areas with a high occurrence of scrub typhus were consistent with the areas experiencing a high distribution of Leptotrombidium scutellare. The incidence of scrub typhus has been rising owing to the increasing population of ticks due to global warming and increased agricultural and outdoor activities. Thus, continuous management of patients and preventive environmental measures are needed to control this disease.

• Environmental Analysis Health and Toxicology
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• v.30
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• pp.12.1-12.7
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• 2015

Objectives In South Korea, health insurance data are used as material for the health insurance of national whole subject. In general, health insurance data could be useful for estimating prevalence or incidence rate that is representative of the actual value in a population. The purpose of this study was to apply the concept of episode of care (EoC) in the utilization of health insurance data in the field of environmental epidemiology and to propose an improved methodology through an uncertainty assessment of disease course and outcome. Methods In this study, we introduced the concept of EoC as a methodology to utilize health insurance data in the field of environmental epidemiology. The characterization analysis of the course and outcome of applying the EoC concept to health insurance data was performed through an uncertainty assessment. Results The EoC concept in this study was applied to heat stroke (International Classification of Disease, 10th revision, code T67). In the comparison of results between before and after applying the EoC concept, we observed a reduction in the deviation of daily claims after applying the EoC concept. After that, we categorized context, model, and input uncertainty and characterized these uncertainties in three dimensions by using uncertainty typology. Conclusions This study is the first to show the process of constructing episode data for environmental epidemiological studies by using health insurance data. Our results will help in obtaining representative results for the processing of health insurance data in environmental epidemiological research. Furthermore, these results could be used in the processing of health insurance data in the future.

• Asian Pacific Journal of Cancer Prevention
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• v.17 no.2
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• pp.839-843
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• 2016

Background: Prostate cancer is second most common cancer in men overall in the world, whereas it is the third most common cancer in men and the sixth most common cancer in Iran. Few studies have been conducted on the epidemiology of prostate cancer in Iran. Since ethnicity of Iranian men is different from Asian people and given the epidemiologic and demographic transition taking place in Iran, this study aimed to investigate trends of incidence and morphology of prostate cancer during 2003 - 2008 in the country. Materials and Methods: Data were collected retrospectively reviewing all new prostate cancer patients in the Cancer Registry Center of the Health Deputy for Iran during a 6-year period. Also carcinoma, NOS and adenocarcinoma, NOS morphology were surveyed. Trends analysis of incidence and morphology was by joinpoint regression. Results: During the six years a total of 16,071 cases of prostate cancer were recorded in Iran. Most were adenocarcinomas at 95.2 percent. Trend analysis of incidence (ASR) There was a significant increase incidence, with annual percentage change (APC) of 17.3% and for morphology change percentage trends there was a significant decrease in adenocarcinoma with an APC of -1.24%. Conclusions: Prostate cancer is a disease of older men and the incidence is increasing in Iran. The most common morphology is adenocarcinoma this appears to be decreasing over time. Due to the changing lifestyles and the aging of the population, epidemiological studies and planning assessment of the etiology of prostate cancer and its early detection are essential.