The impact of weight misperception on health-related quality of life in Korean adults (KNHANES 2007–2014): a community-based cross-sectional study

Weight perception, especially misperception, might affect health-related quality of life (HRQoL); however, related research is scarce and results remain equivocal. We examined the association between HRQoL and weight misperception by comparing obesity level as measured by body mass index (BMI) and weight perception in Korean adults

Prediction of overall survival for patients with metastatic castration-resistant prostate cancer : development of a prognostic model through a crowdsourced challenge with open clinical trial data

Background Improvements to prognostic models in metastatic castration-resistant prostate cancer have the potential to augment clinical trial design and guide treatment strategies. In partnership with Project Data Sphere, a not-for-profit initiative allowing data from cancer clinical trials to be shared broadly with researchers, we designed an open-data, crowdsourced, DREAM (Dialogue for Reverse Engineering Assessments and Methods) challenge to not only identify a better prognostic model for prediction of survival in patients with metastatic castration-resistant prostate cancer but also engage a community of international data scientists to study this disease. Methods Data from the comparator arms of four phase 3 clinical trials in first-line metastatic castration-resistant prostate cancer were obtained from Project Data Sphere, comprising 476 patients treated with docetaxel and prednisone from the ASCENT2 trial, 526 patients treated with docetaxel, prednisone, and placebo in the MAINSAIL trial, 598 patients treated with docetaxel, prednisone or prednisolone, and placebo in the VENICE trial, and 470 patients treated with docetaxel and placebo in the ENTHUSE 33 trial. Datasets consisting of more than 150 clinical variables were curated centrally, including demographics, laboratory values, medical history, lesion sites, and previous treatments. Data from ASCENT2, MAINSAIL, and VENICE were released publicly to be used as training data to predict the outcome of interest-namely, overall survival. Clinical data were also released for ENTHUSE 33, but data for outcome variables (overall survival and event status) were hidden from the challenge participants so that ENTHUSE 33 could be used for independent validation. Methods were evaluated using the integrated time-dependent area under the curve (iAUC). The reference model, based on eight clinical variables and a penalised Cox proportional-hazards model, was used to compare method performance. Further validation was done using data from a fifth trial-ENTHUSE M1-in which 266 patients with metastatic castration-resistant prostate cancer were treated with placebo alone. Findings 50 independent methods were developed to predict overall survival and were evaluated through the DREAM challenge. The top performer was based on an ensemble of penalised Cox regression models (ePCR), which uniquely identified predictive interaction effects with immune biomarkers and markers of hepatic and renal function. Overall, ePCR outperformed all other methods (iAUC 0.791; Bayes factor >5) and surpassed the reference model (iAUC 0.743; Bayes factor >20). Both the ePCR model and reference models stratified patients in the ENTHUSE 33 trial into high-risk and low-risk groups with significantly different overall survival (ePCR: hazard ratio 3.32, 95% CI 2.39-4.62, p Interpretation Novel prognostic factors were delineated, and the assessment of 50 methods developed by independent international teams establishes a benchmark for development of methods in the future. The results of this effort show that data-sharing, when combined with a crowdsourced challenge, is a robust and powerful framework to develop new prognostic models in advanced prostate cancer.Peer reviewe

Incidence of tuberculosis disease in individuals diagnosed with tuberculosis infection after screening: A population-based cohort study in South Korea

Objectives: Limited evidence exists regarding the impact of adherence to diverse tuberculosis (TB) preventive therapy (TPT) regimens on TB risk in individuals with TB infections (TBIs). This study aimed to examine the association between adherence to three TPT regimens and TB incidence. Methods: This population-based retrospective cohort study used South Korean national health insurance data to identify individuals who were newly diagnosed with TBI between 2015 and 2020. TB incidence was compared among the different TPT regimens used. Treatment adherence was evaluated using the medication possession ratio (MPR). Results: The study involved 220,483 individuals with TBI, with half undergoing TPT. Over a mean 3.17-year follow-up, 2,430 cases of active TB were observed. TPT was associated with a 14% reduction in TB incidence risk in the entire study population with varying levels of TB risk. Non-adherence (MPR <80%) rates were 36% for 9 months of treatment with isoniazid, 22% for 4 months of treatment with rifampicin, and 18% for 3 months of treatment with isoniazid and rifampicin. Non-adherence to TPT did not lead to a decrease in the risk of TB incidence, whereas adherence to TPT (MPR ≥80%) reduced the risk of TB incidence by up to 72%. Conclusions: This study reveals increased adherence with shorter TPT regimens in a national TBI cohort, emphasizing the pivotal role of medication adherence in preventing TB

Data_Sheet_1_Factors associated with self-rated health among immigrant workers in South Korea: Analyzing the results of the 2020 survey on immigrants' living conditions and labor force.docx

Immigrants' health is an emerging public health issue worldwide. This study aimed to measure immigrant workers' self-rated health and identify the factors affecting it. Data were obtained from the nationwide 2020 Survey on Immigrants' Living Conditions and Labor Force in Korea. The data from 14,277 economically active immigrants who participated in the study were analyzed. Self-rated health was measured using one question and divided into dichotomized categories (good and poor). Multivariate logistic regression with a weighted sampling method was used to investigate associated factors, namely, individual, social, and living and working environment variables, and to evaluate the interaction effects with gender. Overall, 23.0% of the participants showed poor self-rated health. The odds ratios for poor self-rated health were high in participants who reported unmet healthcare needs (OR = 3.07, 95% confidence interval: 3.00–3.13) compared to those who reported other factors, followed by moderate job satisfaction (OR = 2.23, 95% confidence interval: 2.20–2.26) and unsatisfied residential environment satisfaction (OR = 1.80, 95% confidence interval: 1.74–1.86). Significant associations were found between self-rated health and most variables, including the interaction test (gender × residential environment satisfaction, education level, working hours, and length of residence). To enhance immigrants' health status, the Korean government must develop strategies to increase their access to healthcare services and minimize unmet healthcare needs. In addition, working conditions must be improved, specifically regarding long working hours and discrimination; furthermore, immigrants' living environments should be considered.</p

Performances of machine learning algorithms in discriminating sacroiliitis features on MRI: a systematic review

Objectives Summarise the evidence of the performance of the machine learning algorithm in discriminating sacroiliitis features on MRI and compare it with the accuracy of human physicians.Methods MEDLINE, EMBASE, CIHNAL, Web of Science, IEEE, American College of Rheumatology and European Alliance of Associations for Rheumatology abstract archives were searched for studies published between 2008 and 4 June 2023. Two authors independently screened and extracted the variables, and the results are presented using tables and forest plots.Results Ten studies were selected from 2381. Over half of the studies used deep learning models, using Assessment of Spondyloarthritis International Society sacroiliitis criteria as the ground truth, and manually extracted the regions of interest. All studies reported the area under the curve as a performance index, ranging from 0.76 to 0.99. Sensitivity and specificity were the second-most commonly reported indices, with sensitivity ranging from 0.56 to 1.00 and specificity ranging from 0.67 to 1.00; these results are comparable to a radiologist’s sensitivity of 0.67–1.00 and specificity of 0.78–1.00 in the same cohort. More than half of the studies showed a high risk of bias in the analysis domain of quality appraisal owing to the small sample size or overfitting issues.Conclusion The performance of machine learning algorithms in discriminating sacroiliitis features on MRI varied owing to the high heterogeneity between studies and the small sample sizes, overfitting, and under-reporting issues of individual studies. Further well-designed and transparent studies are required

Temporal trends in heart failure over 11 years in the aging Korean population: A retrospective study using the national health insurance database

Background Understanding national trends of heart failure (HF) is crucial for establishing prevention and treatment strategies. We aimed to investigate the 11-year trends of HF in the South Korean population. Methods Using the Korean National Health Insurance Service database, we identified 3,446,256 patients with HF between 2004 and 2014. Results The prevalence of HF was 1.42% in 2004, steadily increasing to 1.98% in 2014. However, the age-adjusted prevalence of HF remained stable (1.43% in 2014). The incidence of HF was 6.1/1000 person-years in 2004 and remained at similar levels, reaching 5.4/1000 person-years in 2014. The age-adjusted incidence of HF slowly decreased to 3.94/1000 person-years in 2014. The event rate for hospitalized patients with HF remained stable increasing from 1.40 in 2004 to 1.87/1000 person-years in 2014, and the age-adjusted event rate of hospitalized HF decreased to 1.22 in 2014. Conclusions In South Korea, between 2004 and 2014, the prevalence of HF increased while the incidence of HF remained stable. Furthermore, the age-adjusted HF prevalence was stable, and the age-adjusted incidence decreased. This indicates that the aging population is the main cause of the increasing national burden associated with HF and that further attention is warranted in the management of HF in older adults

The association between weight change after gastric cancer surgery and type 2 diabetes risk: A nationwide cohort study

Abstract Background Although gastric cancer patients generally experience drastic weight decrease post‐gastrectomy, the impact of weight decrease on type 2 diabetes risk remains unclear. We investigated the type 2 diabetes risk after gastric cancer surgery according to postoperative weight decrease in gastric cancer survivors in South Korea, the country with the world's highest rate of gastric cancer survival. Methods This retrospective nationwide cohort study included gastric cancer surgery recipients between 2004 and 2014 who survived for ≥5 years post‐surgery. We included patients without a history of diabetes at the time of surgery and those who had not received adjuvant chemotherapy before or after the surgery. Postoperative weight loss was defined as the per cent body weight loss at 3 years post‐surgery compared with the baseline. The type 2 diabetes risk was evaluated using Cox regression analyses for five groups of postoperative weight decrease. Results In 5618 included gastric cancer surgery recipients (mean age, 55.7 [standard deviation, SD, 10.9] years; 21.9% female; mean body mass index, 23.7 [SD, 2.9] kg/m2), 331 patients (5.9%) developed postoperative type 2 diabetes during follow‐up duration of 8.1 years (median; interquartile range, 4.8 years; maximum, 15.2 years). Compared with those who gained weight post‐surgery, patients with ≥ −15% to < −10% of postoperative weight decrease (hazard ratio, 0.65; 95% confidence interval, 0.49–0.87; P = 0.004) had the lowest type 2 diabetes risk. A non‐linear association occurred between postoperative weight decrease and the type 2 diabetes risk in gastrectomy recipients (Akaike's information criterion [AIC] for non‐linear model, 5423.52; AIC for linear model, 5425.61). Conclusions A U‐shaped non‐linear association occurred between the type 2 diabetes risk and postoperative weight decrease in gastric cancer survivors who underwent gastrectomy. The lowest type 2 diabetes risk occurred in patients with ≥ −15% to < −10% of postoperative weight decrease at 3 years

The impact of obesity and overweight on medical expenditures and disease incidence in Korea from 2002 to 2013

<div><p>Objectives</p><p>Few studies have assessed the long-term medical costs and incidence of obesity and overweight in Asia. We evaluated the impact of body mass index (BMI) on medical expenditures and disease incidence and prevalence over more than 10 years in South Korea.</p><p>Methods</p><p>Using 2002–2013 data from the Korean National Claims Database, we analysed two population sets (initial BMI in 2002–2003; consistent BMI in 2002–2003 and 2012–2013). Obesity was defined by Asian BMI criteria. Incremental medical expenditures or Charlson Comorbidity Index (CCI) ratios for obese compared to normal weight individuals were calculated. Medical expenditure over 11 years was estimated by BMI using a generalised linear model. Individual obesity-related disease incidence was determined and adjusted hazard ratios were calculated.</p><p>Results</p><p>Data for 496,469 and 214,477 individuals were included in the entire and consistent BMI level populations, respectively. Average CCI score change in normal weight and the obesity III (BMI 35–59.99 kg/m²) group over 11 years were 0.94 and 1.56, respectively in the entire population, and incremental ratio in the obesity III group was 66.0% compared to the normal weight group. In consistent BMI level population, incremental ratio (92.1%) for obesity III was higher than entire population. Medical costs in the obesity III groups versus the normal weight group in the entire and consistent BMI level populations increased by 38.4% and 77.1%, respectively. Over 11 years, individuals with BMI ≥30 kg/m² in the entire and consistent BMI level populations had post-adjustment medical expenditures of 1.13–1.20 and 1.21–1.40 times the normal weight group, respectively. Incidence rate and adjusted hazard ratio of obesity-related disease increased in the obesity groups compared to the normal weight group.</p><p>Conclusions</p><p>Our findings emphasize the importance of the effective and sustainable obesity management strategies, considering the dramatic increase in obesity (BMI ≥30 kg/m²) in South Korea.</p></div

Baseline characteristics of entire population.

<p>Baseline characteristics of entire population.</p