Epidemiology and Health

Special Article

The Korea National Disability Registration System: Miso Kim, Wonyoung Jung, So Young Kim, Jong Hyock Park, Dong Wook Shin; Epidemiol Health. 2023;45:e2023053. Published online May 11, 2023; DOI: https://doi.org/10.4178/epih.e2023053

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Abstract

The Korea National Disability Registration System (KNDRS) was established in 1989 to provide social welfare benefits based on predefined criteria for disability registration and an objective medical assessment using a disability grading system. Disability registration requires (1) a medical examination by a qualified specialist physician and (2) a medical advisory meeting to review the degree of disability. Medical institutions and specialists for the diagnosis of disabilities are legally stipulated, and medical records for a specified period are required to support the diagnosis. The number of disability types has gradually expanded, and 15 disability types have been legally defined. As of 2021, 2.645 million people were registered as disabled, accounting for approximately 5.1% of the total population. Among the 15 disability types, disabilities of the extremities account for the largest proportion (45.1%). Previous studies have investigated the epidemiology of disabilities using data from the KNDRS, combined predominantly with data from the National Health Insurance Research Database (NHIRD). Korea has a mandatory public health insurance system that covers the entire Korean population, and the National Health Insurance Services manages all eligibility information, including disability types and severity ratings. In short, the KNDRS-NHIRD is a significant data resource for research on the epidemiology of disabilities.

Summary

Korean summary
한국에서는 장애의 유형과 장애 유형별 장애정도를 장애인 복지법에서 규정하고 있다. 우리는 한국의 장애등록제도의 역사와 장애등록절차 그리고 장애유형별 통계 현황에 대해서 다루고자 한다.

Key Message
In Korea, the types and severity levels of disabilities are legally defined by the Korea National Disability Registration System (KNDRS). We address the history of the KNDRS, disability registration procedures, and current statistics.

Citations

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The link between disability and social participation revisited: Heterogeneity by type of social participation and by socioeconomic status
Jinho Kim, Gum-Ryeong Park, Eun Ha Namkung
Disability and Health Journal.2024; 17(2): 101543. CrossRef
Increased Risk of Dementia Following a Diagnosis of Hearing Impairment: A South Korean Nationwide Cohort Study
Minah Park, Sung-In Jang, Kyungduk Hurh, Eun-Cheol Park, Seung Hoon Kim
Journal of Alzheimer's Disease.2024; 97(2): 679. CrossRef
Risk of fracture among patients with spinal cord injury: A nationwide cohort study in South Korea
Seonghye Kim, Bongseong Kim, Kyung-Do Han, Junhee Park, Jung Eun Yoo, Hea Lim Choi, Won Hyuk Chang, In Young Cho, Dong Wook Shin
Bone.2024; 183: 117093. CrossRef
Desafios para inclusão de escolares com deficiência em um estado do brasileiro
Paola Regina Martins Bruno, Graziane Pacini Rodrigues, Damarys Paula Alves Alvim, Francisco Winter dos Santos Figueiredo, Janeisi de Lima Meira, Andreia de Bem Machado, Gabriel Martins Cabral, Fernando Rodrigues Peixoto Quaresma
Cuadernos de Educación y Desarrollo.2024; 16(4): e3840. CrossRef
Korean autistic persons facing systemic stigmatization from middle education schools: daily survival on the edge as a puppet
Wn-ho Yoon, JaeKyung Seo, Cheolung Je
Frontiers in Psychiatry.2024;[Epub] CrossRef
Disability acceptance and depressive symptoms: the moderating role of social support
Gum-Ryeong Park, Sujeong Park, Jinho Kim
Disability and Rehabilitation.2024; : 1. CrossRef
Impact of a Service-Learning Program Using Soccer Training on the Emotional and Behavioral Problems of Children with Developmental Disabilities
Huan Meng, Yonghwan Kim, Kyujin Lee
Children.2024; 11(4): 467. CrossRef
Increased risk of Parkinson's disease amongst patients with age‐related macular degeneration and visual disability: A nationwide cohort study
Je Moon Yoon, Dong Hui Lim, Jinyoung Youn, Kyungdo Han, Bong Sung Kim, Wonyoung Jung, Yohwan Yeo, Dong Wook Shin, Don‐Il Ham
European Journal of Neurology.2023; 30(9): 2641. CrossRef

Cohort Profile

Integrated database-based Screening Cohort for Asian Nomadic descendants in China (Scan-China): Insights on prospective ethnicity-focused cancer screening: Yuelin Yu, Liying Qiao, Jing Han, Weiwei Wang, Weiwei Kang, Yunjing Zhang, Shu Shang, Ruogu Meng, Lin Zhuo, Siyan Zhan, Yunfeng Xi, Shengfeng Wang; Epidemiol Health. 2023;45:e2023048. Published online April 18, 2023; DOI: https://doi.org/10.4178/epih.e2023048

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Abstract Summary PDF Supplementary Material: Abstract
Established in 2017, the Screening Cohort for Asian Nomadic descendants in China (Scan-China) has benefited over 180,000 members of a multi-ethnic population, particularly individuals of Mongolian descent compared with the general population (Han ethnicity), in the Inner Mongolia Autonomous Region, China. This cohort study aims to evaluate the effectiveness of cancer screening and serve as a real-world data platform for cancer studies. The 6 most prevalent cancers in China are considered—namely, breast, lung, colorectal, gastric, liver and esophageal cancer. After baseline cancer risk assessments and screening tests, both active and passive follow-up (based on the healthcare insurance database, cancer registry, the front page of hospital medical records, and death certificates) will be conducted to trace participants’ onset and progression of cancers and other prevalent chronic diseases. Scan-China has preliminarily found a disproportionately lower screening participation rate and higher incidence/mortality rates of esophageal and breast cancer among the Mongolian population than among their Han counterparts. Further research will explore the cancer burden, natural history, treatment patterns, and risk factors of the target cancers.; Summary

Key Message
- Scan-China is the first and largest electronic health data (EHD)-integrated cancer screening program for the Mongolian ethnicity in Inner Mongolia. - Scan-China aims to evaluate the effectiveness of screening interventions, particularly on ethnic minorities, portray the natural history, explore risk factors and summarize treatment patterns and updated outcomes of prevalent tumors/other chronic diseases. - Scan-China database comprises baseline cancer risk assessment, screening tests results, active follow-up investigation for participants at high risk and EHD-integrated passive follow-up. Data sources for passive follow-up include healthcare insurance database, cancer registry, front page of hospital medical record and death certificates.

Original Articles

Changes in the treatment rate of patients newly diagnosed with stage IV cancer near the end of life from 2012 to 2017 in Korea: Kyuwoong Kim, Hyun Jung Jho, So Jung Park, Bohyun Park, Jin Young Choi; Epidemiol Health. 2023;45:e2023021. Published online February 14, 2023; DOI: https://doi.org/10.4178/epih.e2023021

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OBJECTIVES
This study aimed to evaluate changes in the cancer treatment rate among patients newly diagnosed with stage IV cancer using socio-demographic and clinical subgroups in a nationwide cohort of Korean patients.
METHODS
This retrospective, national-level study used the Korea Central Cancer Registry (KCCR), which is linked to the National Health Insurance Service (NHIS) database, from January 1, 2012 to December 31, 2017. The records of patients newly diagnosed with stage IV of the 5 cancers with the highest cancer-related mortality rate were identified to analyze changes in the treatment rate. The main outcome examined in this study was the change in the cancer treatment rate between 2012 and 2017, as measured using the annual percent change (APC).
RESULTS
A total of 106,082 patients with newly diagnosed gastric, colorectal, liver, pancreatic, and lung cancers at the end of life (EoL) were identified from the KCCR-NHIS database. Of these patients, 76,533 (72.1%) received cancer treatment. Over the study period (2012-2017), the proportion of patients who received cancer treatment at EoL decreased by 8.3%, with an APC of -2.1% (95% confidence interval, -2.6 to -1.6). This declining trend of cancer treatment among patients with advanced cancer stage at EoL was consistent among socio-demographic and clinical subgroups.
CONCLUSIONS
The proportion of untreated patients with stage IV cancer is increasing in the Korea. For patients who are not undergoing standard cancer treatment near EoL, an alternative care plan, such as early palliative care, should be considered.; Summary

Korean summary
국민건강보험공단과 중앙암등록본부 자료를 활용하여 4기 암환자의 암 치료 비율 추이를 분석한 결과 2012년부터 2017년까지 위암, 대장암, 간암, 췌장암, 폐암으로 진단받은 4기 암환자들의 암 치료 비율의 연간비율변화는 8.3% 감소하는 것으로 나타났다. 이러한 결과는 인구사회학적 및 임상적 특성에 관계없이 일관되었다. 본 연구결과는 말기에 가까운 4기 암 환자들이 표준 치료를 받지 못하는 경우, 조기 완화의료와 같은 대안적인 계획을 고려할 필요가 있음을 시사한다.

Key Message
● Between 2012 and 2017, there was a significant decrease in the treatment rate among these patients, though most still received cancer treatment. ● Alternative clinical choices, such as the early utilization of hospice and palliative care, may improve quality of life and reduce the need for aggressive care for such patients.

Item non-response imputation in the Korea National Health and Nutrition Examination Survey: Serhim Son, Hyemi Moon, Hyonggin An; Epidemiol Health. 2022;44:e2022096. Published online October 28, 2022; DOI: https://doi.org/10.4178/epih.e2022096

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Abstract Summary PDF Supplementary Material: Abstract
OBJECTIVES
The Korea National Health and Nutrition Examination Survey (KNHANES) is a public health survey that assesses individuals’ health and nutritional status and monitors the prevalence of major chronic diseases. In general, sampling weights are adjusted for unit non-responses and imputation is conducted for item non-responses. In this study, we proposed strategies for imputing item non-responses in the KNHANES in order to improve the usefulness of data, minimize bias, and increase statistical power.
METHODS
After applying logical imputation, we adopted 2 separate imputation methods for each variable type: unweighted sequential hot-deck imputation for categorical variables and sequential regression imputation for continuous variables. For variance estimation, multiple imputations were applied to the continuous variables. To evaluate the performance of the proposed strategies, we compared the marginal distributions of imputed variables and the results of multivariable regression analysis for the complete-case data and the expanded data with imputed values, respectively.
RESULTS
When comparing the marginal distributions, most non-responses were imputed. The multivariable regression coefficients presented similar estimates; however, the standard errors decreased, resulting in statistically significant p-values. The proposed imputation strategies may cope with the loss of precision due to missing data, thus enhancing statistical power in analyses of the KNHANES by providing expanded data with imputed values.
CONCLUSIONS
The proposed imputation strategy may enhance the utility of data by increasing the number of complete cases and reducing the bias in the analysis, thus laying a foundation to cope with the occurrence of item non-responses in further surveys.; Summary

Korean summary
본 연구는 국민건강영양조사에서 발생한 항목무응답의 대체방법에 대해 연구한다. 본 논문에서 제시된 논리적 대체와 무응답 대체법을 이용해 대체된 데이터를 제공함으로써 결과의 편향 감소와 통계적 검정력 향상을 기대할 수 있다. 또한, 본 연구의 결과는 추후 데이터 수집시 발생하는 무응답 발생의 최소화를 위한 대책마련에 사용될 수 있다.

Key Message
The proposed logical imputation and item non-response imputation strategy may enhance the utility of data by increasing the number of complete cases and reducing the bias in the analysis, thus laying a foundation to cope with the occurrence of item non-responses in further surveys.

Incidence of edentulism among older adults using the Korean National Health Insurance Service database, 2013-2018: Hyeonjeong Go, Eun-Kyong Kim, Hoi-In Jung, Song Vogue Ahn, Hosung Shin, Atsuo Amano, Youn-Hee Choi; Epidemiol Health. 2022;44:e2022091. Published online October 17, 2022; DOI: https://doi.org/10.4178/epih.e2022091

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Abstract

OBJECTIVES
Population aging is rapidly accelerating worldwide. Oral diseases related to aging are also on the rise. This study examined trends in the incidence of edentulism among the older Korean population using data from the Korean National Health Insurance Service (KNHIS).

METHODS

Data on older adults, aged ≥75 years of age, were obtained from the KNHIS for the period 2013-2018. Edentulism was defined as a treatment history of complete dentures in the KNHIS database. The exclusion criteria consisted of both disease codes and treatment codes related to conservative dental treatment, including periodontal and extraction treatment afterward. Crude incidence rates (CIRs) and age-standardized incidence rates (AIRs) with 95% confidence intervals were calculated and reported per 100,000 person-years by the direct method. Trends were tested by Cochrane Armitage models.

RESULTS

Statistically significant increasing trends in both CIRs and AIRs were found among the older Korean population registered in the KNHIS (CIRs, 707.92 to 895.92; AIRs, 705.11 to 889.68; p<0.01). The incidence tended to increase in both genders (p<0.01). Both CIRs and AIRs in specific regions also showed slight but significant annual increases except for Jeju Island (p<0.01 or <0.05). The incidence showed increasing trends (p<0.01) in all income quintiles apart from the highest quintile. The edentulism incidence was highest in the lowest income group (the first quintile).

CONCLUSIONS

Our data showed that the incidence of edentulism among the elderly showed an increasing trend from 2013 to 2018. This result provides a basis for future epidemiological studies on the incidence of edentulism in the older Korean population.

Summary

Citations

Citations to this article as recorded by

Trend in the Incidence of Severe Partial Edentulism among Adults Using the Korean National Health Insurance Service Claim Data, 2014–2018
Hyeonjeong Go, Hoi-In Jung, Song Vogue Ahn, Jeonghoon Ahn, Hosung Shin, Atsuo Amano, Youn-Hee Choi
Yonsei Medical Journal.2024; 65(4): 234. CrossRef

Data Profiles

Data resource profile: the allergic disease database of the Korean National Health Insurance Service: Sunyong Yoo, Dong-Wook Kim, Young-Eun Kim, Jong Heon Park, Yeon-Yong Kim, Kyu-dong Cho, Mi-Ji Gwon, Jae-In Shin, Eun-Joo Lee; Epidemiol Health. 2021;43:e2021010. Published online January 21, 2021; DOI: https://doi.org/10.4178/epih.e2021010

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Abstract

Researchers have been interested in probing how the environmental factors associated with allergic diseases affect the use of medical services. Considering this demand, we have constructed a database, named the Allergic Disease Database, based on the National Health Insurance Database (NHID). The NHID contains information on demographic and medical service utilization for approximately 99% of the Korean population. This study targeted 3 major allergic diseases, including allergic rhinitis, atopic dermatitis, and asthma. For the target diseases, our database provides daily medical service information, including the number of daily visits from 2013 and 2017, categorized by patients’ characteristics such as address, sex, age, and duration of residence. We provide additional information, including yearly population, a number of patients, and averaged geocoding coordinates by <i>eup, myeon</i>, and <i>dong</i> district code (the smallest-scale administrative units in Korea). This information enables researchers to analyze how daily changes in the environmental factors of allergic diseases (e.g., particulate matter, sulfur dioxide, and ozone) in certain regions would influence patients’ behavioral patterns of medical service utilization. Moreover, researchers can analyze long-term trends in allergic diseases and the health effects caused by environmental factors such as daily climate and pollution data. The advantages of this database are easy access to data, additional levels of geographic detail, time-efficient data-refining and processing, and a de-identification process that minimizes the exposure of identifiable personal information. All datasets included in the Allergic Disease Database can be downloaded by accessing the National Health Insurance Service data sharing webpage (https://nhiss.nhis.or.kr).

Summary

Korean summary
알레르기질환DB는 환경적 변화와 의료이용 연관성 연구를 지원하기 위해 만들어진 누구나 다운로드 가능한 공개용DB이다. 알레르기질환DB는 한국 전국민의 사회인구학적 특성 및 의료이용 정보가 구축되어 있는 국민건강보험공단의 국민건강정보DB를 활용하여 구축되었다. 알레르기질환DB는 2013년~2017년 알레르기성 비염, 아토피, 천식 상병코드로 청구된 의료이용 정보를 제공하고 있으며, 이를 활용하여 특정 지역에 다양한 환경적 변화와 의료이용과의 연관성 연구 등에 활발히 활용될 것으로 기대된다.

Key Message
The Allergic Disease Database based on the National Health Insurance Data is constructed for analyzing how environmental factors affect the use of medical services. The database provides most Korean medical service information of allergic diseases, such as allergic rhinitis, atopic dermatitis, and asthma from 2013 and 2017. This information enables researchers to study how daily changes of environmental factors in certain regions would influence patients’ behavioral patterns of medical service utilization. Moreover, researchers can analyze the long-term trend of allergic diseases, and health effects caused by environmental factors such as daily climate and pollution data.

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Evaluation of the Regulatory Required Post-Authorization Safety Study for Propacetamol: Nested Case-Control and Case-Time-Control Studies
Sungho Bea, Dongwon Yoon, Han Eol Jeong, Juhong Jung, Seung-Mok Park, Juhee Jeon, Young-Min Ye, Jae-Hyun Lee, Ju-Young Shin
Yonsei Medical Journal.2024; 65(2): 120. CrossRef
The relationship between exposure to environmental noise and risk of atopic dermatitis, asthma, and allergic rhinitis
Yongho Lee, Seunghyun Lee, Seula Park, Seong-Kyu Kang, June-Hee Lee, Dong-Wook Lee, Won-Jun Choi, Wanhyung Lee
Ecotoxicology and Environmental Safety.2023; 268: 115677. CrossRef
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Ji-Sun Paik, Kyungdo Han, Gahee Nam, Sun-Kyoung Park, Ho Sik Hwang, Yoon Hong Chun, Kyung-Sun Na
Scientific Reports.2022;[Epub] CrossRef

Family tree database of the National Health Information Database in Korea: Yeon-Yong Kim, Hae-young Hong, Kyu-Dong Cho, Jong Heon Park; Epidemiol Health. 2019;41:e2019040. Published online October 1, 2019; DOI: https://doi.org/10.4178/epih.e2019040

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Abstract

We constructed the family tree database (DB) by using a new family code system that can logically express interpersonal family relationships and by comparing and complementing health insurance eligibility data and resident register data of the National Health Information Database (NHID). In the family tree DB, Parents and grandparents are matched for more than 95% of those who were born between 2010 and 2017. Codes for inverse relationships and extended relationships are generated using sequences of the three-digit basic family codes. The family tree DB contains variables such as sex, birth year, family relations, and degree of kinship (maximum of 4) between subjects and family members. Using the family tree DB, we find that prevalence rates of hypertension, diabetes, ischemic heart disease, cerebrovascular disease, and cancer are higher for those with family history. The family tree DB may omit some relationships due to incomplete past data, and some family relations cannot be uniquely determined because the source data only contain relationships between head and members of the household. The family tree DB is a part of the NHID, and researchers can submit requests for data on the website at http://nhiss.nhis.or.kr. Requested data will be provided after approval from the data service review board. However, the family tree DB can be limitedly provided for studies with high public value in order to maximize personal information protection.

Summary

Korean summary
가족관계도(family tree) DB는 건강보험공단이 보유하는 건강보험 가입자정보와 행정전산망 정보를 바탕으로 가공·구축된 자료다. 4촌까지의 가족 관계를 파악할 수 있으며, 세대주 중심의 관계코드가 아닌 개인 단위의 논리적 기호로 구성된 관계코드를 통해 촌수, 계통, 성별을 구분하도록 하였다. 이를 바탕으로 의학적, 사회정책적으로 다양한 연구가 가능하다.

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Review Paper

Data resource profile: the National Health Insurance Research Database (NHIRD): Liang-yu Lin, Charlotte Warren-Gash, Liam Smeeth, Pau-Chung Chen; Epidemiol Health. 2018;40:e2018062. Published online December 27, 2018; DOI: https://doi.org/10.4178/epih.e2018062

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Abstract

Electronic health records (EHRs) can provide researchers with extraordinary opportunities for population-based research. The National Health Insurance system of Taiwan was established in 1995 and covers more than 99.6% of the Taiwanese population; this system’s claims data are released as the National Health Insurance Research Database (NHIRD). All data from primary outpatient departments and inpatient hospital care settings after 2000 are included in this database. After a change and update in 2016, the NHIRD is maintained and regulated by the Data Science Centre of the Ministry of Health and Welfare of Taiwan. Datasets for approved research are released in three forms: sampling datasets comprising 2 million subjects, disease-specific databases, and full population datasets. These datasets are de-identified and contain basic demographic information, disease diagnoses, prescriptions, operations, and investigations. Data can be linked to government surveys or other research datasets. While only a small number of validation studies with small sample sizes have been undertaken, they have generally reported positive predictive values of over 70% for various diagnoses. Currently, patients cannot opt out of inclusion in the database, although this requirement is under review. In conclusion, the NHIRD is a large, powerful data source for biomedical research.

Summary

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Antenatal Corticosteroid Exposure is Associated with Childhood Mental Disorders in Late Preterm and Term Infants
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The Journal of Pediatrics.2023; 253: 245. CrossRef
Occupational health surveillance and detection of emerging occupational diseases among Taiwan farmers, through analysis of national‐based farmers' and medico‐administrative databases
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International Journal of Women's Health.2023; Volume 15: 1865. CrossRef
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Regrouped design in privacy analysis for multinomial microdata
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Diseases That Occur Prior to Spontaneous Intracerebral Hemorrhage: Identification of Predisposing and Risk Factors Using Lag Sequential Analysis
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Hydralazine Associated With Reduced Therapeutic Phlebotomy Frequency in a Nationwide Cohort Study: Real-World Effectiveness for Drug Repurposing
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The Journal of Dermatology.2022; 49(8): 753. CrossRef
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Association between glucagon‐like peptide‐1 receptor agonists and biliary‐related diseases in patients with type 2 diabetes: A nationwide cohort study
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A Roadmap for Investigating Preclinical Autoimmunity Using Patient-Oriented and Epidemiologic Study Designs: Example of Rheumatoid Arthritis
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Bisphosphonate Use Is Not Associated With Tuberculosis Risk Among Patients With Osteoporosis: A Nationwide Cohort Study
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Prevalence of exposure to benzodiazepines among pregnant women in Taiwan: A nationwide longitudinal study
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Association between bullous pemphigoid and atopic dermatitis: a population-based case–control study in Taiwan
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The Combination of Sleep Disorders and Depression Significantly Increases Cancer Risk: A Nationwide Large-Scale Population-Based Study
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Oral anticoagulant decreases stroke recurrence in patients with atrial fibrillation detected after stroke
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Health Inequality among Fishery Workers during Climate Change: A National Population-Based and Retrospective Longitudinal Cohort Study
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Clinical Characteristics of Hyperandrogenism Include Hirsutism, Polycystic Ovary Syndrome, and Acne: Association with Psychiatric Disease in Women -A Nationwide Population-Based Cohort Study in Taiwan
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Association of Statin Therapy With Major Adverse Cardiovascular and Limb Outcomes in Patients With End-stage Kidney Disease and Peripheral Artery Disease Receiving Maintenance Dialysis
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Patterns of Outpatient Phecodes Predating the Diagnosis of Systemic Lupus Erythematosus in Taiwanese Women
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Using the Phecode System to Identify the Preoperative Clinical Phenotypes Associated with Surgical Site Infection in Patients Undergoing Primary Total Knee Arthroplasty: The Sex Differences
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Human Papillomavirus and Risk of Colorectal Cancer: An Analysis of Nationwide Claims Data
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Diabetic Patients With Rosacea Increase the Risks of Diabetic Macular Edema, Dry Eye Disease, Glaucoma, and Cataract
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A Machine Learning Model to Predict Length of Stay and Mortality among Diabetes and Hypertension Inpatients
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Relationship among genetic variants, obesity traits and asthma in the Taiwan Biobank
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Residential green space structures are associated with a lower risk of bipolar disorder: A nationwide population-based study in Taiwan
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Changes in Pramipexole Utilization after Introduction of the Extended-Release Formulation: A Nationwide Study in Taiwan
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Nationwide cohort study of tricuspid valve repair versus replacement for infective endocarditis
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Increased risk of dementia in patients with nasopharyngeal cancer treated with radiation therapy: A nationwide population-based cohort study
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Le risque d’hospitalisation évitable avant et après le diagnostic chez des patients atteints de polyarthrite rhumatoïde comparativement à des témoins sans polyarthrite rhumatoïde
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Selective serotonin reuptake inhibitors use and hepatocellular carcinoma in patients with alcohol use disorder
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Association of Obstructive Sleep Apnea With the Risk of Male Infertility in Taiwan
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Augmentation in Healthcare Utilization of Patients with Opioid Use Disorder After Methadone Maintenance Treatment: A Retrospective Nationwide Study
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Use of bladder antimuscarinics is associated with an increased risk of dementia: a retrospective population-based case–control study
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Effect of Permanent Pacemaker Implantation After Valve Surgery on Long-Term Outcomes
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Midterm Prognosis of Patients With Pulmonary Embolism Receiving Catheter‐Directed Thrombolysis or Systemic Thrombolysis: A Nationwide Population‐Based Study
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Association Between Preeclampsia Risk and Fine Air Pollutants and Acidic Gases: A Cohort Analysis in Taiwan
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Fenofibrate Delays the Need for Dialysis and Reduces Cardiovascular Risk Among Patients With Advanced CKD
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Association between gastroesophageal reflux disease and colorectal cancer risk: a population-based cohort study
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Chinese Herbal Medicine Decreases Incidence of Cirrhosis in Patients with Non-Alcoholic Fatty Liver Disease in Taiwan: A Propensity Score-Matched Cohort Study
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Machine Learning Prediction Models for Chronic Kidney Disease Using National Health Insurance Claim Data in Taiwan
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Chronic Kidney Disease Is Associated with High Mortality Risk in Patients with Diabetes after Primary Shoulder Arthroplasty: A Nationwide Population-Based Cohort Study
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High 1-year risk of stroke in patients with hepatocellular carcinoma: a nationwide registry-based cohort study
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Pyogenic Liver Abscess Risk in Patients With Newly Diagnosed Type 2 Diabetes Mellitus: A Nationwide, Population-Based Cohort Study
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Does Statin Therapy Reduce the Risks of Mortality and Major Adverse Cardiac and Cerebrovascular Events in Young Adults with End-Stage Renal Disease? Population-Based Cohort Study
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Increased Risk of Kawasaki Disease in Infants Born of Mothers With Immune Disorders
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Gout as a Risk Factor for Acute Myocardial Infarction: Evidence from Competing Risk Model Analysis
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Dialysis Mode and Associated Outcomes in Patients With End‐Stage Renal Disease and Atrial Fibrillation: A 14‐Year Nationwide Cohort Study
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Risk of herpes zoster in psoriasis patients receiving systemic therapies: a nationwide population-based cohort study
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Risk of diabetes mellitus in patients with prostate cancer receiving injection therapy: A nationwide population‐based propensity score‐matched study
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Long‐Term Outcomes of Acute Kidney Injury After Different Types of Cardiac Surgeries: A Population‐Based Study
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Influence of constipation on atopic dermatitis: A nationwide population‐based cohort study in Taiwan
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Major adverse cardiovascular and limb events in patients with diabetes treated with GLP-1 receptor agonists vs DPP-4 inhibitors
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Clinical Study Using Healthcare Claims Database
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Acupuncture Treatment Reduced the Risk of Coronary Heart Disease in Patients with Depression: A Propensity-Score Matched Cohort Study
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Switching and Discontinuation Pattern of Biologic Disease-Modifying Antirheumatic Drugs and Tofacitinib for Patients With Rheumatoid Arthritis in Taiwan
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Association Between Age‐Related Macular Degeneration and Risk of Heart Failure: A Population‐Based Nested Case‐Control Study
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Review

Registry-based stroke research in Taiwan: past and future: Cheng-Yang Hsieh, Darren Philbert Wu, Sheng-Feng Sung; Epidemiol Health. 2018;40:e2018004. Published online February 4, 2018; DOI: https://doi.org/10.4178/epih.e2018004

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Abstract PDF

Abstract

Stroke registries are observational databases focusing on the clinical information and outcomes of stroke patients. They play an important role in the cycle of quality improvement. Registry data are collected from real-world experiences of stroke care and are suitable for measuring quality of care. By exposing inadequacies in performance measures of stroke care, research from stroke registries has changed how we manage stroke patients in Taiwan. With the success of various quality improvement campaigns, mortality from stroke and recurrence of stroke have decreased in the past decade. After the implementation of a nationwide stroke registry, researchers have been creatively expanding how they use and collect registry data for research. Through the use of the nationwide stroke registry as a common data model, researchers from many hospitals have built their own stroke registries with extended data elements to meet the needs of research. In collaboration with information technology professionals, stroke registry systems have changed from web-based, manual submission systems to automated fill-in systems in some hospitals. Furthermore, record linkage between stroke registries and administrative claims databases or other existing databases has widened the utility of registry data in research. Using stroke registry data as the reference standard, researchers have validated several algorithms for ascertaining the diagnosis of stroke and its risk factors from claims data, and have also developed a claims-based index to estimate stroke severity. By making better use of registry data, we believe that we will provide better care to patients with stroke.

Summary

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David S. Liebeskind, Colin P. Derdeyn, Lawrence R. Wechsler, Greg Albers, Eric P. Ankerud, Johannes Boltze, Joseph Broderick, Bruce C.V. Campbell, Mitchell S.V. Elkind, Derick En’Wezoh, Anthony J. Furlan, Philip B. Gorelick, James Grotta, David Hess, Anee
Stroke.2018; 49(9): 2241. CrossRef

Original Article

Prefectural difference in spontaneous intracerebral hemorrhage incidence in Japan analyzed with publically accessible diagnosis procedure combination data: possibilities and limitations: Toru Fukuhara, Yusuke Hori; Epidemiol Health. 2016;38:e2016028. Published online July 2, 2016; DOI: https://doi.org/10.4178/epih.e2016028

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Abstract PDF

Abstract

OBJECTIVES
Annually reported, publically accessible Diagnosis Procedure Combination (DPC) data from the Japanese government is a part of the total DPC database of the Japanese medical reimbursement system for hospitalization. Although medical issues can be evaluated with these data promptly, the applicability of these data in epidemiological analyses has not been assessed.

METHODS

We performed analyses using only statistical indices reported on the a government website. As a preliminary step, the prefectural consistency of spontaneous intracerebral hemorrhage (sICH) was examined with prefectural mortality over 20 years. Then the prefectural incidence of sICH for four years was calculated, utilizing publically accessible DPC data. To determine its reliability, the consistency was examined, and correlations were analyzed with three prefectural factors expected to have an effect: the elderly rate, mortality due to sICH, and the non-DPC bed rate. In addition, a comparison model between prefectures with this method was developed by analyzing other prefecture-specific factors.

RESULTS

Prefectural mortality due to sICH and prefectural sICH incidence in the DPC database were both consistent over the years. Prefectural sICH incidence had a constant positive correlation with the elderly rate, a partial correlation with mortality due to sICH, but no correlation with the non-DPC bed rate, which is one of the major biases when utilizing the DPC database. In the comparison model, the factors of low income and alcohol consumption showed increased sICH incidence.

CONCLUSIONS

Although careful attention to its limitations is required, publically accessible DPC data will provide insights into epidemiological issues.

Summary

Citations

Citations to this article as recorded by

Trends in surgical procedures for spontaneous intracerebral hemorrhage in Japan
Shigeyuki Tahara, Yujiro Hattori, Shotaro Aso, Kazuaki Uda, Ryosuke Kumazawa, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga, Akio Morita
Journal of Stroke and Cerebrovascular Diseases.2022; 31(9): 106664. CrossRef
Comparison of Perioperative Complications Between Anterior Fusion and Posterior Fusion for Osteoporotic Vertebral Fractures in Elderly Patients
Shingo Morishita, Toshitaka Yoshii, Atsushi Okawa, Hiroyuki Inose, Takashi Hirai, Takahisa Ogawa, Kiyohide Fushimi, Takeo Fujiwara
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Parameter estimation without confidence intervals?
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Epidemiology and Health.2016; 38: e2016036. CrossRef

Review

Epidemiological Researches on the Health Hazards in Veterans of United States of America.: Hyun Sul Lim; Korean J Epidemiol. 2001;23(1):23-35.

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Abstract PDF: Abstract
The Department of Veterans Affairs(VA) maintains some large automated databases that provide the opportunity for studying long-term health effects of military service. The Beneficiary Identification and Record Locator Subsystem(BIRLS) is an excellent source of vital status information on veterans. The VA Patient Treatment File(PTF) is a computerized hospital discharge abstract system of inpatient records, including patients' demographic data, surgical and procedural transactions, and patient movements and diagnosis. The computerized Agent Orange Registry data include veteran's name, address, some information on military service, and findings at the time of his physical examination. The US conducted 235 atmospheric nuclear tests from 1945 through 1962. Many of the 250,000 test participants were exposed to low levels of radiation. The overall average radiation dose was estimated as 0.6 rem per year. In 1976, a claim relating acute myelocytic leukemia to radiation exposure from nuclear weapon testing received extensive publicity. Several thousand "atomic veterans" have sought medical care and compensation from VA for medical conditions that they believe are related to the nuclear weapon testing. Many WWII veterans have contracted the US VA about health problems that they attribute to their exposure to mustard gas. From 1962 to 1971, 75 million liters of herbicides, including over 41 million liters of the phenoxy herbicide Agent Orange, were sprayed on almost 9% of Vietnam. Many studies have been conducted to determine the association of various cancers with military service in Vietnam. Some diseases have been compensated for Vietnam veterans. Health problems reported following the Gulf War include a wide variety of symptoms similar to those found in acute combat reaction, posttraumatic stress disorder, and chronic fatigue. Health problems associated with war have continued and in some ways intensified. Therefore, The United States developed a plan for establishing a national center for the study of war-related illnesses and post-deployment health issues.; Summary

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