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2 "Monte Carlo method"
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Original Article
Multimorbidity adjusted years lost to disability rates calculated through Monte-Carlo simulation in Korea
Yoonhee Shin, Eun Jeong Choi, Bomi Park, Hye Ah Lee, Eun-Kyung Lee, Hyesook Park
Epidemiol Health. 2022;44:e2022090.   Published online October 17, 2022
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  • 127 Download
AbstractAbstract AbstractSummary PDFSupplementary Material
To efficiently utilize limited health and medical resources, it is necessary to accurately measure the level of health, which requires estimating the multimorbidity-corrected burden of disease.
This study used 2015 and 2016 data from the National Health Insurance Service, and employed the list of diseases defined in a Korean study of the burden of disease, the criteria for prevalence, and the “cause–sequelae–health state” disease system. When calculating the years lost to disability (YLD), multimorbidity was corrected using Monte-Carlo simulation.
Correcting for multimorbidity changed YLD at all ages in Korea by -1.2% (95% confidence interval [CI], -24.1 to 3.6) in males and -12.4% (95% CI, -23.0 to 0.3) in females in 2015, and by -10.8% (95% CI, -24.1 to 4.6) in males and -11.1% (95% CI, -22.8 to 1.7) in females in 2016. The YLD rate for non-communicable diseases in males decreased more than that of other disease groups in both years, by -11.8% (95% CI, -19.5 to 3.6) and -11.5% (95% CI, -19.3 to -3.0), respectively. The overall YLD rate changed by -1.3% in the 5-year to 9-year age group, and the magnitude of this change remained similar until the 10-19-year age group, gradually decreased after 20 years of age, and steeply increased to more than 10% in those aged 60 and older.
Calculations of YLD should adjust for multimorbidity, as the disease burden can otherwise be overestimated for the elderly, who tend to exhibit a high prevalence of multimorbidity.
Korean summary
복합질환 유병률이 증가됨에 따라 인구의 건강수준 측정 시 복합질환을 고려하는 것은 중요하다. 이에 본 연구에서는 복합질환 유병상태를 고려한 YLD(장애로 인한 손실년수)를 산출하고, 복합질환 유병상태를 고려하지 않고 산출한 YLD값과 비교하여 질병부담 산출 시 복합질환 유병상태를 보정하는 것의 효과 크기를 추정하였다. 복합질환의 유병률이 높은 노령층에서 복합질환을 고려하지 않고 YLD를 계산 할 경우 질병부담이 과대 추정될 수 있어, 복합질환을 보정하여 YLD를 산출하는 것이 필요하다.
Key Message
For the elderly whose disease burden can be overestimated, the multimorbidity should be adjusted during YLD calculations.
Methodological issues for determining intervals of subsequent cancer screening
Jong-Myon Bae
Epidemiol Health. 2014;36:e2014010.   Published online July 30, 2014
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  • 142 Download
  • 5 Web of Science
  • 5 Crossref
AbstractAbstract AbstractSummary PDFSupplementary Material
The gap between nationwide recommendations of cancer screening and the related evidences obtained from Korean adults should be filled. Estimation of the mean sojourn time (MST) in a specific cancer is important to determine the intervals of subsequent screening. This author arranged the methods for calculating MST into 5 categories based on the parameters used. Under the legal barrier for protection of individual privacy and confidentiality in a Korean academic situation, the methods involving the use of transition rates or prevalence/incidence ratio would be applicable among these methods.
Korean summary
국가 암조기 검진사업에서 제시하는 검진지침은 우리나라 국민을 대상으로 한 역학연구 결과에 근거하여 개발해야 한다. 특정 암에 대한 조기검진 지침에는 검진방법, 시작 및 종료 연령과 함께 검사 주기를 담아야 한다. 이중 반복검사의 간격은 해당 암의 평균체류기간을 산출하여 결정한다. 저자는 특정 암의 평균체류기간을 구하는 방법을 5가지로 분류하여 제시하였다. 또한 현재 개인정보 보호를 강조하는 여건에서 수행이 가능한 방법을 검토하였다.


Citations to this article as recorded by  
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  • Optimal Interval for Repeated Gastric Cancer Screening in Normal-Risk Healthy Korean Adults: A Retrospective Cohort Study
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