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Systematic Review
Food frequency questionnaires developed and validated in Iran: a systematic review
Arezoo Rezazadeh, Nasrrin Omidvar, Katherine L. Tucker
Epidemiol Health. 2020;42:e2020015.   Published online March 30, 2020
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  • 8 Citations
AbstractAbstract PDF
To systematically review and identify food frequency questionnaires (FFQs) developed for the Iranian population and their validation and reproducibility in order to determine possible research gaps and needs.
Studies were selected by searching for relevant keywords in the PubMed, Scopus, Science Direct, Google Scholar, SID, and Iranmedex databases, unpublished data, and theses in November 2016 (updated in September 2019). All English-language and Persian-language papers were included. Duplicates, articles with unrelated content, and articles only containing a protocol were excluded. The FFQs were categorized based on: (1) number of food items in to short (≤80 items) and long (>80 items) and; (2) the aim of the FFQ to explore total consumption pattern/nutrients (general) or to detect specific nutrient(s)/food group(s) (specialized).
Sixteen reasonably validated questionnaires were identified. However, only 13 presented a reproducibility assessment. Ten FFQs were categorized as general (7 long, 3 short) and 6 as specialized (3 long, 3 short). The correlation coefficients for nutrient intake between dietary records or recalls and FFQs were 0.07-0.82 for long (general: 0.07-0.82 and specialized: 0.26-0.67) and 0.20-0.67 for short (general: 0.24-0.54 and specialized: 0.20-0.42) FFQs. Long FFQs showed higher validity and reproducibility than short FFQs. Reproducibility of FFQs was acceptable (0.32-0.89). The strongest correlations were reported by studies with shorter intervals between FFQs.
FFQs designed for the Iranian population appear to be appropriate tools for dietary assessment. Despite their acceptable reproducibility, their validity for assessing specific nutrients and their applicability for populations other than those they were developed for may be questionable.
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    Niloufar Rasaei, Rasool Ghaffarian-Ensaf, Fatemeh Gholami, Farideh Shiraseb, Alireza Khadem, Seyedeh Fatemeh Fatemi, Khadijeh Mirzaei
    BMC Endocrine Disorders.2023;[Epub]     CrossRef
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    Bijan Ahmadi, Amirhossein Ramezani Ahmadi, Mohamadreza Jafari, Nava Morshedzadeh
    Food Science & Nutrition.2023;[Epub]     CrossRef
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    Sedigheh Yeganeh, Niloofar Motamed, Saeid Najafpour Boushehri, Razieh Bagherzadeh, Maryam Ravanipour
    BMC Pediatrics.2023;[Epub]     CrossRef
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    BMC Women's Health.2022;[Epub]     CrossRef
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    Food Science & Nutrition.2022; 10(11): 3920.     CrossRef
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    BMC Endocrine Disorders.2022;[Epub]     CrossRef
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    Faezeh Abaj, Masoumeh Rafiee, Fariba Koohdani
    Scientific Reports.2021;[Epub]     CrossRef
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    Ariel Fangting Ying, Shazma Khan, Ying Wu, Aizhen Jin, Aidan S.Y. Wong, Eng‐King Tan, Jian‐Min Yuan, Woon‐Puay Koh, Louis C.S. Tan
    Movement Disorders.2020; 35(10): 1765.     CrossRef
Methodological issues in estimating sodium intake in the Korea National Health and Nutrition Examination Survey
Hyun Ja Kim, Kyungwon Oh
Epidemiol Health. 2014;36:e2014033.   Published online November 28, 2014
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  • 11 Citations
AbstractAbstract AbstractSummary PDFSupplementary Material
For policy goal setting, efficacy evaluations, and the development of related programs for reducing sodium intake, it is essential to accurately identify the amount of sodium intake in South Korea and constantly monitor its trends. The present study aimed to identify the status of sodium intake in South Korea and to review the methods and their validity for estimating sodium intake in each country; through this, we aim to determine more accurate methods for determining sodium intake and to monitor the trend in sodium intake for Korean citizens in the future. Using 24-hour dietary recall data from the 2012 Korea National Health and Nutrition Examination Survey (KNHANES) to estimate daily sodium intake, the average daily sodium intake among Koreans was 4,546 mg (men, 5,212 mg; women, 3,868 mg). In addition to the nutrition survey that uses the 24-hour dietary recall method, sodium intake can also be calculated from the amount of sodium excreted in 24-hour urine, 8-hour overnight urine, and spot urine samples. Although KNHANES uses the 24-hour dietary recall method to estimate the sodium intake, the 24-hour dietary recall method has the disadvantage of not being able to accurately determine the amount of sodium intake owing to its unique characteristics of the research method and in the processing of data. Although measuring the amount of sodium excreted in 24-hour urine is known to be the most accurate method, because collecting 24-hour urine from the general population is difficult, using spot urine samples to estimate sodium intake has been suggested to be useful for examining the trend of sodium intake in the general population. Therefore, we planned to conduct a study for estimating of 24-hour sodium excretion from spot urine and 8-hour overnight urine samples and testing the validity among subsamples in the KNHANES. Based on this result, we will adopt the most appropriate urine collection method for estimating population sodium intake in South Korea.
Korean summary
이 연구에서는 나트륨 섭취량 조사방법과 각 조사방법의 타당성을 고찰하여 나트륨 섭취량과 추이를 보다 정확하게 파악할 수 있는 방법을 모색해보고자 하였다. 국민건강영양조사에서는 24시간 회상법을 이용하여 우리나라 국민의 나트륨 섭취량을 산출하고 있으나, 정확성과 추이 비교에 제한점을 가지므로 소변을 이용하여 나트륨 섭취량을 추정하는 방법에 대한 검토가 필요하다. 이에, 국민건강영양조사의 일부 대상자에서 단회뇨, 야간뇨, 24시간 소변을 수집∙이용하여 24시간 소변 나트륨 배설량을 추정하는 식을 개발하고 그 타당도를 검증하는 연구를 수행하여 가장 적절한 소변 수집 방법을 국민건강영양조사에 도입할 계획이다.
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  • The intake of ultra-processed foods, all-cause, cancer and cardiovascular mortality in the Korean Genome and Epidemiology Study-Health Examinees (KoGES-HEXA) cohort
    Anthony Kityo, Sang-Ah Lee, Shaonong Dang
    PLOS ONE.2023; 18(5): e0285314.     CrossRef
  • The Intake of Ultra-Processed Foods and Prevalence of Chronic Kidney Disease: The Health Examinees Study
    Anthony Kityo, Sang-Ah Lee
    Nutrients.2022; 14(17): 3548.     CrossRef
  • Epidemiology of gastric cancer in Korea
    Kwang-Pil Ko
    Journal of the Korean Medical Association.2019; 62(8): 398.     CrossRef
  • Prevalence, Awareness, Treatment, and Control of Hypertension in Korea
    Si-Hyuck Kang, Sun-Hwa Kim, Jun Hwan Cho, Chang-Hwan Yoon, Seung-Sik Hwang, Hae-Young Lee, Tae-Jin Youn, In-Ho Chae, Cheol-Ho Kim
    Scientific Reports.2019;[Epub]     CrossRef
  • Sodium and Potassium Intake from Food Diaries and 24-h Urine Collections from 7 Days in a Sample of Healthy Greek Adults
    Adelais Athanasatou, Aikaterini Kandyliari, Olga Malisova, Alex Pepa, Maria Kapsokefalou
    Frontiers in Nutrition.2018;[Epub]     CrossRef
  • High sodium intake and sodium to potassium ratio may be linked to subsequent increase in vascular damage in adults aged 40 years and older: the Korean multi-rural communities cohort (MRCohort)
    Sukyoung Jung, Mi Kyung Kim, Jinho Shin, Bo Youl Choi, Young-Hoon Lee, Dong Hoon Shin, Min-Ho Shin
    European Journal of Nutrition.2018;[Epub]     CrossRef
  • Sodium Intake Estimated from Spot Urine Samples and the Prevalence of Metabolic Syndrome in the Korea National Health and Nutrition Examination Survey
    Young Gyu Cho
    Korean Journal of Family Medicine.2017; 38(4): 171.     CrossRef
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  • Factors Associated With High Sodium Intake Based on Estimated 24-Hour Urinary Sodium Excretion
    Jae Won Hong, Jung Hyun Noh, Dong-Jun Kim
    Medicine.2016; 95(9): e2864.     CrossRef
  • The Use and Interpretation of Sodium Concentrations in Casual (Spot) Urine Collections for Population Surveillance and Partitioning of Dietary Iodine Intake Sources
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Original Articles
The Validity and Reliability of Characterizing Epilepsy Based on an External Review of Medical Records
Bong Su Kang, Hae-Kwan Cheong, Ki-Young Jung, Sang Hyeon Jang, Jae Kook Yoo, Dong Wook Kim, Soo-Eun Chung, Seo-Young Lee
Epidemiol Health. 2013;35:e2013006.   Published online August 23, 2013
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  • 120 Download
  • 9 Citations
AbstractAbstract PDF

Our goal is to validate diagnosing and characterizing epilepsy based on a medical record survey by external reviewers.


We reviewed medical records from 80 patients who received antiepileptic drugs in 2009 at two hospitals. The study consisted of two steps; data abstraction by certified health record administrators and then verification by the investigators. The gold standard was the results of the survey performed by the epileptologists from their own hospital.


The specificity was more than 90.0% for diagnosis and activity, and for new-onset seizures. The sensitivity was 97.0% or more for diagnosis and activity and 66.7-75.0% for new-onset epilepsy. This method accurately classified epileptic syndromes in 90.2-92.9% of patients, causes in 85.4-92.7%, and age of onset in 78.0-81.0%. Kappa statistics for inter-rater reliability and test-retest reliability ranged from 0.641-0.975, which means substantial to near-perfect agreement in all items.


Our data suggest that epilepsy can be well identified by external review of medical records. This method may be useful as a basis for large-scale epidemiological research.

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    Joonsang Yoo, Jee Hyun Kim, Jimin Jeon, Jinkwon Kim, Tae-Jin Song
    Neurology.2022; 98(19): e1886.     CrossRef
  • The association between early childhood onset epilepsy and attention-deficit hyperactivity disorder (ADHD) in 3237 children and adolescents with Autism Spectrum Disorder (ASD): a historical longitudinal cohort data linkage study
    Lauren Carson, Valeria Parlatini, Tara Safa, Benjamin Baig, Hitesh Shetty, Jacqueline Phillips-Owen, Vibhore Prasad, Johnny Downs
    European Child & Adolescent Psychiatry.2022;[Epub]     CrossRef
  • The bumpy road to achieve reliability of clinical profile characteristics in psychosis and related disorders
    Steven Berendsen, Mirjam J. van Tricht, Amy Tedja, Thijs J. Burger, Mariken B. de Koning, Lieuwe de Haan
    International Journal of Methods in Psychiatric Research.2021;[Epub]     CrossRef
  • Staging and profiling for schizophrenia spectrum disorders: Inter-rater reliability after a short training course
    Steven Berendsen, Jasper W. van der Paardt, Henricus L. Van, Marion van Bruggen, Hans Nusselder, Margje Jalink, Olav R. de Peuter, Jaap Peen, Mirjam J. van Tricht, Lieuwe de Haan
    Progress in Neuro-Psychopharmacology and Biological Psychiatry.2020; 99: 109856.     CrossRef
  • The new definition and classification of seizures and epilepsy
    Jessica J. Falco-Walter, Ingrid E. Scheffer, Robert S. Fisher
    Epilepsy Research.2018; 139: 73.     CrossRef
  • Presentation and management of community-onset vs hospital-onset first seizures
    Emma Foster, Sarah Holper, Zhibin Chen, Patrick Kwan
    Neurology: Clinical Practice.2018; 8(5): 421.     CrossRef
  • Estimating the Prevalence of Treated Epilepsy Using Administrative Health Data and Its Validity: ESSENCE Study
    Seo-Young Lee, Soo-Eun Chung, Dong Wook Kim, So-Hee Eun, Hoon Chul Kang, Yong Won Cho, Sang Do Yi, Heung Dong Kim, Ki-Young Jung, Hae-Kwan Cheong
    Journal of Clinical Neurology.2016; 12(4): 434.     CrossRef
  • Early Antiretroviral Therapy Is Protective Against Epilepsy in Children With Human Immunodeficiency Virus Infection in Botswana
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  • Clinical characteristics of patients with treated epilepsy in Korea: A nationwide epidemiologic study
    Dong Wook Kim, Seo-Young Lee, Soo-Eun Chung, Hae-Kwan Cheong, Ki-Young Jung
    Epilepsia.2014; 55(1): 67.     CrossRef
Reliability and Validity of the Modified Korean Version of Baecke Questionnaire on Physical Activity.
Ji Young Lee, Young Ho Yun, Eun Cheol Park, Hong Wan Seo, Ju Huk Lee, Hai Rim Shin, Kui Son Choi
Korean J Epidemiol. 2004;26(2):20-31.
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AbstractAbstract PDF
Our main goal is to test the reliability and validity of the Korean version of Baecke questionnaire on physical activity by using 507 men and women aged 20-70 years.
This study was carried out using the cancer screening participants of the National Cancer Center. All subjects were sent the Korean version of Baecke questionnaire by mail to measure their physical activity.
The mean score on the sport index during leisure-time for men was significantly higher than that for women. In contrast, the mean score of the work index for men was significantly lower than that for women. Cronbach`s alphas for work, sport and leisure-time index were 0.75, 0.81 and 0.39 for men, respectively, and 0.67, 0.75 and 0.35 for women respectively. By a principal components analysis the three conceptually meaningful factors were distinguished, except for the leisure-time factor. Due to the low cronbach`s alphas and undistinguished factors, work and sports factors were used on the final analysis, excluding the leisure time factor, in the Korean version of Baecke`s questionnaire. Two-factor analysis was used to assess the validity of work items and sports items. Work factor and sports factor were definitely distinguished as two factors. Multiple regression analysis showed that lean body mass was significantly related the work index(p<0.0001) and sports index (p<0.05).
Our results suggest that the modified Korean version of Baecke`s questionnaire is appropriate to assess the physical activity in Koreans.
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Measurement Errors on Normotensive Subjects in Screening Test.
Jong Myon Bae, Dae Sung Kim, Jaiyong Kim, Yoon Ok Ahn
Korean J Epidemiol. 1999;21(1):1-7.
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AbstractAbstract PDF
Blood pressure measurements with a mercury sphygmomanometer serve as the screening test to establish the clinical diagnosis of primary hypertension. But one of the problems of hypertension screening is the variability of blood pressure measurements.
In order to identify the measurement error of blood pressure through the biennial health screening program of Korea Insurance Medical Corporation, we compared the blood pressure of screening test with true value which defined as the mean of blood pressures taken from the direct contact and twice check-up among normotensive Seoul Cohort participants.
Three hundred forty-nine participants had both data of screening measurement and survey of direct contact. The means of difference in systolic and diastolic blood pressure between both data were 8.47 mmHg and 6.54 mmHg, respectively. These results showed statistical significance with paired t-test (p=0.001).
Our findings indicated that screening measurement of blood pressure had false negative. And if a epidemiologic study about blood pressure used the data of screening test, it should adjust value of systolic and diastolic blood pressure with adding 8 and 7 mmHg, respectively.
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Methodologic Considerations on the Cohort Study of Risk Factors of Stomach Cancer: On the Incompleteness of Case Ascertainment.
Moo Song Lee, Wee Chang Kang, Dong Hyun Kim, Jong Myun Bae, Myung Hee Shin, Young Jo Lee, Yoon Ok Ahn
Korean J Epidemiol. 1997;19(2):152-160.
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AbstractAbstract PDF
AND PURPOSE: The authors conducted the study to evaluate the incompleteness of follow-up as well as the validity of the diagnostic code in the medical insurance databases in a cohort study. They also suggested several useful regression models for the analysis of such incomplete data.
The subjects of Seoul Cohort(n=14,533) were followed up for three and a half years. Based on the chart reviews of the subjects who had the diagnostic code of gastric cancer in the medical insurance databases, forty-four cases of gastric cancer were idenfified, using cancer registry databases and death certificates as the secondary source. Regression coefficients and the associated p-values were estimated using the following six methods and the results were compared with each other. Method 1: The subjects with the diagnostic code in the medical insurance databases were considered as the cases of gastric cancer.
2: The confirmed cases were considered as the cases of gastric cancer. Method 3: The cases were the subjects with the diagnositc code whose diagnosis was confirmed by medical chart reriew. Method 4: Ordinal logistic regression.
5: Weighted logistic regression. Method 6: Polytomous logistic regression RESULTS: A total of 12,541 subjects were followed up excluding censored cases. One hundred and nine subjects were diagnosed with gastric cancer in the medical utilization databases: forty-three were probable cases whose dianosis was not confrimed by chart review, twenty-six were ruled out and 26 were confirmed cases. Another 14 cases were confirmed using the cancer registry and death certificates. Using the secondary sources, four another cases were confirmed and 44 cases were confirmed during follow-up. In method 1, past history of gastritis and gastric ulcer was significant risk factor whereas intake frequency of fresh vegetable, ice cream and coffee was associated with significantly decreased risk. In the second and the sixth method, green tea was a significant protective factor, whereas in methods 3-5, no significant variables were found.
Polytomous logistic regression was the preferred method in the cohort study using secondary sources of information for the follow-up, and it provided additional information for the risk factor identification, especially for the specificity of the risk factors.
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