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우리나라 일부 의학 학술지에 게재된 의약품 광고의 과학적 근거에 대한 평가
안성복,최원,김철준,최성준,이강희,하경수,김현창 한국의료QA학회 2005 한국의료질향상학회지 Vol.12 No.1
Background : The promotion and advertisement of pharmaceuticals should be based on evidence from clinical trials. We conducted this study to assess whether the pharmaceutical advertisement claims in Korean medical journals had relevant references, and whether the claims were supported by the references. Methods : We reviewed pharmaceutical advertisements in five Korean medical journals issued during the first half of 1999 and during the first half of 2004. Three investigators independently reviewed the advertisements to see whether the studies quoted to endorse the advertising messages supported the corresponding claims. Using multiple logistic regression analyses, we investigated which factors were associated with the quality of the advertisement claims. Results : From the 550 advertisements in the five journals, we identified 157 different advertisements and 475 different promotional claims. Only 149 claims had at least one reference, and 105 claims had references of published article. We could find supporting evidences in the 90 claims. The factors which were associated with the quality of advertisement claims were category of drugs, category of claims, and the manufacturer characteristics. Claims for cardiovascular and endocrine drugs, and claims on efficacy, and claims of multinational company were more evidence-based. Conclusion : Majority of the pharmaceutical advertisement claims in Korea did not have appropriate references. Drug category, claim category, and the manufacturer characteristics were associated with the quality of advertisement claims, and the manufacturer characteristics was the most important determinants.
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Ahn, Song Vogue,Kim, Hyeon Chang,Nam, Chung Mo,Suh, Il Elsevier 2018 Journal of cardiology Vol.71 No.2
<P><B>Abstract</B></P> <P><B>Objective</B></P> <P>Diabetic women have a greater relative risk of coronary heart disease than diabetic men. However, the sex difference in the effect of fasting serum glucose levels below the diabetic range on the risk of coronary heart disease is unclear. We investigated whether the association between nondiabetic blood glucose levels and the incident risk of coronary heart disease is different between men and women.</P> <P><B>Methods</B></P> <P>The fasting serum glucose levels and other cardiovascular risk factors at baseline were measured in 159,702 subjects (100,144 men and 59,558 women). Primary outcomes were hospital admission and death due to coronary heart disease during the 11-year follow-up.</P> <P><B>Results</B></P> <P>The risk for coronary heart disease in women significantly increased with impaired fasting glucose levels (≥110mg/dL) compared to normal glucose levels (<100mg/dL), whereas the risk for coronary heart disease in men was significantly increased at a diabetic glucose range (≥126mg/dL). Women had a higher hazard ratio of coronary heart disease associated with the fasting serum glucose level than men (<I>p</I> for interaction with sex=0.021).</P> <P><B>Conclusions</B></P> <P>The stronger effect of the fasting serum glucose levels on the risk of coronary heart disease in women than in men was significant from a prediabetic range (≥110mg/dL).</P> <P><B>Highlights</B></P> <P> <UL> <LI> The risk of coronary heart disease increased from a prediabetic range (≥110mg/dL) in women. </LI> <LI> Women have a higher relative risk of coronary heart disease associated with the fasting serum glucose level than men do. </LI> <LI> More careful glycemic control in women with hyperglycemia is needed to prevent coronary heart disease. </LI> </UL> </P>
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( Hyun Wook Kim ),( Song Vogue Ahn ),( Shi Na Lee ),( Seung Jung Kim ),( Duk Hee Kang ),( Kyu Bok Choi ),( Dong Ryeol Ryu ) 대한내과학회 2014 대한내과학회 추계학술대회 Vol.2014 No.1
Background: To date, there has been no data on the detailed analyses for the incidences of major cardiovascular events in large-scale, Asian population-based cohort. Therefore, in this study, we approached these issues using the Korean Health Insurance Review and Assessment Service (HIRA) database. Methods: We analyzed eligible 30279 [22892 hemodialysis (HD) patients and 7387 peritoneal dialysis (HD) patients] incident chronic dialysis patients who were defi ned as starting dialysis therapy and remaining on that modality at least 3 months. The events were assessed by “major adverse cardiac (MACE) and cerebrovascular events” (“MACCE”). To estimate and to compare the incidence rate of each event, Poisson regression models and Cox proportional hazards models with the propensity score matching were used. Results: During median follow-up of 24.5 months, crude incidence rates of MACCE, MACE, all-cause mortality, non-fatal AMI, TVR, and non-fatal stroke were 182 (95% CI, 178-185), 138 (95% CI, 135-141), 116 (95% CI, 113-118), 18 (95% CI, 17-19), 17 (95% CI, 16-18), and 60 (95% CI, 58-62) per 1000 patient-years, respectively. When comparing all baseline covariate-adjusted relative risks of each end point between HD and PD patients, MACCE, MACE, all-cause mortality, non-fatal AMI, and TVR occurred signifi cantly more frequently in the patients on PD than in those on HD, whereas hemorrhagic subtype of non-fatal stroke was more frequent in the patients on HD than in those on PD. Conclusions: The results suggest that HD is overall superior to PD in terms of MACCE, as a composite end point, but analyzed by the separate end points, the comparison results are rather complex. The results of our study can help to give some basis for risk stratifi cation and customized care for major cardiovascular events in ESRD patients.
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Kim Bongyoung,Ahn Song Vogue,Kim Dong-Sook,Chae Jungmi,정수진,어영,Kim Hong Bin,Kim Hyung-Sook,Park Sun Hee,Park Yoon Soo,최준용 대한의학회 2022 Journal of Korean medical science Vol.37 No.24
Background: The Korea National Antimicrobial Use Analysis System (KONAS), a benchmarking system for antimicrobial use in hospitals, provides Korean Standardized Antimicrobial Administration Ratio (K-SAAR) for benchmarking. This article describes K-SAAR predictive models to enhance the understanding of K-SAAR, an important benchmarking strategy for antimicrobial usage in KONAS. Methods: We obtained medical insurance claims data for all hospitalized patients aged ≥ 28 days in all secondary and tertiary care hospitals in South Korea (n = 347) from January 2019 to December 2019 from the Health Insurance Review & Assessment Service. Modeling was performed to derive a prediction value for antimicrobial use in each institution, which corresponded to the denominator value for calculating K-SAAR. The prediction values of antimicrobial use were modeled separately for each category, for all inpatients and adult patients (aged ≥ 15 years), using stepwise negative binomial regression. Results: The final models for each antimicrobial category were adjusted for different significant risk factors. In the K-SAAR models of all aged patients as well as adult patients, most antimicrobial categories included the number of hospital beds and the number of operations as significant factors, while some antimicrobial categories included mean age for inpatients, hospital type, and the number of patients transferred from other hospitals as significant factors. Conclusion: We developed a model to predict antimicrobial use rates in Korean hospitals, and the model was used as the denominator of the K-SAAR.
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Oh, Hyung Jung,Ahn, Song Vogue,Yoo, Dong Eun,Kim, Seung Jun,Shin, Dong Ho,Lee, Mi Jung,Kim, Hyoung Rae,Park, Jung Tak,Yoo, Tae-Hyun,Kang, Shin-Wook,Choi, Kyu Hun,Han, Seung Hyeok International Society of Nephrology 2012 Kidney international Vol.82 No.12
Henöch-Schönlein purpura nephritis (HSPN) is considered a systemic form of immunoglobulin A nephropathy (IgAN). Although these are different pictures of a single disease, there are no studies directly comparing long-term outcomes of these two clinical entities. To clarify this, we studied 120 patients with biopsy-proven HSPN and 1070 patients with IgAN. The primary outcome was the composite of a doubling of baseline serum creatinine, end-stage renal disease, or death. Secondary outcomes included the individual renal outcomes or the rate of decline in estimated glomerular filtration rate. In the unmatched cohort, patients with HSPN had more vasculitic symptoms, more favorable histologic features, and were more commonly treated with steroids than patients with IgAN. The risk of reaching the primary outcome was significantly lower in HSPN patients than patients with IgAN (hazard ratio, 0.67). The 1:2 propensity score matching gave matched pairs of 89 patients with HSPN and 178 patients with IgAN, resulting in no differences in baseline conditions. In this matched cohort, there were no significant differences in reaching the primary and secondary outcomes between the two groups. Thus, after adjustment by propensity score matching, clinical outcomes did not differ between HSPN and IgAN, suggesting the two forms of the same disease have a similar prognosis.
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Improving Outcome of Capd: Twenty-Five Years’ Experience in a Single Korean Center
Han, Seung Hyeok,Lee, Sang Choel,Ahn, Song Vogue,Lee, Jung Eun,Choi, Hoon Young,Kim, Beom Seok,Kang, Shin-Wook,Choi, Kyu Hun,Han, Dae Suk,Lee, Ho Yung SAGE Publications 2007 Peritoneal dialysis international Vol.27 No.4
<B>Background</B><P> Continuous ambulatory peritoneal dialysis (CAPD) is an established treatment for end-stage renal disease (ESRD). We investigated the outcome of CAPD over a period of 25 years at our institution. </P><B>Methods</B><P> CAPD has been performed in 2301 patients in 25 years. After excluding patients with less than 3 months of follow-up and missing data, we evaluated 1656 patients who started peritoneal dialysis between November 1981 and December 2005. Data for sex, age, primary disease, co-morbidities, follow-up duration, cause of death, and cause of technique failure were collected. We also examined data for urea kinetic modeling (UKM), beginning in 1990, and peritonitis episodes, including causative organisms, starting in 1992. </P><B>Results</B><P> Compared to incident patients from 1981 - 1992, mean age and incidence of ESRD caused by diabetic nephropathy increased in patients from 1993 to 2005. Technique survival after 5 and 10 years was 71.9% and 48.1% respectively. Technique survival was significantly higher in patients who started CAPD after 1992 than in those who started before 1992. Peritonitis was the main reason for technique failure. Overall peritonitis rate was 0.38 episodes per patient-year, with a significant downward trend to 0.29 per patient-year over 10 years, corresponding to a decrease in gram-positive peritonitis. Patient survival after 5 and 10 years was 69.8% and 51.8% respectively. Patient survival improved significantly during 1992 - 2005 compared to 1981 - 1992 after adjustment for age, gender, diabetes, and cardiovascular comorbidities [hazard ratio (HR) 0.68, p @@<@@ 0.01]. Subgroup analysis based on UKM revealed that dialysis adequacy did not affect patient survival. However, diabetes (HR 2.78, p @@<@@ 0.001), older age (per 1 year: HR 1.06; p @@<@@ 0.001), serum albumin level (per 1 g/dL: increase, HR 0.52; p @@<@@ 0.05), and cardiovascular comorbidities (HR 2.32, p @@<@@ 0.01) were identified as significant risk factors. </P><B>Conclusion</B><P> Technique survival has improved due partly to a decrease in peritonitis, which was attributed to a decrease in gram-positive peritonitis. Patient survival has also improved considering increases in aged patients and ESRD caused by diabetes. The mortality rate of CAPD is still high in older, diabetic, malnourished, and cardiovascular diseased patients. A more careful management of higher risk groups will be needed to improve the outcome of CAPD patients in the future. </P>
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Oh, Sun-Min,Kim, Hyeon-Chang,Ahn, Song-Vogue,Chi, Hye-Jin,Suh, Il The Korean Society for Preventive Medicine 2010 Journal of Preventive Medicine and Public Health Vol.43 No.6
Objectives: The effect of meat consumption on cardiometabolic risk has been continuously studied, but their associations are not conclusive. The aim of this study is to examine the association between the consumption of meat or red meat and carotid intima-media thickness (IMT) in healthy Korean adults. Methods: This study evaluated 2374 community-dwelling adults (933 men and 1441 women) who were free of cardiovascular disease or cancer, living in a rural area in Korea. Total meat and red meat intakes were assessed with a validated 103 item-food frequency questionnaire. Carotid IMT was evaluated ultrasonographically, IMTmax was defined as the highest value among IMT of bilateral common carotid arteries. Results: After adjustment for potential confounding factors, the mean IMTmax tended to increase in higher meat consumption groups in both men and women with metabolic syndrome (p for trend= 0.027 and 0.049, respectively), but not in participants without metabolic syndrome. Frequent meat consumption (${\geq}5$ servings/week) was significantly associated with higher IMTmax in men with metabolic syndrome (by 0.08 mm, p=0.015). Whereas, the association was not significant in women (by 0.05 mm, p=0.115). Similar but attenuated findings were shown with red meat intake. Conclusions: Our findings suggest that a higher meat consumption may be associated with a higher carotid IMT in Korean adults with metabolic syndrome. The frequent meat consumption (${\geq}5$ servings/week), compared with the others, was associated with a higher carotid IMTmax only in men with metabolic syndrome. Further research is required to explore optimal meat consumption in people with specific medical conditions.
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