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유승흠,채수응,김춘배,강명근,송재만,이은식,이정구,이춘용,홍성준,Yu, Seung-Hum,Chai, Soo Eung,Kim, Chun-Bae,Kang, Myung Geun,Song, Jae Mann,Lee, Eun Sik,Lee, Jung Gu,Lee, Tchun Yong,Hong, Sung Joon 한국의료질향상학회 1997 한국의료질향상학회지 Vol.3 No.2
Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.
전립선비대증의 진료지침 개발을 위한 한국문헌의 메타분석
유승흠,김춘배,강명근,송재만,Yu, Seung-Hum,Kim, Chun-Bae,Kang, Myung-Geun,Song, Jae-Mann 대한예방의학회 1997 Journal of Preventive Medicine and Public Health Vol.30 No.3
This study is to provide evidence-based recommendations for the most-effective treatments of benign prostatic hyperplasia based on patient preference or clinical need, and to meta-analyze the Korean literatures for the development of BPH treatment guidelines. For these analyses, extensive literature searches (208 articles), with priority given to the Korean Journal of Urology, were conducted from 1960 to August, 1996. Meta-analysis, like all statistical analysis, has two main functions: data summarization (qualitative meta-analysis) and smoothing o. pattern recognition (quantitative meta-analysis). As well, critical reviews and syntheses with the mean and 90-percent confidence intervals for the likelihood were used to evaluate empirical evidence and significant outcomes of the BPH treatment literatures (106 articles). For this task, the Methodologic Panel for BPH Guidelines was composed of multidisciplinary experts in the field. The results of the study were summarized as follows: For all that watchful waiting is an appropriate treatment strategy for the majority of patients with prostatism, we couldn't find the Korean literatures which carried this article. The literatures on alpha-1-adrenergic receptor blockers provide no evidence to suggest that any one alpha blocker is more effective than another. The finasteride reduces the size of the prostate, on average, and leads to a small yet perceptible reduction in sysptoms. Of all treatment options, prostate surgery with transurethral resection of the prostate (TURP), transurethral incision of the prostate (TUIP), and so on, offers the best chance for symptom improvement. However, surgery also has the highest rates of significant complications. Therefore, surgery need not always be a treatment of last resort. Balloon dilation of the prostatic urethra is clearly less effective than surgery in relieving symptoms, but it is associated with fewer complications. Emerging technologies for treating BPH include lasers, coils, stents, thermal therapy and hyperthermia. Established technologies will also be reanalyzed as results of new trials are reported. Although this study has some limitations due to lacking for good quality literatures, ' it provides a cornerstone for our medical research. It represents the most current scientific knowledge regarding the clinical epidemiology including treatment of BPH. It will be revised and updated as needed.
우리나라 전립샘비대증 발생률: 국민건강보험공단자료를 이용하여
고태화 ( Tae-hwa Go ),김혜심 ( Hye Sim Kim ),강대용 ( Dae Ryong Kang ),정재흥 ( Jae Hung Jung ),권성원 ( Sung Won Kwon ),김세철 ( Sae Chul Kim ),송재만 ( Jae Mann Song ),정현철 ( Hyun Chul Chung ),고상백 ( Sang Baek Koh ) 한국보건정보통계학회(구 한국보건통계학회) 2018 보건정보통계학회지 Vol.43 No.3
Objectives: We investigated the incidence rate of benign prostatic hyperplasia (BPH) in Korean adult males. Methods: Data were obtained from 2008 to 2016 in the National Health Insurance Service. The incidence was defined as a newly diagnosed patients with BPH in 2012-2016 after excluding patients with BPH in 2008-2011. The incidence rate was confirmed by age, administrative districts, and scale of city. Results: The age-standardized incidence rate of BPH was 16.3% from 2012 to 2016. The incidence rate was presented to be 8.9%, 16.8%, 25.0%, 26.7%, and 30.4%, respectively, in the 40s to 80s or over. According to administrative districts, the highest incidence rate was 18.2% and 17.3% in Daejeon and Gwangju, respectively, and the lowest incidence rate was 15.0% in Gangwon. And the highest incidence of 16.5% was observed in the big city among big city, small-to-medium city and rural area. Conclusions: The age-standardized incidence rate in Korea was 16.3% and incidence rate of BPH increased with age.
우리나라 전립샘비대증 유병률: 국민건강보험공단자료를 이용하여
김혜심 ( Hye Sim Kim ),고태화 ( Tae Hwa Go ),강대용 ( Dae Ryong Kang ),정재흥 ( Jae Hung Jung ),권성원 ( Sung Won Kwon ),김세철 ( Sae Chul Kim ),송재만 ( Jae Mann Song ),정현철 ( Hyun Chul Chung ),고상백 ( Sang Baek Koh ) 한국보건정보통계학회(구 한국보건통계학회) 2018 보건정보통계학회지 Vol.43 No.3
Objectives: To provide evidences for effective management and prevention of benign prostate hyperplasia (BPH) by analyzing the status of the prevalence of BPH in Korea. Methods: This study was conducted on patients diagnosed with BPH from the claim data of the Korean National Health Insurance Service between 2012 and 2016. We calculated the age-standardization prevalence of patients with BPH and conducted comparative analysis by region and year. Results: The prevalence of age-standardization was 10,847.09 per 100,000 population in 2012 (95% CI, 10,828.72-10,865.47) and 23,552.31 in 2016 (95% CI, 23,526.70-23,577.92). According to comparative analysis by administrative districts, the cumulative prevalence was the highest at in Daejeon (26,076.23, 95% CI, 25,912.82-26,239.64) and the lowest in Ulsan (20,966.97, 95% CI, 20,795.85-21,138.08) in 2016. Also, the proportion of patients who did not visit continuously was 23.5% in 2013 and 37.1% in 2016. Conclusions: The prevalence of BPH increased by 46% in 2016 compared to 2012, and the prevalence increased with age. Therefore, in order to prevent BPH related health problem, it is necessary to develop a systematic management and preventive policy for a super-aged society.
국민건강보험공단 자료를 활용한 전립샘암 발생의 위험요인 연구: 연령별 BMI 영향
김혜심 ( Hye Sim Kim ),고태화 ( Tae Hwa Go ),강대용 ( Dae Ryong Kang ),정재흥 ( Jae Hung Jung ),권성원 ( Sung Won Kwon ),김세철 ( Sae Chul Kim ),송재만 ( Jae Mann Song ),정현철 ( Hyun Chul Chung ),고상백 ( Sang Baek Koh ) 한국보건정보통계학회(구 한국보건통계학회) 2019 보건정보통계학회지 Vol.44 No.4
Objectives: To provide evidences for effective management and prevention of prostate cancer (PCa) by analyzing risk factors of prostate cancer in Korea. Methods: This study utilized the Korean National Health Insurance Service data of patients diagnosed with PCa between 2013 and 2017 and the risk factors were identified using the health checkup records from 2009 to 2010. To identify risk factors that affect the incidence of prostate cancer, the Cox proportional hazard model was used to analyze. Results: The hazard ratio (HR) of incidence of PCa was 1.37 times higher (95% CI, 1.22-1.56) people with body mass index (BMI) over 30.0 k/m2 than those with BMI below 18.5 k/m2. And age stratification analysis has shown that increased BMI at 50 years old or older increases the risk of incidence prostate cancer from 1.35 to 2.38. Conclusions: Among the many risk factors affecting the development of prostate cancer, BMI has been identified as a risk factor for most ages. Therefore, it is necessary to consider the results of this study when establishing a policy for preventing the occurrence of prostate cancer. Through this, it is expected that not only the prevention of early prostate cancer but also the cost of socioeconomic loss can be lowered by lowering the incidence of prostate cancer.