호흡기계(系) 질환의 역학적(疫學的) 조사방법 개발에 관한 연구(I) -번역설문서 응답양상(應答樣相)에 대한 비교평가-

안윤옥,박병주,권이혁,Ahn, Yoon-Ok,Park, Byung-Joo,Kwon, E-Hyock 대한예방의학회 1982 예방의학회지 Vol.15 No.1

Korean versions of British Medical Research Council (MRC), Cornell Medical Index(CMI), and American Thoracic Society 78 (ATS-DLD-78) respiratory questionaires were compared with each other, and were tested the stability, in terms of test-retest reliability, of each questions by self-administration of those to 156 medical students. The results obtained and conclusions drawn are as follow: 1. The degree of agreements between responses to the comparable questions of CMI vs MRC, and of CMI vs ATS-DLD-78 were not satisfactory. There were, however, $71{\sim}100$ per cent of agreement between responses to the questions on Cough, Wheezing, Phlegm, Breathlessness, and Chest illness of ATS-DLD-78 vs MRC questionaire. And the ATS-DLD-78 tended to yield greater number of positive responses than MRC (See Table 4). 2. All of the coefficient of stability of each questions in 3 questionaires were statistically significant, ranged $77{\sim}100$ per cent, except that of the question on episode of cough and phlegm in ATS-DLD-78 questionaire (See Table 5-1). The question is composed of two collateral conditions, 'lasting for 3 weeks or more' and 'each year'. 3. It can be insisted that the Section-B questions of CMI is not proper for use in epidemiologic survey on respiratory illness. And rather than MRC, the ATS-DLD-78 questionaire deserves to prefer to be used in epidemiologic studies on respiratory illness. 4. In question-wording, especially, of inquiring past experience, it is possible to lessen the reliability of the question that including collateral conditions such as 'the duration lasted of symptoms', and moreover, of which words are not common usage. For example, for Korean '10days' or 'half a month' is more familiar time unit rather than 'week'.

호흡기계(系) 질환의 역학적(疫學的) 조사방법 게발에 관한 연구(II) -한국(韓國) 실정에 맞는 설문조사서 개발-

안윤옥,김건열,권이혁,Ahn, Yoon-Ok,Kim, Keun-Youl,Kwon, E-Hyock 대한예방의학회 1982 예방의학회지 Vol.15 No.1

Questionaires on symptoms of respiratory disease have been used in Korea to elicit the probable health effects of air pollution in epidemiologic studies: The objectives of such studies often include comparing prevalence of symptoms of respiratory system between different population groups or between the same population groups, at different times. Unfortunately, little attention has, been paid to standardization of those questionaires, whether those are Korean. versions or not. Furthermore, no attempt to develop Korean ,questionaire on respiratory symptoms and relevant information has been made. Followed by 'a comparative study on responses to Korean version questionaires(English origin) of CMI, MRC, and ATS-DLD-78' two types of questionaires on respiratory symptoms and relevant information for Korean adult, which are short form (SUN-81-AS) and long forms (optional questions are added to the short one, SUN-81-AL), have been designed suitable to Korean background by authors (see Annex). The self-administered and closed-question questionaire were tested their validity and reliability by administration to l80 normal adults (medical and nursing students) and 60 clinical patients of Seoul National University Hospital, with spirometric exam. The results obtained and conclusions drawn are as follow: 1. It took less than 10 minutes to complete the questionaire SNU-81-AS and SNU-81-AL. 2. The test-retest reliability of each questions in AS and AL ,were observed as 92.7% and 92.1%, respectively. And all of the level of agreement are statistically significant with kappa statistic. 3. In addition to higher prevalence rate of symptoms in patients group compared, with, normal. group, the correlations between FEV 1.0/FVC predictive value(%) and number of symptoms were statistically significant inpatients group (See Fig. 1 and, Table 7). 4. The answer rate to optional questions in AL form among those who are not to do was about 10%, while the no-answer rate among who are to do was about 15% in Normal (medical and nursing students) group. 5. From the viewpoints of validity and reliability, the new Korean questionaire (SNU-81-AS and AL) developed by authors are to be recommendable to use in epidemiologic studies on respiratory illness in Korea. The self-administration, however, of optional questions in AL form may not assure the quality of data gathered.

Some Biologic Correlates of Perinatal Mortality

안윤옥,Ahn, Yoon-Ok The Korean Society for Preventive Medicine 1976 예방의학회지 Vol.9 No.1

가족계획사업(家族計劃事業)이 주창(主唱)되고 채택(採擇)함에 있어 원(願)한 임신(妊娠)을 만족(滿足)스러운 결과(結果)로 이끌어야 한다는 전제(前題)의 중요성(重要性)은 아무리 강조(强調)해도 지나치지 않는다 하겠다. 따라서 위해(危害)한 임신(姙娠)을 일찍 발견(發見)하고 이에 대(對)한 적절(適切)한 산전관리(産前管理)를 제공(提供)하는 것은 모자보건사업(母子保健事業)의 주요(主要)한 관심사(關心事)이다. 더구나 한국(韓國)에 있어서 이러한 모자보건사업(母子保健事業)의 중요성(重要性)이 정책입안자(政策立案者)들에게 긍정적으로 인식되여진 것은 가족계획(家族計劃)이 국책(國策)의 하나로 채택(採擇)된지 건의 10년(年)이 지난 후이었다는 것을 생각할 때 우리나라에서의 모자보건사업(母子保健事業)은 더욱 중요(重要)한 의미(意味)를 지닌다 할 수 있다. 모자보건상태(母子保健狀態)를 나타내 주는 여러가지 지표중(指標中)에서도 주산기사망률(周産基死亡率)이 그 기본(基本)이 되는 것은 주지(周知)의 사실(事實)이다. 주산기(周産基)에 일어나는 사망(死亡)의 기저(基底)에는 일련(一聯)의 공통(共通)된 요인(要因)들이 작용(作用)하고 있으며 고로 그 관리방법(管理方法) 또한 다양(多樣)하지 않아도 소기의 성과를 기대할 수 있다는 특징이 있다. 그러나 그러한 관리방안(管理方案)을 계획수립(計劃樹立)하는 데에는 주산기사망(周産基死亡)에 관여(關與)되는 공통요인(共通要因)을 정확(正確)히 밝혀주는 통계자료(統計資料)가 필요(必要)로 하고 있다. 우리나라에 있어 주산기사망(周産基死亡)에 관(關)한 연구(硏究)는 그동안 매우 부진하였으며 이에 대(對)한 자료(資料) 또한 거의 전무(全無)하다고 해도 과언은 아닐 것이다. 이에 본저자(本著者)는 비록 한정(限定)된 자료(資料)이긴 하지만 병원분만예(病院分娩例)를 중심(中心)으로 분석가능(分析可能)한 요인(要因)을 검토(檢討)하여 모자보건사업(母子保健事業)의 효과적(效果的)인 수행(遂行)에 일말(一抹)의 방향(方向)을 제시(提示)하고져 본연구(本硏究)를 시도하였으며 한편으로는 이 분야(分野)에 대(對)한 연구(硏究)가 앞으로 보다 적극적(積極的)으로 활발(活潑)하게 전개(展開)될 수 있기를 바라는 마음에서 약간(若干)의 지견(知見)이 나마 이에 발표(發表)하는 바이다. 1973년(年)부터 75년(年)까지 만(滿) 3년(年)동안 서울대학병원(大學病院)에서 분만(分娩)된 2,421예(例)를 연구대상(硏究對象)으로 하였으며 동기간(同其間)에 발생(發生)된 주산기사망(周産基死亡)과 이에 관련(關聯)된 생물학적(生物學的) 제요인(諸要因), 즉 모(母)년령, 임신회수(姙娠回數), 출산순위(出産順位), 임신기간(姙娠其間), 출산체중(出産體重), 미숙아(未熟兒)여부, 쌍생아(雙生兒)여부등(等)과를 통계학적(統計學的)으로 cemputer에 의(依)해 처리하였다. 얻어진 소견(所見)은 다음과 같았다. 1. 모년령(母年齡), 임신회수(姙娠回數), 임신기간(姙娠其間), 출산시체중등(出産時體重等)의 제요인(諸要因)은 주산기사망(周産基死亡)에 대(對)하여 통계적(統計的)으로 유의(有意)한 영향을 미치고 있어 $25{\sim}29$세(歲)의 연령군에서, 2번째 임신과 2번째의 출산에서 그리고 만삭의 임신 기간에, 출산시체중(出産時體重) $3.50{\sim}3.99kg$사이의 아이에서 그 주산기사망률(周産基死亡率)이 각각 가장 낮았다. 2. 사산(死産)과 초생아사망(初生兒死亡)을 구분( The causes and problems underlying deaths in perinatal period are often similar and might be expected to yield to same type of preventive measures. This is one of the reasons for attempting to develop a reporting of perinatal mortality and its related matters. This study aims at figuring out the biologic risk factors onto the perinatal death. Considering stillbirth and early neonatal mortality separately, considerable associations between stillbirth and reproductive history of women, are observed, ana it is found that prematurity is the the far most important factor in the early neonatal mortality.

자료처리과정(資料處理過程)에 대(對)한 통계학적(統計學的) 검토(檢討) -일부(一部) 의학잡지(醫學雜誌)에 게재(揭載)된 논문예(論文例)를 중심(中心)으로-

안윤옥,고응린,Ahn, Yoon-Ok,Ko, Ung-Ring 대한예방의학회 1973 Journal of Preventive Medicine and Public Health Vol.6 No.1

One hundred and thirty one health articles (as 'original articles') reported in medical journals published in Korea during the period from Jan. to Dec. 1971. were selected as the study materials for tile purpose of resumption and criticism. Of a total of 131 articles, thirty-nine were not required the statistical application for the data processing and drawing their conclusions and ninty-two, 70.2%, were needed to apply. The 92 articles were divided into three groups by the types of study: 54 for experimental study, 30 for clinical case analytic study and 8 for field study. Each report was resumed and criticised under the statistical aspects in terms of data processing and the validity of the conclusions. The results of resumption of the 92 articles needed statistical application are summarized as follow; 1. Of the 54 articles of experimental studies resumed, thirty-one articles, 57.4%, were considered acceptable. Among the 38 articles classified as clnical case analytic and field studies, only 28.9 per cent were considered acceptable. In total 45.7 per cent or less than half were considered acceptable. 2. Types of errors encountered are as shown in Table 3. 3. The most frequently encountered error was that the conclusions were drawn without having made any statistical test. This type of error was found in 14 out of 35 errors presented in experimental studies, 11 of 35 in clinical case analytic studies and 5 of 9 in field studies and 30 out of 97, 38.2%, in total.

암 등록사업의 현황과 추진방향

안윤옥,Ahn, Yoon-Ok 대한예방의학회 2007 예방의학회지 Vol.40 No.4

It was not until 1975 that cancer registration was initiated in Korea; voluntary registration of cancer patients of training hospitals throughout the country began under the auspices of the Korean Cancer Society(KCS). However, an official cancer registration, the Korea Central Cancer Registry(KCCR), began on July 1st, 1980. Forty-five training and two non-training hospitals throughout the country initiated registration of patients in whom neoplasms had been found. Data related to case information specified are to be sent to the KCCR at the National Medical Center(it moved at National Cancer Center in 2000). The initial cancer registration of KCS was merged to the KCCR in 1980. Although the KCCR covers most all the large training hospitals in Korea, it cannot provide incidence data. It is, however, the only of its kind in the world, being neither hospital nor population based. The first population based cancer registry(PBCR) was launched in a small county, Kangwha(it has around 80,000 inhabitants), by Yonsei University Medical College in 1983. All data were collected by active methods, and incidence statistics for 1986-1992 appeared in Vol VII of the CI5. Another PBCR, Seoul Cancer Registry(SCR), started in 1991. It was supported by a civilian foundation, the Korean Foundation for Cancer Research. The basic idea of case registration of SCR was the incorporation of KCCR data to PBCR, e. g. dual sources of case registration, i.e., from the KCCR and also including cases diagnosed in small hospitals and other medical facilities. Assessing completeness and validity of case registration of SCR, the program and methodology used by the SCR was later extended to other large cities and areas in Korea, and the PBCR in each area was established. Cancer incidence statistics of Seoul for 1993-1997, Busan for 1996-1997, and Daegu for 1997-1998, as well as Kangwha for 1993-1997, appeared eventually in Vol VIII of the CI5. The Korean or 'pillar' model for a PBCR is a new one. The KCCR data file is a reliable basis, as a pillar, for a PBCR in each area. The main framework of the model for such a registry is the incorporation of a KCCR data file with data from additionally surveyed cases; the data related to cancer deaths, medical insurance claims, and visit-and surveillance of non-KCCR medical facilities. Cancer registration has been adopted as a national cancer control program by Korean government in 2004 as the Anti-Cancer Act was enacted. Since then, some officers have tried to launch a nation-wide PBCR covering whole country. In the meantime, however, cancer registration was interrupted and discontinued for years due to the Privacy Protection Law, which was solved by an amendment of the Anti-Cancer Act in 2006. It would be premature to establish the nation-wide PBCR in Korea. Instead, continuous efforts to improve the completeness of registration of the KCCR, to progress existing PBCRs, and to expand PBCRs over other areas are still to be devoted. The nation-wide PBCR in Korea will be established eventually with summation of the PBCRs of the Korean model.

중년 남성에서 고정상혈압에 의한 고혈압발생 위험 규명을 위한 코호트내 환자-대조군 연구

안윤옥,배종면,Ahn, Yoon-Ok,Bae, Jong-Myon 대한예방의학회 1999 Journal of Preventive Medicine and Public Health Vol.32 No.4

Objectives : High-normal blood pressure' is a factor influencing decision to initiate targeted intensive intervention strategy in westernized populations. JNC-VI offered the vigorous lifestyle modification for persons with 'high-normal blood pressure', who could be early detected. As a hypertension seems to be the result of multiple genetic factors operating in concert with associated environmental factors, it will be necessary to identify the high-normal blood pressure as a risk factor of hypertension for applying primary prevention strategy in Korean people. Methods : Although cohort study design might be adequate to recruit incidence cases, to keep time sequence of events, and to prevent information bias, nested case-control study was chosen for avoiding measurement errors because hypertension is a benign disease. Source population was the 'Seoul Cohort' participants and follow-up was done by using Korea Medical Insurance Corporation's database on the utilization of health services from 1 Jan93 to 30Jun97. Incidence cases were ascertained through the chart review, telephone contacts, and direct blood pressure measurements. Controls included the pairing of 4 individuals to each case on the basis of age. Results : As 75% of 247 incident cases had high-normal blood pressure, the crude odds ratio for hypertension was 2.04 (95% CI 1.47-2.83). Another statistically significant risk factors of hypertension were body mass index, dietary fiber, alcohol consumption, weekly activity and history of quitting smoking. The multivariate odds ratio of high-normal blood pressure adjusted for all risk factors was 1.84 (95% CI 1.31-2.56). Among high-normal blood pressure group, body mass index, weekly ethanol amounts, weekly physical activity, and dietary fiber except history of quitting smoking were still risk factors of hypertension. Conclusion : 'High-normal blood pressure' is a risk factor for hypertension in Korean middle-aged men, which represents that the vigorous lifestyle modification for persons with 'high-normal blood pressure' is need.

기간분석에 따른 수정된 누적한계 추정량

김진흠,안윤옥,Kim, Jin-Heum,Ahn, Yoon-Ok 한국통계학회 2006 응용통계연구 Vol.19 No.3

임상시험 연구나 역학 연구에서 환자들의 예후는 흔히 생존을 추정을 통해 수량화 되곤 한다. 하지만 코호트 분석이나 완전분석에 의한 생존율 추정량들은 수년 전에 진단된 환자에 크게 의존하기 때문에 실제 생존율보다 더 낮게 추정하곤 한다. 본 연구에서는 최근의 생존정보를 잘 반영하는 생존을 추정을 위해 기간분석 방법을 통한누적한계 추정량을 제안하였고, 그 방법을 1993년 1월-1997년 12월 사이에 조사된 서울시 암등록 자료(Ahn등, 2002)에 적용하여 결과를 고찰하였다. Long-term survival rates are the most commonly used outcome measures for patients with cancer. However, traditional long-term survival statistics, which are derived by cohort analysis or complete analysis, essentially reflect the survival expectations of patients diagnosed many years ago. They are often outdated at the time they become available. In this article, we propose a modified product-limit method to obtain up-to-date estimates of long-term survival rates via a period analysis. The proposed method is illustrated with cancer registry data collected from January 1993 to December 1997.

호암상 수상 기념특강 : B형간염 예방접종 시행 후, 우리나라 B형간염 관련 질환의 변화와 추이

안윤옥 ( Yoon Ok Ahn ),김정룡 ( Chung Yong Kim ),배상혁 ( Sang Hyuck Bae ),장현갑 ( Hyun Gab Chang ) 대한간학회 2010 Clinical and Molecular Hepatology(대한간학회지) Vol.16 No.4(S)

우편 설문 응답 양상에 관한 경험

강대희,안윤옥,Kang, Dae-Hee,Ahn, Yoon-Ok 대한예방의학회 1988 Journal of Preventive Medicine and Public Health Vol.21 No.2

1. 회신율은 연구 주관기관이나 설문조사 내용, 표본의 성격, 응답자에게 주는 이익의 정도, 독촉 방법에 따라 많은 차이를 보이겠지만 본 사례에서 우편설문에 관한 응답양상을 살펴본 바, 회신율에 있어서는 1차 발송후 총 대상에 대하여 약 15-20% , 미응답 대상에 대한 2차 발송 후 2차 대상의 약 30%, 1, 2차 미응답 대상에 대한 3차 발송후 3차 대상의 약 20%정도의 회신율을 보여 총 회신율에 있어서는 약 54%정도를 보이었다. 이것은 사회과학 연구 조사에서의 회신율 10-25%에 비하여는 상당히 높다고 할 수 있고(김경동, 1986), 질문서 회신율이 50%면 분석의 목적 상 무난하다고 보아야 하고, 60%면 좋은 편이고, 70%가 넘으면 아주 훌륭하다는 Babbie(1973)의 의견에 비추어 볼 때 무응답 대상에 대한 비교연구가 수반되어야 정확한 판단을 내릴 수 있겠지만 본 사례에서의 회신율은 그런대로 만족할 수 있는 수준이라고 생각된다. 2. 미응답 대상에 대한 독촉 발송 시기에 있어서는 미응답 대상에 대하여 최초 발송 2주일 후 정도가 적절할 것으로 판단되며, 3차 발송까지 시행하는 것이 회신율을 높일 수 있는 방법으로 생각된다. 3차 발송 이후에도 응답이 없는 경우 또다시 독촉(4차 이상 발송)하여도 전체 회신율에는 크게 영향을 미치지 않을 것으로 예상된다. Christopher는 정부의 후원을 받는 조사 연구의 경우 회신율이 높다고 보고하였는데 이번 조사연구에서도 관련 부처로부터의 협조 공문이 회신율을 높이는데 기여하였다고 사료된다(Oppenheim, 1966).

한국 중년 남성을 대상으로 한 식품 섭취빈도 조사에서 나타난 식품 섭취빈도의 상관성 분석

안윤진(Ahn Younjhin),백희영(Paik Hee Young),안윤옥(Ahn Yoon Ok) 韓國營養學會 2000 Journal of Nutrition and Health Vol.33 No.2