Journal of Korean Medical Science最新文献

{"title":"Erratum: Correction of Funding Information in the Article \"Administration of Calcium and Magnesium in Acute Intracerebral Hemorrhage Patients: Assessing Safety and Feasibility\".","authors":"Moinay Kim, Wonhyoung Park, Jun Ha Hwang, Jae Hyun Kim, Yeongu Chung, Si Un Lee, Joonho Byun, Jung Cheol Park, Jae Sung Ahn, Seungjoo Lee","doi":"10.3346/jkms.2025.40.e157","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e157","url":null,"abstract":"<p><p>This corrects the article on p. e45 in vol. 40, PMID: 40228559.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 17","pages":"e157"},"PeriodicalIF":3.0,"publicationDate":"2025-05-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12056061/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comprehensive Classification of Surgically Resected Pituitary Neuroendocrine Tumors: Updates From a Single-Institution Experience Based on the WHO 5th Edition.","authors":"Hyunhee Kim, Eric Eunshik Kim, Yong Hwy Kim, Jin Woo Park, Kyeong Cheon Jung, Haeryoung Kim, Jae Kyung Won, Sung-Hye Park","doi":"10.3346/jkms.2025.40.e56","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e56","url":null,"abstract":"&lt;p&gt;&lt;strong&gt;Background: &lt;/strong&gt;The 5th edition of WHO classification (WHO5) renamed pituitary adenoma as pituitary neuroendocrine tumor (PitNET), aligning with NET nomenclature from other sites. This study investigated the clinicopathological characteristics of surgically resected PitNET based on the WHO5 classification.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Methods: &lt;/strong&gt;A retrospective analysis was conducted on 210 cases of surgically resected and pathologically confirmed PitNET treated at Seoul National University Hospital from 2021 to 2023. The tumors were graded using the French five-tiered grading system proposed by Trouillas et al. Detailed information on grade 3 metastatic PitNET cases is provided.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Results: &lt;/strong&gt;The cohort's median age was 53 years (age range: 8-84 years), with a male-to-female ratio of 1:1.1. Mean tumor size was 2.5 cm (range: 0.1-6.5 cm). Macroadenomas predominated (91.9%), followed by microadenoma (6.7%), and giant tumors (1.4%), with 56.2% extending suprasellarly. SF1-lineage PitNET was most prevalent (49.5%), followed by PIT1-lineage (23.3%) and TPIT-lineage (17.1%). Null cell tumors (5.7%) and unclassified plurihormonal PitNET (4.3%) were rare. PIT1-lineage PitNET comprised somatotrophs (47.0%), mature plurihormonal PIT1 lineage tumors (18.4%), thyrotrophs (16.3%), immature PIT1-lineage tumors (16.3%), and acidophilic stem cell tumors (n=1), however, there was no lactotroph PitNET. Among SF1-lineage tumors, serologically non-functional tumors predominated (79%), while, immunohistochemically, 71.2% were gonadotrophin (FSH/LH)-positive. Tumor grades by the French five-tiered classification system were distributed as follows: grade 1a (58.1%), 1b (17.6%), 2a (16.2%), 2b (7.1%), and 3 (1.0%). Two cases of metastatic corticotroph PitNET were observed: The first case, a 50-year-old female had liver metastasis and experienced tumor recurrence 7 years after his initial diagnosis of PitNET, ultimately dying 9.5 years later. The primary tumor appeared bland, but the metastatic tumor exhibited a high mitotic rate and a Ki-67 index was 48%. The second case involved a 44-year-old man with metastases to the paranasal sinus, liver, and bone. Despite showing initial bland histopathology and a low proliferation index, this tumor displayed aggressive behavior. The patient had a recurrence 1.5 years after diagnosis, with additional metastases emerging 3 years later. He survived for 8.0 years and is currently disease-free following surgery, chemotherapy, and radiotherapy.&lt;/p&gt;&lt;p&gt;&lt;strong&gt;Conclusion: &lt;/strong&gt;This comprehensive analysis of surgically resected PitNETs using the new WHO5 classification provides valuable insights into the distribution of the subtypes in the surgical cohort. Key findings were the predominant gonadotroph PitNET, the absence of lactotroph PitNET, and the rarity of null cell tumors in surgical cases. The lack of lactotrophs was mainly due to medical treatment. This study highlights the discrepancy between serolog","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e56"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040610/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064079","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sentinel Safety Monitoring System for Adverse Events of Special Interest Associated With Non-NIP Vaccines in Korea.","authors":"Hakjun Hyun, Jung Yeon Heo, Yu Jung Choi, Eliel Nham, Jin Gu Yoon, Ji Yun Noh, Joon Young Song, Woo Joo Kim, Won Suk Choi, Min Joo Choi, Yu Bin Seo, Jacob Lee, Hee Jin Cheong","doi":"10.3346/jkms.2025.40.e152","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e152","url":null,"abstract":"<p><p>South Korea's current vaccination policies leave a surveillance gap for non-National Immunization Program (NIP) vaccines. In this study, we proposed a sentinel surveillance approach for monitoring the safety of non-NIP vaccines. Vaccination data were collected retrospectively among patients hospitalized with pre-defined adverse events of special interest (AESI) by reviewing electronic medical records in five university hospitals. This approach incorporates expert assessment to determine the causal relationship. We confirmed that 16 patients had received non-NIP vaccines among 860 patients diagnosed with AESI. We concluded one case of preeclampsia was possibly related to tetanus-diphtheria-pertussis vaccination. We propose a multi-hospital-based, retrospective assessment system for pre-defined AESIs as an alternative to active vaccine safety monitoring method. These efforts are expected to enhance both the accuracy and timeliness of safety monitoring in South Korea.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e152"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040605/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144064081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Experiences of Managers and Practitioners in Infectious Disease Management Organizations During the COVID-19 Response: A Qualitative Study.","authors":"Jeehee Pyo, Jiyoon Jeong, Hyeran Jeong, Minsu Ock","doi":"10.3346/jkms.2025.40.e58","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e58","url":null,"abstract":"<p><strong>Background: </strong>Even before coronavirus disease 2019 (COVID-19), unexpected new infectious diseases such as severe acute respiratory syndrome, novel influenza A and Middle East respiratory syndrome (MERS) affected the Korean healthcare systems. Nevertheless, during the COVID-19 period, we still experienced difficulties in systematic response. Especially in Ulsan Metropolitan City, which had no confirmed cases during the MERS, the response infrastructure was also very insufficient. Therefore, this study aimed to investigate in depth experiences of managers and practitioners of infectious disease management organizations with the COVID-19 response and identify areas for improvement in the response to future novel infectious diseases.</p><p><strong>Methods: </strong>We recruited participants through targeted and snowball sampling. Data were collected between March 27 and May 2, 2023, through in-depth interviews with 15 healthcare workers from Ulsan Metropolitan City, South Korea, including civil servants, physicians, nurses, and administrative staff, all of whom had experience with the COVID-19 response.</p><p><strong>Results: </strong>We extracted 1,496 semantic units, 16 subcategories, and 5 categories. The participants experienced confusion at being inserted into the infectious disease response without a thorough understanding of the work due to the sudden appearance of COVID-19. In the absence of precise manuals or designated consultancies, the participants' confusion was exacerbated by frequent changes to guidelines and insufficient communication, and they felt despair by others' passive attitudes, which contradicted their own feelings. They also felt bewildered that they were not supported by policy, despite having chosen to support a great cause in an emergency. Excessive workloads led to health problems. Nevertheless, the participants actively sought help, received support, made efforts to construct the response environment, and felt a sense of reward when they witnessed the results. The participants emphasized the need to build up the inadequate public healthcare system in Ulsan to prepare for future novel infectious diseases, to maintain a trained, professional workforce, and to secure a sufficient budget to provide support and compensation.</p><p><strong>Conclusion: </strong>The findings indicate that local governments need to establish public healthcare systems and secure professionals for responding to novel infectious diseases.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e58"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040607/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144015427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Exome-Based Redefinition and Reclassification of Retinitis Pigmentosa.","authors":"Hyo Song Park, Kyung Kim, Dongwook Lee, Jong-Young Lee, Jeong Nam Choi, Jin Ha Kim, Jung Woo Han, Tae Kwann Park","doi":"10.3346/jkms.2025.40.e54","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e54","url":null,"abstract":"<p><strong>Background: </strong>Because of the low prevalence of inherited retinal diseases, reports on the distribution of retinitis pigmentosa (RP)-related genes in Korean patients are scarce. The aim of this study was to determine the mutation spectrum and allele frequency and observe the final diagnoses in a Korean cohort clinically diagnosed with RP.</p><p><strong>Methods: </strong>We used whole-exome sequencing (WES) to analyze a Korean cohort of 100 unrelated patients clinically diagnosed with RP. The possible pathogenicity of each variant was assessed based on the guidelines of the American College of Medical Genetics and Genomics and Association for Molecular Pathology, in-silico prediction tools, known clinical phenotypes, and inheritance patterns.</p><p><strong>Results: </strong>Definite causative genes were detected in 60/100 patients (60.0%). Of these 60 cases, <i>USH2A</i> was the most common causative gene (14/60, 23.3%), followed by <i>EYS</i> (13/60, 21.7%) and <i>RP1</i> (6/60, 10.0%). The clinical diagnosis was redefined in 9 of the 60 probands (15.0%) with causative genes after WES. Five of the 60 patients (8.3%) carried a causative variant in <i>CHM</i>, and the clinical diagnosis was redefined as choroideremia. Leber congenital amaurosis was diagnosed in 2/60 probands (3.3%), and <i>RDH12</i> and <i>RPGRIP1</i> were the causative genes in each patient. One patient (1/60, 1.7%) was diagnosed with Bietti's crystalline dystrophy, with <i>CYP4V2</i> identified as the causative gene. In another patient (1/60, 1.7%), <i>ABCA4</i> variants were detected with clinical findings suggestive of cone-rod dystrophy.</p><p><strong>Conclusion: </strong>This study reports the mutational spectrum of a cohort of Korean patients with a clinical diagnosis of RP who were referred for genetic testing. This study adds valuable data regarding the frequency of genes as well as their relation to the age of symptom onset and relation to other inherited retinal degenerations.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e54"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040603/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029997","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In This Issue on 28-April-2025.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2025.40.e151","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e151","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e151"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040604/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144011158","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"On the Controversies Surrounding the <i>Lab-Leak</i> Theory of COVID-19.","authors":"Jin-Hong Yoo","doi":"10.3346/jkms.2025.40.e153","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e153","url":null,"abstract":"","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e153"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040609/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143986275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on the Healthcare Workforce and Care for Acute Stroke: Results From the Survey of Hospitals Included in the National Acute Stroke Quality Assessment Program.","authors":"Jong Young Lee, Jun Kyeong Ko, Hak Cheol Ko, Hae-Won Koo, Hyon-Jo Kwon, Dae-Won Kim, Kangmin Kim, Myeong Jin Kim, Hoon Kim, Keun Young Park, Kuhyun Yang, Jae Sang Oh, Won Ki Yoon, Dong Hoon Lee, Ho Jun Yi, Heui Seung Lee, Jong-Kook Rhim, Dong-Kyu Jang, Youngjin Jung, Sang Woo Ha, Seung Hun Sheen","doi":"10.3346/jkms.2025.40.e44","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e44","url":null,"abstract":"<p><strong>Background: </strong>With growing elderly populations, management of patients with acute stroke is increasingly important. In South Korea, the Acute Stroke Quality Assessment Program (ASQAP) has contributed to improving the quality of stroke care and practice behavior in healthcare institutions. While the mortality of hemorrhagic stroke remains high, there are only a few assessment indices associated with hemorrhagic stroke. Considering the need to develop assessment indices to improve the actual quality of care in the field of acute stroke treatment, this study aims to investigate the current status of human resources and practices related to the treatment of patients with acute stroke through a nationwide survey.</p><p><strong>Methods: </strong>For the healthcare institutions included in the Ninth ASQAP of the Health Insurance Review and Assessment Service (HIRA), data from January 2022 to December 2022 were collected through a survey on the current status and practice of healthcare providers related to the treatment of patients with acute stroke. The questionnaire consisted of 19 items, including six items on healthcare providers involved in stroke care and 10 items on the care of patients with acute stroke.</p><p><strong>Results: </strong>In the treatment of patients with hemorrhagic stroke among patients with acute stroke, neurosurgeons were the most common providers. The contribution of neurosurgeons in the treatment of ischemic stroke has also been found to be equivalent to that of neurologists. However, a number of institutions were found to be devoid of healthcare providers who perform definitive treatments, such as intra-arterial thrombectomy for patients with ischemic stroke or cerebral aneurysm clipping for subarachnoid hemorrhage. The intensity of the workload of healthcare providers involved in the care of patients with acute stroke, especially those involved in definitive treatment, was also found to be quite high.</p><p><strong>Conclusion: </strong>Currently, there are almost no assessment indices specific to hemorrhagic stroke in the ASQAP for acute stroke. Furthermore, it does not reflect the reality of the healthcare providers and practices that provide definitive treatment for acute stroke. The findings of this study suggest the need for the development of appropriate assessment indices that reflect the realities of acute stroke care.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e44"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040608/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144029003","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"<i>Clonorchis sinensis</i> and Cholangiocarcinoma.","authors":"Eun-Min Kim, Sung-Tae Hong","doi":"10.3346/jkms.2025.40.e145","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e145","url":null,"abstract":"<p><p>Clonorchiasis is a parasitic disease caused by <i>Clonorchis sinensis</i>, a trematode that inhabits the intrahepatic bile ducts of humans and mammals. <i>C. sinensis</i> is one of common food-borne trematodes, prevalent in East Asia including Korea. The International Agency for Research on Cancer reclassified <i>C. sinensis</i> as the Group 1 biological carcinogen of human cholangiocarcinoma (CCA). Evidence supporting the carcinogenicity of <i>C. sinensis</i> includes epidemiological studies showing increased prevalence and odds ratio (OR) of CCA in clonorchiasis patients, the development of CCA in experimental animals, and molecular studies. Approximately 10% of CCA in Korea are believed to be solely caused by clonorchiasis, with an OR of 4.7 for CCA risk among clonorchiasis patients. All hamsters exposed to both of <i>C. sinensis</i> and N-nitrosodimethylamine (NDMA) developed CCA while those exposed to either <i>C. sinensis</i> or NDMA alone did not. In vitro studies using cell models investigated carcinogenetic changes of the intracellular molecules and genes following stimulation with a soluble extract of <i>C. sinensis</i>. The in vitro stimulated cells showed a significant shift to G2/M phage, produced oncogenic molecules, changed expression of oncogenes, increased cell proliferation and suppressed apoptosis. Additionally, the gap-junction proteins between cells, such as connexin (Cx) 43, Cx 26, and Cx 32, were changed significantly, disrupting intercellular homeostasis. These findings suggest that <i>C. sinensis</i> and nitrogen compounds synergistically stimulate the cholangiocytes to become neoplastic. <i>C. sinensis</i> is a biological carcinogen of human CCA, and the World Health Organization guidelines enlist food-borne trematodes as one of target neglected tropical diseases to be eliminated by 2030. The present article reviews and updates perspectives on clonorchiasis, focusing on carcinogenesis.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 16","pages":"e145"},"PeriodicalIF":3.0,"publicationDate":"2025-04-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12040606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144022624","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Trauma Mortality Prediction Models With Updated Survival Risk Ratios in Korea.","authors":"Juyoung Kim, Yun Jung Heo, Yoon Kim","doi":"10.3346/jkms.2025.40.e51","DOIUrl":"https://doi.org/10.3346/jkms.2025.40.e51","url":null,"abstract":"<p><strong>Background: </strong>Despite the considerable disease burden due to trauma injury, sufficient effort has not been made for the assessment of nationwide trauma care status in Korea. We explored the feasibility of a diagnosis code-based injury severity measuring method in light of its real-world usage.</p><p><strong>Methods: </strong>We used datasets from the National Emergency Department Information System to calculate the survival risk ratios (SRRs) and the Korean Trauma Data Bank to predict models, respectively. The target cohort was split into training and validation datasets using stratified random sampling in an 8:2 ratio. We established six major mortality prediction models depending on the included parameters: 1) the Trauma and Injury Severity Score (TRISS) (age, sex, original Revised Trauma Score [RTS], Injury Severity Score [ISS]), 2) extended International Classification of Diseases-based Injury Severity Score (ICISS) 1 (age, sex, original RTS, ICISS using international SRRs), 3) extended ICISS 2 (age, sex, original RTS, ICISS using Korean SRRs based on 4-digit diagnosis codes), 4) extended ICISS 3 (age, sex, original RTS, ICISS using Korean SRRs based on full-digit diagnosis codes), 5) extended ICISS 4 (age, sex, modified RTS, and ICISS using Korean SRRs based on 4-digit diagnosis codes), 6) extended ICISS 5 (age, sex, modified RTS, and ICISS using Korean SRRs based on full-digit diagnosis codes). We estimated the model using training datasets and fitted it to the validation datasets. We measured the area under the receiver operating characteristic curve (AUC) for discriminative ability. Overall performance was also evaluated using the Brier score.</p><p><strong>Results: </strong>We observed the feasibility of the extended ICISS models, though their performance was slightly lower than the TRISS model (training cohort, AUC 0.936-0.938 vs. 0.949). Regarding SRR calculation methods, we did not find statistically significant differences. The alternative use of the Alert, Voice, Pain, Unresponsive Scale instead of the Glasgow Coma Scale in the RTS calculation did not degrade model performance.</p><p><strong>Conclusion: </strong>The availability of the practical ICISS model was observed based on the model performance. We expect our ICISS model to contribute to strengthening the Korean Trauma Care System by utilizing mortality prediction and severity classification.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"40 15","pages":"e51"},"PeriodicalIF":3.0,"publicationDate":"2025-04-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12011615/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143970182","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}