Journal of Korean Medical Science最新文献

{"title":"Retrospective Evaluation of an AI-Based Computer-Aided Detection Algorithm for Lung Cancer Detection on Cardiac CT: A Multicenter Study.","authors":"Jinwoo Son, Jin Young Kim, Suyon Chang, Young Joo Suh","doi":"10.3346/jkms.2026.41.e208","DOIUrl":"10.3346/jkms.2026.41.e208","url":null,"abstract":"<p><strong>Background: </strong>To investigate the effectiveness of an artificial intelligence (AI)-based computer-aided detection (CAD) system in identifying incidental lung cancer on cardiac computed tomography (CT) scans and to compare its performance with that of radiologists.</p><p><strong>Methods: </strong>In this retrospective, multicenter study, 652 cardiac CT scans from 581 patients subsequently diagnosed with lung cancer were analyzed. A commercial AI-CAD system was employed to detect pulmonary lesions on cardiac CT. The detection rate of AI-CAD was compared to that of the radiologist, based on the radiology report, as well as to the detection rate when combining AI-CAD and the radiologist. The characteristics of the lesions detected and missed by the radiologist and AI-CAD were compared.</p><p><strong>Results: </strong>Radiologists and AI-CAD demonstrated similar detection rates for lung cancer (76.2% vs. 77.4%, <i>P</i> = 0.551). However, combining radiologists and AI-CAD significantly improved the detection rate to 90.4% (<i>P</i> < 0.001) compared to that of the radiologist alone. AI-CAD showed a higher detection rate in identifying small, peripheral, and part-solid lesions (all <i>P</i> < 0.001). Furthermore, AI-CAD outperformed radiologists in detecting limited-stage lung cancer (80.3% vs. 74.7%, <i>P</i> = 0.006). Among lung cancer cases missed by radiologists, 94.2% experienced diagnostic delays of > 100 days, with 78.2% leading to stage progression. AI-CAD identified 58.5% of these diagnostic delays.</p><p><strong>Conclusion: </strong>AI-CAD demonstrated the potential to improve the detection rate of incidental lung cancer by identifying a subset of lesions that were initially overlooked by radiologists on cardiac CT. It exhibited particular strength in identifying early-stage cancers and small, subsolid lesions.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 32","pages":"e208"},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481817/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794317","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":"Temporal Trends in Needlestick and Sharp Injury Incidence Rates During the COVID-19 Pandemic in a Tertiary Care Hospital in Korea.","authors":"Shinwon Lee, Hyesun Jang, Namjeong Park, Jeong Eun Lee, Soon Ok Lee, Chang Won Kim, WooSeog Ko, Hyunjin Son, Sun Hee Lee","doi":"10.3346/jkms.2026.41.e209","DOIUrl":"https://doi.org/10.3346/jkms.2026.41.e209","url":null,"abstract":"<p><strong>Background: </strong>The coronavirus disease 2019 (COVID-19) pandemic has significantly impacted the healthcare workforce. This study aimed to compare needlestick and sharp injuries (NSIs) incidence between the pre-pandemic period and the pandemic period and to assess how hospital responses influenced NSI incidence among healthcare workers.</p><p><strong>Methods: </strong>This retrospective study was conducted at a tertiary care hospital designated for COVID-19 management. We compared the incidence of NSIs before (2017-2019) and after (2020-2022) the pandemic onset. The incidence, expressed as cases per 100 full-time equivalents (FTEs) per year, was analyzed using generalized linear regression with interrupted time series analysis based on the Prais-Winsten model.</p><p><strong>Results: </strong>Hospital admissions (7.63%) and surgeries (7.01%) declined in the first pandemic year and continued to decrease, whereas the workforce steadily increased. A total of 844 NSIs were reported, with 475 (56.3%) before the pandemic and 369 (43.7%) during the pandemic. The overall NSI incidence (per 100 FTEs/year) declined both immediately after the outbreak (from 5.78 in 2019 to 4.58 in 2020, <i>P</i> = 0.530) and throughout the pandemic (from 4.58 in 2020 to 3.89 in 2022, <i>P</i> = 0.756). By occupation, incidence among nurses significantly decreased immediately after the outbreak (from 7.6 in 2019 to 5.2 in 2020, <i>P</i> = 0.035). Of the 369 NSIs during the pandemic, most occurred in non-COVID-19 care areas, with only 9 cases (2.4%) in COVID-19 care areas.</p><p><strong>Conclusion: </strong>Our study observed a declining trend in NSI incidence during the COVID-19 pandemic, likely related to reduced hospitalizations, adequate staffing, optimized patient contact and infection control measures.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 32","pages":"e209"},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481819/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794283","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":"Age-Related Cognitive Patterns in Children With Attention-Deficit/Hyperactivity Disorder and Typically Developing Children: A Comparative Study.","authors":"Hee Jin Kim, Kun Jung Kim, Doug Hyun Han, Sun Mi Kim, Hyunchan Hwang, Ji Sun Hong","doi":"10.3346/jkms.2026.41.e221","DOIUrl":"https://doi.org/10.3346/jkms.2026.41.e221","url":null,"abstract":"<p><strong>Background: </strong>Attention-deficit/hyperactivity disorder (ADHD), characterized by inattention and hyperactivity-impulsivity, profoundly influences cognitive and behavioral development. Compared with their typically developing (TD) counterparts, children diagnosed with ADHD consistently exhibit impaired performance, which manifests as delays in response inhibition, interference selection, and working memory. We hypothesized that with increasing age, the attentional differences observed in younger children would progressively diminish, and that these developmental changes would be associated with behavioral and emotional problems.</p><p><strong>Methods: </strong>We analyzed data from 131 children diagnosed with ADHD, sourced from the psychiatric outpatient departments of two hospitals, alongside data from 167 TD children aged 4-12 years. Using analysis of variance, we investigated differences in Comprehensive Attention Test (CAT) scores, intelligence quotients, and the Korean version of the Child Behavior Checklist (K-CBCL) scores between children with ADHD and their TD peers.</p><p><strong>Results: </strong>Compared with their TD counterparts, children diagnosed with ADHD exhibited lower intelligence quotient scores across multiple subscales and elevated levels of diverse behavioral problems. Age-related patterns unveiled shifts in CAT scores. K-CBCL externalizing and internalizing problem scale and CAT scores were correlated.</p><p><strong>Conclusion: </strong>This study revealed age-related patterns of cognition among pediatric patients with ADHD when compared with a non-ADHD control group. With maturation, developmental delays may lessen, and attention improvement follows a discernible sequence, commencing with basic attention, followed by inhibition and ultimately, interference selection. Furthermore, age-dependent correlations between CAT and K-CBCL scale scores were identified. These findings highlight the clinical importance of considering age-specific patterns of cognitive and behavioral characteristics in the assessment of ADHD.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 32","pages":"e221"},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481828/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794312","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":"Interim Positron Emission Tomography-Adapted Treatment Strategies for Classic Hodgkin Lymphoma: Insights From Korean Real-World Data.","authors":"Seonggyu Byeon, Ka-Won Kang, Kunye Kwak, Kwai Han Yoo, Sang Eun Yoon, Won Seog Kim, Seok Jin Kim","doi":"10.3346/jkms.2026.41.e213","DOIUrl":"https://doi.org/10.3346/jkms.2026.41.e213","url":null,"abstract":"<p><strong>Background: </strong>ABVD chemotherapy (consisting of doxorubicin, bleomycin, vinblastine, and dacarbazine) and positron emission tomography (PET)-guided risk-adapted treatment have improved outcomes in classic Hodgkin lymphoma (cHL), but real-world evidence from Asian populations remains limited.</p><p><strong>Methods: </strong>We retrospectively analyzed 270 patients with classical Hodgkin lymphoma treated with ABVD at two Korean tertiary centers (2015-2024). Survival analyses were performed on an intention-to-treat basis including all 270 patients.</p><p><strong>Results: </strong>Among end-of-treatment (EOT) evaluable patients (n = 266), the complete response (CR) rate and overall response rate were 89.1% and 95.5%, respectively. With a median follow-up of 58.3 months, the estimated 5-year progression-free survival (PFS) and overall survival (OS) were 81.6% (95% confidence interval [CI], 75.8-86.2%) and 88.8% (95% CI, 83.6-92.4%), respectively. In the interim PET-CR subgroup (n = 200), bleomycin omission (ABVD→AVD) did not impact survival (PFS: <i>P</i> = 0.904; OS: <i>P</i> = 0.290). In multivariate analysis, male sex, an Eastern Cooperative Oncology Group (ECOG) performance status score of ≥ 2 points, and failure to achieve EOT CR were independent predictors of poor PFS, while age ≥ 65 years, extranodal involvement, and non-CR at EOT were associated with inferior OS.</p><p><strong>Conclusion: </strong>ABVD with PET-guided modification remains an effective and pragmatic first-line approach for cHL in Korean clinical practice. Real-world outcomes align with clinical trial data, even with limited use of novel agents. These findings support risk-adapted therapy tailored to patient response and regional treatment availability.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 32","pages":"e213"},"PeriodicalIF":3.2,"publicationDate":"2026-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13481814/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148794310","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":"Vaccine Handling Management in Korea, Japan, and Taiwan: A Comparative Study of Storage Standards, Implementation Practices, and Regulatory Approaches.","authors":"Cho Ryok Kang, Ji Yun Noh, Won Suk Choi, Young June Choe, Hajime Kamiya, Seiichi Tomotaki, Hiroko Tomotaki, Li-Min Huang, Sumyeong Choe, Young Hwa Lee, Nam-Kyong Choi, Heehyun Won, Suyeon Jeong, Jong-Koo Lee","doi":"10.3346/jkms.2026.41.e200","DOIUrl":"10.3346/jkms.2026.41.e200","url":null,"abstract":"<p><strong>Background: </strong>Robust vaccine cold-chain management safeguards potency and public trust. Korea, Japan, and Taiwan share core practices (2-8°C storage, continuous monitoring, first-expiry-first-out [FEFO] stock rotation) yet differ in implementation and governance. We compared standards and real-world practices across the three systems to identify actionable improvements for Korea.</p><p><strong>Methods: </strong>From March-July 2025 we conducted structured interviews and onsite observations at public health centers, hospitals, and clinics in Korea, Taiwan (National Taiwan University Children's Hospital), and Japan (Kyoto University Hospital, Katsura Hospital, and multiple Osaka/Mie sites). We reviewed the latest national guidance and synthesized findings across four domains: 1) storage facilities/equipment, 2) temperature monitoring and excursion response, 3) inventory management/disposal, and 4) governance/compliance.</p><p><strong>Results: </strong>All three countries uphold core cold-chain principles, but system design varies. Taiwan applies centrally coordinated, de facto mandatory standards: government-supported data loggers with alarms, immediate excursion reporting, regular checklist-based inspections, regional backup storage, and a differentiated wastage policy (reimbursement for unavoidable loss; penalties for preventable waste). Japan employs a trust-based, decentralized model, where the widespread use of purpose-built refrigerators and continuous monitoring is common practice rather than a national legal mandate. This system is governed by professional norms, provider-borne financial liability for waste, provider-led excursion decisions (discarding if viability is uncertain), and local-level stock redistribution networks. Korea's evolving hybrid model provides detailed technical guidance (since 2021), promotes automated monitoring and FEFO, and encourages contingency planning; however, requirements are largely advisory, inspections are ad hoc, and formal redistribution and incident-reporting systems remain under development. Comparative tables highlight stricter equipment mandates and enforcement in Taiwan, Japan's reliance on professional norms and financial incentives, and Korea's partial implementation gap.</p><p><strong>Conclusion: </strong>To strengthen reliability and reduce waste, Korea could 1) confer regulatory status on key standards, 2) institute routine audits and incident reporting, 3) formalize regional backup/storage networks, 4) enable systematic stock redistribution, and 5) align incentives with a differentiated compensation scheme. Drawing on Taiwan's enforcement/support model and Japan's local-level redistribution networks can help Korea achieve uniformly high performance while maintaining operational feasibility.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 31","pages":"e200"},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457786/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706814","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":"Real-World Treatment Patterns for Waldenstrom Macroglobulinemia: Implications for Treatment Sequencing.","authors":"Seo Yoon Jang, Ja Min Byun, Sung-Soo Park, Youngju Kim, Jeongmin Park, Dong-Yeop Shin, Youngil Koh, Inho Kim, Chang Ki Min, Sung-Soo Yoon","doi":"10.3346/jkms.2026.41.e206","DOIUrl":"10.3346/jkms.2026.41.e206","url":null,"abstract":"<p><strong>Background: </strong>Due to the rarity of Waldenstrom macroglobulinemia (WM) and scarcity of direct comparative data, there remains uncertainty regarding the optimal therapeutic approach for treatment-naïve patients and subsequent treatment sequence. To bridge such knowledge gap and generate data on most appropriate treatment in relatively resource constraint setting, we conducted this study with 168 WM patients.</p><p><strong>Methods: </strong>Due to the diversity of treatment regimens, patients were categorized into four groups: cytotoxic regimen, rituximab-based regimen, proteasome inhibitor (PI)/immunomodulatory drug (IMiD)-based regimen, and bruton tyrosine kinase inhibitor (BTKi). Treatment patterns and efficacy outcomes were analyzed.</p><p><strong>Results: </strong>The overall response rate (ORR) between rituximab-based vs. PI/IMiD based regimens were similar (74.2% vs. 80.0%, <i>P</i> = 0.750), but rituximab-based regimens were associated with longer response (median progression free survival [PFS] 44.3 vs. 8.5 months, <i>P</i> < 0.001), while PI/IMiD based regimens were associated with faster response (median time to initial response 1.8 vs. 0.9 months, <i>P</i> = 0.040). Among rituximab-based regimens, bendamustine-rituximab was associated with better response (ORR, 83.3%) and significantly longer PFS compared to rituximab + cyclophosphamide-based regimen group (median PFS 61.3 months vs. 18.2 months, <i>P</i> < 0.001). Ultimately 56% underwent second line treatment. Prior treatment did not seem to affect subsequent BTKi efficacy.</p><p><strong>Conclusion: </strong>Our findings underscore the importance of optimizing treatment strategies and offer real-world data to support informed decision-making in settings with constrained resources.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 31","pages":"e206"},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457695/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706808","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 Palliative Care Access Between Patients With Liver Cirrhosis and Hepatocellular Carcinoma: Nationwide Population-Based Study.","authors":"Jung Sil Jang, Si Nae Oh, Haeyong Pak","doi":"10.3346/jkms.2026.41.e202","DOIUrl":"10.3346/jkms.2026.41.e202","url":null,"abstract":"<p><strong>Background: </strong>In August 2017, Republic of Korea (South Korea) expanded its national hospice and palliative care program to cover several serious non-cancer illnesses, including liver cirrhosis (LC). We aimed to examine the access of palliative care services among adults who died of LC compared with those who died of hepatocellular carcinoma (HCC).</p><p><strong>Methods: </strong>We conducted a population-based retrospective cohort study using National Health Insurance Service data, including adults who died of LC or HCC between 2018 and 2022. Associations between cause of death (LC vs. HCC) and advance care planning (ACP) completion and receipt of hospice and palliative care services were estimated using multivariable logistic regression.</p><p><strong>Results: </strong>The final analytic cohort comprised 44,787 patients died from LC (71% women; mean age, 66 years) and 58,685 patients died from HCC (67% women; mean age, 70 years). Patients with LC had significantly lower rates of ACP completion (23.1 vs. 31.2%; adjusted odds ratio [aOR], 0.765; 95% confidence interval [CI], 0.723-0.809; <i>P</i> < 0.001) and hospice and palliative care service utilization (3.7% vs. 9.1%; aOR, 0.558; 95% CI, 0.499-0.623; <i>P</i> < 0.001) compared to those with HCC.</p><p><strong>Conclusion: </strong>Despite nationwide coverage of hospice and palliative care services, LC decedents remained less likely than HCC decedents to complete ACP or receive hospice and palliative-care services in Korea.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 31","pages":"e202"},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706852","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":"Toward a Unified Framework for Climate and Health Research: Gaps in Exposure Metrics and Health Outcomes.","authors":"Soonsu Shin, Dajeong Ham, Sanghyuk Bae, Minkyo Song","doi":"10.3346/jkms.2026.41.e294","DOIUrl":"10.3346/jkms.2026.41.e294","url":null,"abstract":"<p><p>As the health impacts of climate change become increasingly evident, research on climate-related exposures and health outcomes has grown. However, a disproportionate focus on certain exposures and health outcomes persists, and substantial inconsistencies remain in the definitions and measurement methods used across studies, hindering the integration of findings and the development of comprehensive public health strategies. To address this gap, we assessed epidemiological literature, identifying uneven research distribution and highlighting areas requiring further investigation. We conducted a literature search in PubMed, the Cochrane Library, and Embase using key terms related to climate change and health. A total of 611 original studies on human populations, published in English from January 2000 to June 2024, were included. Significant heterogeneity was evident in the definitions of climate-related exposure metrics. The focus areas of climate-related exposure were narrow, primarily limited to temperature and temperature-related hazards (n = 526), precipitation (n = 88), and air pollution (n = 39), while research on extreme weather events was scarce. Similarly, the scope of health outcomes studied was largely confined to all-cause mortality (n = 249), cardiovascular disease (n = 159), and communicable diseases (n = 148). In contrast, relatively few studies have addressed the impacts of climate change on neurodegenerative diseases (n = 8), endocrine disorders (n = 4), or hematologic diseases (n = 3), indicating a critical need for broader investigation into these underrepresented health outcomes. Future research should prioritize the transparent reporting of both context-specific and standardized exposure definitions to improve cross-study comparability and broaden its scope to encompass more diverse climate-related exposures and health outcomes.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 31","pages":"e294"},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457779/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706817","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":"Validation of Self-Reported Disease History in Korea: A National Health Insurance Cohort Study.","authors":"Yeon Woo Oh, Eun-Cheol Park","doi":"10.3346/jkms.2026.41.e201","DOIUrl":"10.3346/jkms.2026.41.e201","url":null,"abstract":"<p><strong>Background: </strong>Self-reported disease history is widely used in epidemiological studies but is susceptible to misclassification. This study aimed to evaluate the accuracy of self-reported history of hypertension, diabetes, dyslipidemia, and stroke in Korea and to identify factors associated with reporting accuracy.</p><p><strong>Methods: </strong>We analyzed data from the National Health Insurance Service (NHIS)-National Sample Cohort (2002-2019) for participants aged ≥ 40 years who underwent health check-ups (n = 312,367 for hypertension, 291,356 for diabetes, 289,596 for dyslipidemia, and 278,296 for stroke). Self-reported disease history was compared with medical claims records, which served as the reference standard for diagnosis history. Sensitivity, specificity, positive predictive value, negative predictive value, and observed agreement were calculated. Logistic regression models identified factors associated with false negative responses.</p><p><strong>Results: </strong>Self-reported prevalence was substantially lower than claims-based prevalence across all conditions: hypertension (33.9% vs. 47.9%), diabetes (15.0% vs. 36.1%), dyslipidemia (14.7% vs. 66.8%), and stroke (2.0% vs. 7.7%). Sensitivity was highest for hypertension (69.9%), followed by diabetes (40.7%), dyslipidemia (21.6%), and stroke (21.8%). Specificities exceeded 99% for all conditions. Factors reflecting greater healthcare engagement-advanced age and higher comorbidity burden-were associated with better reporting accuracy. Longer duration since initial diagnosis improved sensitivity for chronic conditions, while longer time since last hospital visit decreased sensitivity for hypertension and dyslipidemia.</p><p><strong>Conclusion: </strong>Self-reported disease history in the NHIS health check-up demonstrates high specificity but variable sensitivity across conditions, with underreporting being the primary concern. Temporal factors and healthcare engagement patterns significantly influence reporting accuracy. Our disease-specific validation parameters provide essential benchmarks for bias correction in epidemiological research and clinical practice in Korea, particularly for conditions with lower reporting sensitivities.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 31","pages":"e201"},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457785/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706855","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":"Risk of Cardiovascular Disease According to Standard Industrial Sectors: A Nationwide Longitudinal Study.","authors":"Hee Joo Park, Youngsun Park, Juyeon Oh, Jian Lee, Juho Sim, Byungyoon Yun, Jin-Ha Yoon","doi":"10.3346/jkms.2026.41.e203","DOIUrl":"10.3346/jkms.2026.41.e203","url":null,"abstract":"<p><strong>Background: </strong>Cardiovascular disease (CVD) is a leading global cause of morbidity and mortality, with occupational factors significantly contributing to risk. However, industry-specific CVD risks in Asia remain understudied. This study evaluates CVD and all-cause mortality risks across industrial sectors in Republic of Korean (South Korea) using a nationally representative dataset.</p><p><strong>Methods: </strong>This study examined middle-aged paid workers (aged 40-59 years) using data from the National Health Insurance Service database, which integrates biennial health screening data with insurance claims. We included individuals who underwent health examinations between 2009 and 2010 and followed them to identify CVD events through insurance claims records. Age-standardized incidence ratios were calculated using indirect standardization with the entire population as the control group, and 95% confidence intervals (CIs) were estimated using the Poisson distribution, with results stratified by sex. Population-attributable fractions were calculated to estimate each sector's contribution to the CVD burden.</p><p><strong>Results: </strong>Among males, the highest standardized incident ratios for CVD were observed in the \"A. Agriculture, Forestry and Fishing\" (1.20; 95% CI, 1.10-1.31) and \"H. Transportation and Storage\" (1.19; 1.17-1.21) sectors. For females, elevated standardized incidence ratios were found in the \"D. Electricity, Gas, Steam and Air Conditioning Supply\" (1.31; 1.09-1.57) and \"H. Transportation and Storage\" (1.15; 1.10-1.20) sectors. The \"H. Transportation and Storage\" sector showed the highest population-attributable fraction for males (3.34%), while the \"I. Accommodation and Food Service Activities\" sector led for females (1.64%).</p><p><strong>Conclusion: </strong>This study provides the first comprehensive analysis of industry-specific CVD risks in Asia, highlighting elevated risks in transportation possibly due to long working hours, sedentary behavior, and occupational stress. Targeted interventions are needed to address these occupational health disparities.</p>","PeriodicalId":16249,"journal":{"name":"Journal of Korean Medical Science","volume":"41 31","pages":"e203"},"PeriodicalIF":3.2,"publicationDate":"2026-08-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13457691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148706860","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}