Journal Of Korean Medical Science[JOURNAL]
Sun
200 papers
Protocol for DESCIDE-RD: Determining Effectiveness of Shared Decision Making in Drug Therapy Selection for Rheumatic Diseases.
Choi SR, Cho SK, Nam B … +9 more , Park HR, Lee SB, Ko HR, Choi YJ, Nam E, Lee SW, Yoon S, Sung YK, and on behalf of DESCIDE-RD Investigators
J Korean Med Sci · 2026 Jan · PMID 41589079 · Full text
The availability of biologic agents and Janus kinase (JAK) inhibitors has expanded therapeutic options for rheumatic diseases, and international guidelines now recommend shared decision-making (SDM) to guide treatment se...
The availability of biologic agents and Janus kinase (JAK) inhibitors has expanded therapeutic options for rheumatic diseases, and international guidelines now recommend shared decision-making (SDM) to guide treatment selection. This study will evaluate whether a structured SDM model enhances patients' perceptions of SDM when selecting biologic agents or JAK inhibitors for rheumatoid arthritis (RA) and ankylosing spondylitis (AS), compared to standard care. This open-label, multicentre, stratified cluster-randomised trial will enrol 300 patients with RA or AS. Participants will be assigned in a 1:1:1 ratio to one of three groups: SDM Group I, SDM Group II, or standard care. In the SDM groups, the Three-Talk Model (Team Talk, Option Talk, and Decision Talk) will be implemented. SDM Group I will receive decision aids during Option Talk, while SDM Group II will receive both decision aids and an artificial intelligence-based chatbot. In the standard care group, treatment recommendations will be made at the physician's discretion. The primary outcome will be the Shared Decision-Making Questionnaire score. Secondary outcomes will include changes in the Decisional Conflict Scale, the Health Empowerment Scale, the Leeds Satisfaction Questionnaire, and the EuroQol-5 Dimension. Data will be collected using iCReaT (http://icreat.kr). This study will provide evidence on the effectiveness of structured SDM in selecting biologic agents and JAK inhibitors for RA and AS, with potential implications for improving treatment decisions and patient outcomes. Clinical Research Information Service Identifier: KCT0011310.
Study Protocol of a Korean Patient-Centered Shared Decision-Making Model for Management of Severe Knee Osteoarthritis: A Multicenter Pragmatic Clinical Trial (K-SDM-KOA).
Choi BS, Seo S, Chang MJ … +6 more , Kim JI, Kim SH, Lee DW, Ro DH, Choi H, Han HS
J Korean Med Sci · 2026 Jan · PMID 41589078 · Full text
Severe knee osteoarthritis (KOA) involves complex, preference-sensitive treatment decisions, ranging from non-operative to surgical options. However, despite the preference-sensitive nature of KOA, existing shared decisi...
Severe knee osteoarthritis (KOA) involves complex, preference-sensitive treatment decisions, ranging from non-operative to surgical options. However, despite the preference-sensitive nature of KOA, existing shared decision-making (SDM) processes often lack clarity in effectively incorporating patients' values and preferences into treatment decisions. Moreover, most SDM models have been developed in western contexts, which may limit their applicability in other cultural settings. To address these limitations, a Korean Shared Decision-Making Model for KOA (K-SDM-KOA) has been developed using a culturally adapted, five-step framework that integrates a web-based decision-support platform and age-friendly educational media. The K-SDM-KOA model is designed to support preference-sensitive decision-making through a pragmatic, multicenter cohort framework involving 1,300 patients with Kellgren-Lawrence grade 3-4 across five hospitals. Within this framework, patients receive either standard care or the K-SDM-KOA intervention, which combines pre-consultation preparation (step 1-3) with in-clinic deliberation and decision-making (step 4-5). The primary outcome is patient-perceived SDM measured using the Korean-validated 9-item Shared Decision Making Questionnaire, reported on a 0-100 scale, with higher scores indicating greater SDM. Secondary outcomes include patients' preferred role in decision-making, decisional conflict, decision regret, and knowledge gain related to KOA. Additionally, a nested cohort of 50 patients undergoing contralateral total knee arthroplasty will provide paired analyses of early pain and function (visual analogue scale, Western Ontario and McMaster Universities Osteoarthritis Index, Knee Society Score) at baseline, 3 months, and 12 months. Analyses will follow an intention-to-treat principle and employ linear mixed-effect models and appropriate statistical tests to assess between group differences. This article presents a culturally tailored, technology-supported SDM model designed to enhance decision quality and early patient-reported outcomes in severe KOA. Findings may provide a foundation for future empirical studies and support the broader adoption of structured SDM in Korea's healthcare system.
Shared Decision-Making for Periodontally Compromised Teeth: Study Protocol for an Ongoing Prospective Multicenter Before-and-After Clinical Trial.
Ko KA, Jung JY, Park Y … +14 more , Chi C, Jung HI, Cho YD, Joo JY, Yu SJ, Cho IW, Kim YG, Lee DW, Kim YT, Lee JK, Kim OS, Hong JY, Lee JH, Lee JS
J Korean Med Sci · 2026 Jan · PMID 41589077 · Full text
Treatment decisions for teeth with poor periodontal prognosis are often complicated, requiring careful balancing of clinical evidence and patient values. Shared decision-making (SDM) is increasingly recognized as a benef...
Treatment decisions for teeth with poor periodontal prognosis are often complicated, requiring careful balancing of clinical evidence and patient values. Shared decision-making (SDM) is increasingly recognized as a beneficial approach to align clinical judgment with patient preferences. However, structured SDM implementation in dental settings remains limited. This study was designed to evaluate the effectiveness of a structured SDM protocol compared to usual care decision-making for patients with severe periodontitis and hopeless-prognosis teeth. A multicenter, before-and-after clinical trial will be conducted across 12 dental centers in South Korea. Each center will apply usual care decision-making for the first six months, followed by the SDM intervention for the subsequent six months. The SDM process involves a three-step model: team talk, option talk (aided by web-based decision aids), and decision talk. Eligible participants include patients with stage III or IV periodontitis and at least one hopeless-prognosis tooth. Each patient follows a three-visit schedule. Primary outcome is the rate of tooth preservation decisions. Secondary outcomes include measures related to SDM (SDM-Q-9, SDM-Q-Doc), patient experience (Perceived Involvement in Care Scale [PICS], Decisional Regret Scale [DRS], treatment adherence), and clinical measures (periodontal condition and treatment costs). Data are collected via Research Electronic Data Capture, and statistical analyses include McNemar's test for binary outcomes and repeated-measures analysis of variance for continuous data. This study is expected to provide evidence supporting the integration of structured SDM protocols in dental practice. By evaluating both patient-centered and clinical outcomes, the research aims to advance personalized, participatory approaches in managing severe periodontitis. Clinical Research Information Service Identifier: KCT0010405.
Toward the Implementation of Shared Decision-Making in Korean Clinical Practice: Study Protocol for a Foundational Research Project.
Kim MJ, Yoo SH, Woo KS … +8 more , Choi H, Chang E, Choi K, Park YS, Kim Y, Kim DH, Kim J, Shin DW
J Korean Med Sci · 2026 Jan · PMID 41589076 · Full text
Shared decision-making (SDM) is an essential component of patient-centered care, yet its implementation in South Korea remains limited due to a persistent physician-centered clinical culture. This project, supported by t...
Shared decision-making (SDM) is an essential component of patient-centered care, yet its implementation in South Korea remains limited due to a persistent physician-centered clinical culture. This project, supported by the Ministry of Health and Welfare, aims to establish a foundation for nationwide SDM implementation by developing a culturally adapted Korean SDM model and creating a framework to support its institutionalization and widespread clinical adoption. This four-year project consists of five interlinked work packages (WPs) organized into two phases, each lasting two years. Using a multi-method approach-comprising nationwide surveys, systematic literature reviews, and psychometric validation studies-we will assess the current landscape (WP1) and develop standardized SDM evaluation tools for primary stakeholders (WP2). A clinical research data management system will be designed and implemented to support data integration and monitoring (WP3). The central component involves developing a Korean SDM conceptual model and corresponding implementation strategies (WP4). Economic evaluations and legal analyses will inform the design of a pilot reimbursement framework to support sustainable system-level integration (WP5). The project is expected to produce the following outcomes: i) an analysis of domestic and international SDM trends; ii) validated SDM assessment tools and guidelines tailored for the Korean context; iii) a standardized and interoperable SDM data management system; iv) a culturally grounded Korean SDM model with evidence-based implementation strategies; and v) policy proposals, including a reimbursement model, to facilitate system-wide adoption. This work will provide the theoretical, empirical, and policy basis required to advance SDM within the Korean healthcare system. By addressing cultural characteristics and structural barriers, the resulting SDM model and policy recommendations are expected to support the sustainable institutionalization of SDM and strengthen patient autonomy and the quality of clinical practice in Korea.
Erratum: Correction of Funding in the Article "Prognostic Significance of Fatty Liver Index for the Development of Hypertension and Cardiovascular Events in Populations With Suboptimal Blood Pressure".
Bok Y, Roh JH, An SY … +11 more , Jin SA, Kim JH, Joo HJ, Son JW, Kim SH, Choi S, Han S, Shin MS, Kim EJ, Jeong JO, Working Group on Hypertension Complication
J Korean Med Sci · 2026 Jan · PMID 41555806 · Full text
This corrects the article on p. e135 in vol. 40, PMID: 40625044.
This corrects the article on p. e135 in vol. 40, PMID: 40625044.
Outcomes of Highly Urgent ABO-Incompatible Living Donor Liver Transplantation in National Databases.
Kim J, Kim SJ, Park B … +11 more , Kim K, Choi Y, Hong G, Park JY, Han YS, Yi NJ, Hong SH, Kim SY, Park J, Hwang Y, Jung DH
J Korean Med Sci · 2026 Jan · PMID 41555805 · Full text
BACKGROUND: Highly urgent adult living donor liver transplantation (HU-LDLT) is essential for patients with acute liver failure (ALF), acute-on-chronic liver failure (ACLF), and severe cirrhosis who are in life-threateni...
BACKGROUND: Highly urgent adult living donor liver transplantation (HU-LDLT) is essential for patients with acute liver failure (ALF), acute-on-chronic liver failure (ACLF), and severe cirrhosis who are in life-threatening situations. The results of adult highly urgent ABO-incompatible (ABOi) living donor liver transplantation (LDLT) remain ambiguous when there is insufficient time to await a compatible organ. This study aimed to compare the results of adult ABOi HU-LDLT with those of adult ABO-compatible (ABOc) HU-LDLT utilizing data from the Korean Network for Organ Sharing (KONOS). METHODS: We conducted a retrospective study using KONOS data from 363 consecutive adult HU-LDLT patients between 2017 and 2021 in Korea. RESULTS: The incidence of ABOc-LDLTs and ABOi-LDLTs was 90.6% (n = 329) and 9.4% (n = 34), respectively. Hepatitis B virus infection and alcoholism are the main etiologies of adult HU-LDLT. The median waiting time was 1 day (range, 0-36 days) for ABOc LDLT patients and 3 days (range, 0-28 days) for ABOi LDLT patients. None of the patients developed antibody-mediated rejection during follow-up. The incidence of graft failure was 17.6% in ABOi LDLT patients and 7.6% in ABOc LDLT patients. However, the overall survival and graft survival rates in the ABOi LDLT patients were not different from those in the ABOc LDLT patients. ABOi LDLT was not associated with graft failure or death in multivariable analysis. CONCLUSION: The present study supports ABOi-LDLTs as a feasible and safe treatment for highly urgent patients.
Reliability and Validity of the Korean Version of the Digital Health Literacy Instrument.
Lee J, Ahn C, Park J … +4 more , Kim S, Kim Y, Park J, Shin J
J Korean Med Sci · 2026 Jan · PMID 41555804 · Full text
BACKGROUND: As digital transformation accelerates, individuals increasingly engage with digital health services and online medical resources, and digital health literacy (DHL) becomes increasingly important. While the Di...
BACKGROUND: As digital transformation accelerates, individuals increasingly engage with digital health services and online medical resources, and digital health literacy (DHL) becomes increasingly important. While the Digital Health Literacy Instrument (DHLI) has been validated internationally, a Korean version applicable across all adult age groups remains limited. This study develops and validates the Korean DHLI, assessing its reliability and validity for broader applicability among Korean adults. METHODS: The DHLI was translated, culturally adapted, and reviewed by expert panels following World Health Organization guidelines. A cross-sectional nationwide web survey was conducted with 524 adults aged 19-69. A follow-up survey was administered to 134 participants after four weeks to assess test-retest reliability. Internal consistency and test-retest reliability were assessed. Construct validity was examined using confirmatory factor analysis (CFA) to determine the most appropriate factor structure in the Korean population. Convergent and discriminant validity were assessed, and hypothesis-testing construct validity was evaluated through correlations with age, health status, and eHealth literacy. RESULTS: The Korean version of the DHLI (K-DHLI) exhibited excellent psychometric properties. Internal consistency was high (α = 0.91), and test-retest reliability was deemed acceptable (intraclass correlation coefficient = 0.70). CFA demonstrated a 7-factor model, which showed a superior model fit (χ²/degrees of freedom = 2.14, comparative fit index = 0.966, root mean square error of approximation = 0.047) as compared to the 5-factor model. Convergent and discriminant validity were confirmed, with AVE values ranging from 0.7218 to 0.8947 and construct reliability values between 0.8837 and 0.9622. Hypothesis-testing construct validity was supported by hypothesized correlations between K-DHLI scores and age ( = -0.254, < 0.001), health status ( = 0.252, < 0.001), and eHealth literacy ( = 0.688, < 0.001). CONCLUSION: The K-DHLI is a reliable and valid instrument for assessing DHL in the Korean population. The findings confirm that the 7-factor structure demonstrates superior model fit and further support its applicability across diverse adult groups. This study provides a standardized instrument for assessing DHL in Korea and facilitates its use in national surveys, clinical screening, and research. It may help identify individuals with limited DHL, thereby supporting targeted interventions to reduce health disparities and improve access to care.
Kidney Injury Induced by High-Dose Chaga Mushroom Consumption: Experimental Evidence in a Rat Model.
Lee S, Cui S, Fang X … +6 more , Lee H, Lim SW, Shin YJ, Li C, Yang CW, Chung BH
J Korean Med Sci · 2026 Jan · PMID 41555803 · Full text
BACKGROUND: Kidney damage can result not only from the overproduction of endogenous oxalate but also from excessive dietary intake. This study investigated whether oxalate-rich Chaga mushroom induces kidney injury. METHO...
BACKGROUND: Kidney damage can result not only from the overproduction of endogenous oxalate but also from excessive dietary intake. This study investigated whether oxalate-rich Chaga mushroom induces kidney injury. METHODS: Wistar rats were allocated to three groups based on dosese extrapolated from a previously reported clinical case. The standard-dose group received Chaga mushroom powder at 1,281.6 mg/kg body weight (equivalent to oxalate at 183 mg/kg body weight), and the high-dose (HD) group at 3,844.8 mg/kg body weight (equivalent to oxalate at 549 mg/kg body weight); the control group received no supplements. The study assessed chronic kidney injury by evaluating renal function, histopathology, oxidative stress, and apoptosis via immunohistochemistry and immunoblot assay. RESULTS: The final body weight of the HD group was significantly lower than that of the other groups ( = 0.011), and urinary protein excretion in the HD group was significantly higher than in the other groups ( = 0.001). Histopathologic examination revealed oxalate crystal deposition and tubular injury in the HD group. Oxidative stress markers, including 8-hydroxy-2'-deoxyguanosine levels in serum, urine, and kidney tissue from the HD group, were significantly elevated compared to other groups ( < 0.05). CD68/SR-D1 antibody levels in the HD group were significantly increased ( < 0.050). Terminal deoxynucleotidyl transferase deoxyuridine triphosphate nick end labeling and Bax positive cells in the HD group were higher than in other groups ( < 0.05), while Bcl positive cells were fewer ( < 0.05). CONCLUSION: High-dose consumption of Chaga mushrooms may cause kidney damage due to its high oxalate content.
Hand Grip Strength Predicts Cognitive Decline in Subjective Cognitive Decline: 2-Year Follow-up Results.
Lim EY, Hong YJ, Jeong JH … +6 more , Park KH, Kim S, Wang MJ, Shim Y, Choi SH, Yang DW
J Korean Med Sci · 2026 Jan · PMID 41555802 · Full text
BACKGROUND: Hand grip strength (HGS) has been proposed as a potential clinical marker for cognitive decline. However, its association with domain-specific cognitive changes and underlying amyloid pathology remains unclea...
BACKGROUND: Hand grip strength (HGS) has been proposed as a potential clinical marker for cognitive decline. However, its association with domain-specific cognitive changes and underlying amyloid pathology remains unclear. METHODS: This longitudinal study included 107 older adults with subjective cognitive decline (SCD) who completed a 24-month follow-up. Participants were categorized based on the presence of HGS weakness using Asian Working Group of Sarcopenia criteria. Logistic regression analyses were performed to examine the association between baseline HGS and cognitive decline across multiple domains, adjusting for relevant covariates. Repeated measures analysis of variance evaluated longitudinal changes in neuropsychological performance. RESULTS: Participants with HGS weakness had significantly higher amyloid positron emission tomography (PET) positivity (47.1% vs. 18.9%, = 0.012). HGS weakness was associated with poorer baseline performance and greater decline in visuospatial and executive function over 24 months. Baseline HGS weakness predicted decline in visuospatial function (odds ratio [OR], 3.517; 95% confidence interval [CI], 1.072-11.535) and verbal memory (OR, 3.503; 95% CI, 1.046-11.729), but these associations lost significance after adjusting for amyloid positivity. CONCLUSION: HGS weakness is associated with cognitive decline, particularly in visuospatial and executive domains, and may serve as an early indicator of amyloid-related neurodegeneration in older adults with SCD. HGS assessment could be a practical clinical tool for identifying individuals at risk, especially when amyloid PET is not available.
Seroepidemiological Study of Varicella Zoster Virus in Korea, 2023.
Cho Y, Cho EY, Lee A … +1 more , Lee H
J Korean Med Sci · 2026 Jan · PMID 41555801 · Full text
BACKGROUND: Seroprevalence studies monitor changes in the immune status of populations. During the coronavirus disease 2019 (COVID-19) pandemic, public health measures such as social distancing and mask-wearing led to si...
BACKGROUND: Seroprevalence studies monitor changes in the immune status of populations. During the coronavirus disease 2019 (COVID-19) pandemic, public health measures such as social distancing and mask-wearing led to significant changes in the epidemiology and transmission patterns of many infectious diseases. In the post-pandemic period, outbreaks of various infectious diseases have been reported globally. In this context, this study evaluated changes in varicella zoster virus (VZV) seroepidemiology in the Republic of Korea after the COVID-19 pandemic. METHODS: Residual serum samples were collected from specimens referred to Seoul Clinical Laboratories in 2023. Serum samples were collected after anonymization, with all identifiable information excluded except for date, age, sex, and region. Samples were collected evenly by age group in 5-year intervals. The evaluation of anti-VZV IgG antibodies was performed using a chemiluminescence immunoassay analyzer (LiaisonXL; Diasorin). RESULTS: The study population comprised 995 participants including 581 males and 414 females. The overall VZV IgG seropositivity rate was 82.9%. The seropositivity rates of VZV IgG antibodies were 88.1% in males and 75.6% in females. VZV IgG seroprevalence showed variations across different age groups. VZV IgG seropositivity was 80% in the 1-4 year age group, declined to 53% in the 5-9 year age group, and reached its lowest at 43% in 10-14 year-olds. Seropositivity rates steadily increased from 71% in the 15-19 year-olds, to 85% in the 25-29 year group, and exceeded 95% in subjects ≥ 40 year of age. CONCLUSION: Seropositivity rates in children (5-19 year) and adults (20-39 year) were lower than in previous studies in the Republic of Korea, likely due to reduced community exposure to varicella during the pandemic. These findings highlight a potential need to reinforce infection control measures and vaccination policies to address vulnerable age groups.
Nationwide Trends and Future Projections of Diabetes and Diabetic Retinopathy Prevalence in Korea: Korean National Health and Nutrition Examination Survey Study.
Kim MS, Nam S, Lee J … +1 more , Woo SJ
J Korean Med Sci · 2026 Jan · PMID 41555800 · Full text
BACKGROUND: The prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) is expected to increase globally; however, there have been no reports predicting DR prevalence in Korea. This study aimed to estimate the...
BACKGROUND: The prevalence of diabetes mellitus (DM) and diabetic retinopathy (DR) is expected to increase globally; however, there have been no reports predicting DR prevalence in Korea. This study aimed to estimate the nationwide trend of the prevalence of DM and DR in Korea. METHODS: Diabetic patients aged over 40 were included from the Korean National Health and Nutrition Examination Survey database (2008-2020). The prevalence of DM and DR during the study period was calculated. Four interpolation methods were applied to address the missing DR data (2013-2016), and the method with the smallest error was selected for projection. Holt's linear trend model was used to predict DM and DR prevalence through 2040. We further projected the future number of DR patients in Korea using population projections. RESULTS: We included 8,007 diabetic patients aged 40 years or older and 4,540 individuals with fundus photography results. The prevalence of DM increased from 13.2% in 2008 to 17.3% (4.98 million) in 2020, while the prevalence of DR rose from 16.6% in 2008 to 24.6% (1.23 million) in 2020. The projected prevalence of DM is estimated to reach 19.7% in 2030 and 23.0% in 2040, while DR prevalence is expected to rise to 30.8% (1.97 million) in 2030 and 38.8% (3.15 million) in 2040. CONCLUSION: The prevalence of DM and DR, as well as the number of patients, have increased over 13 years, and this trend is projected to continue through 2040 in Korea. Therefore, it is essential to establish effective healthcare strategies to address this trend.
Semi-Supervised Fatty Liver Classification Using Attention-Based Graph Neural Network Models.
Kim SY, Wang S, Sohn KA … +1 more , Choe EK
J Korean Med Sci · 2026 Jan · PMID 41555799 · Full text
BACKGROUND: Fatty liver disease is a common condition linked to metabolic syndrome, cardiovascular diseases, and liver cirrhosis, and timely, accurate diagnosis is crucial. In clinical studies, incorporating deep learnin...
BACKGROUND: Fatty liver disease is a common condition linked to metabolic syndrome, cardiovascular diseases, and liver cirrhosis, and timely, accurate diagnosis is crucial. In clinical studies, incorporating deep learning models often faces the challenge of scarce labeled data. This study investigates the effectiveness of graph-based deep learning models with attention mechanisms to predict fatty liver disease even with limited labeled data. METHODS: We utilized a dataset of 7,953 individuals, focusing on clinical variables obtained during health check-ups. Graph Neural Networks (GNNs) with attention mechanisms were assessed for predicting fatty liver disease in a semi-supervised learning setting. GNNExplainer was employed for feature importance analysis, and subgroup analysis was conducted to identify clusters with distinct risk factors. RESULTS: Our findings indicate that attention-based GNNs significantly outperformed conventional models in predicting fatty liver disease under semi-supervised settings, with statistically significant improvements in area under the curves (AUCs) (all < 0.05) compared to logistic regression across most labeling scenarios. With only 10 labeled samples per class, the Graph Attention Network (GAT) and Simplified Graph Transformer with Graph Attention achieved AUCs of 0.7049 ± 0.0570 and 0.7184 ± 0.0395, respectively, and achieved AUCs of 0.7893 ± 0.0171 when 100 labeled samples were used. Feature importance analysis identified HbA1c (relative importance score = 1.0), body fat amount (0.998), and glucose (0.6934) as the most influential predictors. Subgroup analysis revealed two distinct patient clusters-one characterized by metabolic risk factors and the other by demographic and lifestyle factors-emphasizing the potential for individualized risk stratification in fatty liver disease. CONCLUSION: Attention-based GNNs demonstrated strong predictive performance for fatty liver disease using a small number of labeled samples. This methodological approach illustrates how graph-based learning can leverage relational structures in routine clinical data to support data-efficient, individualized risk assessment in label-constrained settings.
Erratum: Correction of Figures in the Article "Validation of the Phoenix Criteria for Sepsis and Septic Shock in a Pediatric Intensive Care Unit".
Han CH, Kim H, Park M … +5 more , Kim SY, Kim JD, Sohn MH, You SC, Kim KW
J Korean Med Sci · 2026 Jan · PMID 41527319 · Full text
This corrects the article on p. e106 in vol. 40, PMID: 40098493.
This corrects the article on p. e106 in vol. 40, PMID: 40098493.
Welcoming the Resumption of the Section.
Yoo JH
J Korean Med Sci · 2026 Jan · PMID 41527318 · Full text
Abstract loading — click title to view on PubMed.
Risk of Depression Related to Use of Proton Pump Inhibitors and Tegoprazan: A Nationwide Cohort Study.
Kim S, Kim JS
J Korean Med Sci · 2026 Jan · PMID 41527317 · Full text
BACKGROUND: There are potential concerns of depression associated with the use of gastric acid suppressants. This study compared associations of potassium competitive acid blockers (PCABs) and proton pump inhibitors (PPI...
BACKGROUND: There are potential concerns of depression associated with the use of gastric acid suppressants. This study compared associations of potassium competitive acid blockers (PCABs) and proton pump inhibitors (PPIs) with the development of depressive disorder. METHODS: Patients newly prescribed five PPIs (omeprazole, pantoprazole, lansoprazole, rabeprazole, and esomeprazole) and one PCAB (tegoprazan) from January 2020 to April 2022 were identified by Health Insurance Review and Assessment Service. Primary outcome was diagnosis of depression with more than 60 prescription days of antidepressants. Multivariable logistic regression and survival curve analysis with Kaplan-Maier method were performed with two models to calculate the risk of depression with all PPIs (model 1) or each individual PPIs (model 2) compared to tegoprazan. Sensitivity analyses using propensity score matching (PSM) and subgroup analyses stratified by treatment duration were followed. RESULTS: A total of 6,104,743 patients aged 18-80 years were included. The occurrence of depression was higher in all PPI groups (adjusted odds ratio for all PPIs, 1.34; 95% confidence interval, 1.24-1.44; lansoprazole, 1.80; pantoprazole, 1.42; esomeprazole, 1.32; rabeprazole, 1.22; omeprazole, 1.15) than in the PCAB group. Cumulative incidence of depression up to 1200 days after beginning prescription was significantly higher in PPI groups (all < 0.001) than in the PCAB group. Sensitivity and subgroup analyses using PSM replicated significance except for esomeprazole. CONCLUSION: In this national longitudinal study, PCAB users had a lower likelihood of developing depression than PPI users. Additional studies on the biological mechanism for the risk of depression and gastric acid suppressants are needed.
Sex-Specific Association of Drinking Habit and Alcohol Beverage Type With Serum Uric Acid in a Healthy Population.
Hong S, Kim K, Hwang J … +10 more , Hur J, Chang Y, Cha HS, Cho SJ, Kim J, Son H, Lim H, Park HD, Ahn JK, Kang M
J Korean Med Sci · 2026 Jan · PMID 41527316 · Full text
BACKGROUND: This study aimed to assess the sex-specific effects of alcohol consumption on serum uric acid (SUA) levels regarding alcohol amount, beverage types and drinking habits in Koreans. METHODS: We evaluated 17,011...
BACKGROUND: This study aimed to assess the sex-specific effects of alcohol consumption on serum uric acid (SUA) levels regarding alcohol amount, beverage types and drinking habits in Koreans. METHODS: We evaluated 17,011 adults who underwent health examinations at Samsung Medical Center between January 2011 and June 2016. Alcohol intake was measured in a standard drink unit (SDU), contained 8 g of ethanol. Individuals were categorized into six groups according to their alcohol intake from none to heavy drinkers. A dominant beverage was defined if it accounted for more than 75% of total alcohol intake. Multivariable linear regression models were used to investigate alcohol effect on SUA levels. RESULTS: The mean age was 51.67 ± 7.10 years, with 53.4% of men. Higher total alcohol intake was associated with higher SUA levels ( for trend < 0.001). This dose-dependent association was observed for all beverage types. Among men, heavy drinking showed a larger effect on SUA levels in the beer-dominant group (0.88 [95% confidence interval {CI}, 0.36-1.41] mg/dL per SDU) than in other dominant groups. Little soju intake in men and light beer intake in women were associated with elevated SUA levels (0.12 [95% CI, 0.03-0.20] and 0.34 [95% CI, 0.18-0.50] mg/dL per SDU, respectively). The increment in SUA levels was higher in subjects with a body mass index (BMI) < 25 kg/m² than in those with BMI ≥ 25 kg/m² across most beverage types. The effect of soju intake on SUA levels was more than twice as high in women compared to men (0.07 [95% CI, 0.02-0.11] versus 0.03 [95% CI, 0.02-0.04] mg/dL per SDU) in the BMI < 25 kg/m² group. CONCLUSION: Dose-dependent associations between SUA levels and alcohol consumption were consistently observed across different beverage types, drinking habits, sex, and BMI, even at low dose alcohol intake. These findings may aid healthcare providers to offer personalized guidance on alcohol consumption for individuals with hyperuricemia.
Case 21: A 29-Year-Old Man With Bloating and Borborygmus.
Kang Y, Cho Y, Baek JE … +5 more , Yang K, Lim J, Lee DS, Cheung DY, Lee HH
J Korean Med Sci · 2026 Jan · PMID 41527315 · Full text
Abstract loading — click title to view on PubMed.
Clinical Outcomes of a Coordinator-Based Fracture Liaison Service for Hip Fractures in Korea.
Kim SH, Cha Y, Kim JH … +4 more , Yoo JI, Kim JT, Kim JW, Choy W
J Korean Med Sci · 2026 Jan · PMID 41527314 · Full text
BACKGROUND: Hip fractures in older adults are associated with high rates of mortality, functional decline, and secondary fractures. Although Fracture Liaison Services (FLSs) have shown clinical benefits in many countries...
BACKGROUND: Hip fractures in older adults are associated with high rates of mortality, functional decline, and secondary fractures. Although Fracture Liaison Services (FLSs) have shown clinical benefits in many countries, a comprehensive, coordinator-based FLS model has not been widely implemented in Korea. This study aimed to evaluate the clinical impact of a newly introduced coordinator-based FLS in elderly hip fracture patients. METHODS: This prospective cohort study included patients aged 65 and older who were admitted with a hip fracture to a single tertiary hospital between June 2022 and February 2024. Patients were divided into two groups: those who received FLS after July 2023 (n = 105) and those who did not (n = 168). Clinical data were collected during hospitalization and at 6 weeks, 3 months, 6 months, and 1 year postoperatively. Variables included time to surgery, length of hospital stay, mortality, refracture rate, osteoporosis treatment rates, functional and nutritional outcomes, and patient satisfaction. RESULTS: The FLS group had significantly shorter time to surgery (2.5 ± 2.3 vs. 4.4 ± 5.5 days, < 0.001) and hospital stay (20.0 ± 11.3 vs. 24.7 ± 18.0 days, = 0.010). In-hospital mortality (1.0% vs. 4.2%), 6-month (4.8% vs. 6.5%), and 1-year mortality (8.6% vs. 12.5%) were all lower in the FLS group ( < 0.05). Refracture rates at 6 months (2.8% vs. 7.1%) and 1 year (5.7% vs. 10.7%) were also significantly lower in the FLS group ( < 0.05). Osteoporosis medication prescription (68.6% vs. 48.8%) and calcium/vitamin D supplementation (63.8% vs. 15.9%) were significantly higher in the FLS group ( < 0.001). Although no significant differences were observed in functional recovery, the FLS group showed a significant increase in serum albumin over 1 year ( = 0.022). Patient satisfaction exceeded 90% at all follow-up intervals. CONCLUSION: The coordinator-based FLS service reduced the length of hospital stay and time from admission to surgery in elderly hip fracture patients, while also lowering the risk of postoperative mortality and refracture. It increased the prescription rate of osteoporosis medications and can improve patients' nutritional status. However, further research is needed to assess functional improvement.
ChatGPT-4.0 as a Tool for Automated Review of Ethics and Transparency in Biomedical Literature.
Doskaliuk B, Seiil B, Qumar A
J Korean Med Sci · 2026 Jan · PMID 41527313 · Full text
BACKGROUND: The integration of artificial intelligence, specifically large language models, into editorial processes, is gaining interest due to its potential to streamline manuscript assessments, particularly regarding...
BACKGROUND: The integration of artificial intelligence, specifically large language models, into editorial processes, is gaining interest due to its potential to streamline manuscript assessments, particularly regarding ethical and transparency reporting in public health journals. This study aims to evaluate the capability and limitations of ChatGPT-4.0 in accurately detecting missing ethical and transparency statements in research articles published in high-ranked (Q1) versus low-ranked (Q4) public health journals. METHODS: Articles from top-tier (Q1) and low-tier (Q4) public health journals were analyzed using ChatGPT-4.0 for the presence of essential ethical components, including ethics approval, informed consent, animal ethics, conflicts of interest, funding notes, and open data sharing statements. Performance metrics such as sensitivity, recall, and precision were calculated. RESULTS: ChatGPT exhibited high sensitivity and recall across all evaluated components, accurately identifying all missing ethics statements. However, precision varied significantly between categories, with notably high precision for data availability statements (0.96) and significantly lower precision for funding statements (0.16). A comparative analysis between Q1 and Q4 journals showed a marked increase in missing ethics statements in the Q4 group, particularly for open data sharing statements (4 vs. 50 cases), ethics approval (2 vs. 5 cases), and informed consent statements (3 vs. 8 cases). CONCLUSION: ChatGPT-4.0 in preliminary screening shows considerable promise, providing high accuracy in identifying missing ethics statements. However, limitations regarding precision highlight the necessity for additional human checks. A balanced integration of artificial intelligence and human judgment is recommended to enhance editorial checks and maintain ethical standards in public health publishing.
The Impact of National Health Insurance Expansion on Suspected Obstructive Sleep Apnea: A Nine-Year Single-Center Study.
Lee H, Lee E
J Korean Med Sci · 2026 Jan · PMID 41527312 · Full text
BACKGROUND: Despite significant morbidity and mortality, obstructive sleep apnea (OSA) remains underdiagnosed. In 2018, the South Korean National Health Insurance (NHI) expanded its coverage for polysomnography (PSG) to...
BACKGROUND: Despite significant morbidity and mortality, obstructive sleep apnea (OSA) remains underdiagnosed. In 2018, the South Korean National Health Insurance (NHI) expanded its coverage for polysomnography (PSG) to enhance diagnostic access for suspected OSA. This study evaluated the influence of expanded NHI coverage on PSG utilization, patient demographics, and OSA diagnosis rates in a single tertiary center. METHODS: A retrospective analysis was conducted on 1,821 adult patients who underwent in-laboratory PSG between 2015 and 2023. Demographic and clinical data, including comorbidities and PSG parameters, were collected before (pre-NHI, n = 477) and after (post-NHI, n = 1,344) coverage implementation. Patient characteristics, OSA diagnosis rates, and PSG parameters were compared between the two periods. RESULTS: Post-NHI, annual PSG utilization increased by 1.8-fold compared to the pre-NHI period (2015-mid-2018), with OSA diagnosis rates rising by 9.3%, reaching 84.8%, including a 7.7% increase in severe OSA cases. The mean patient age increased by 4.3 years, with a significant increase in patients aged ≥ 60 years (33.1%) and females (22.1%). Despite a stable body mass index, OSA severity metrics and comorbidities were higher post-NHI. Referral sources expanded beyond otorhinolaryngology and comprised 31.5% of the total requests post-NHI. CONCLUSION: Expanded NHI coverage positively affected OSA detection and patient management, providing valuable insights into the potential for policy-driven improvements in the management of sleep disorders. The expanded PSG coverage effectively improved OSA detection in the underserved and high-risk populations.
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