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Article ; Online: Comparative effectiveness of moderate-intensity statin with ezetimibe therapy versus high-intensity statin monotherapy in patients with acute coronary syndrome

Ji-Yong Jang / Seonji Kim / Jaehyeong Cho / Sung-youn Chun / Seng Chan You / Jung-Sun Kim

Scientific Reports, Vol 14, Iss 1, Pp 1-

a nationwide cohort study

2024 Volume 9

Abstract: Abstract The long-term outcome of first-line moderate-intensity statin with ezetimibe combination therapy for secondary prevention after percutaneous coronary intervention in patients with acute coronary syndrome (ACS) compared to high-intensity statin ... ...

Abstract	Abstract The long-term outcome of first-line moderate-intensity statin with ezetimibe combination therapy for secondary prevention after percutaneous coronary intervention in patients with acute coronary syndrome (ACS) compared to high-intensity statin monotherapy remains elusive. The objective of this study was to compare the effectiveness of moderate-intensity statin and ezetimibe combination therapy with high-intensity statin monotherapy. We conducted a nationwide, population-based, retrospective, cohort study of patients with ACS from 2013 to 2019. The patients using combination therapy were matched (1:1) to those using monotherapy. The primary outcome was a composite of myocardial infarction, stroke and all-cause mortality. We estimated the hazard ratios (HR) and 95% confidence intervals (CIs) using the Cox proportional hazards regression. After propensity score matching, 10,723 pairs were selected. Men accounted for 70% of the patients and 37% aged > 70 years. The primary endpoint occurred in 1297 patients (12.1%) in the combination group and in 1426 patients (13.3%) in the monotherapy group, and decreased risk (HR 0.85, 95% CI 0.78–0.92, P < 0.001) in the combination group. Among the patients with ACS, moderate-intensity statin with ezetimibe combination therapy was associated with decreased risk of adverse cardiovascular outcomes compared with high-intensity statin monotherapy in a nationwide population-based study representing routine clinical practice.
Keywords	Medicine ; R ; Science ; Q
Subject code	610 ; 616
Language	English
Publishing date	2024-01-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Effect of renin-angiotensin-aldosterone system inhibitors on Covid-19 patients in Korea.

Jungchan Park / Seung-Hwa Lee / Seng Chan You / Jinseob Kim / Kwangmo Yang

PLoS ONE, Vol 16, Iss 3, p e

2021 Volume 0248058

Abstract: Background The effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated the association between RAAS inhibitor use and outcomes of Covid-19. Methods This ... ...

Abstract	Background The effect of renin-angiotensin-aldosterone system (RAAS) inhibitors in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated the association between RAAS inhibitor use and outcomes of Covid-19. Methods This study was a retrospective observational cohort study that used data based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea by May 15, 2020. These claims comprised all Covid-19 tested cases and the history of medical service use in these patients for the past five years. The primary outcome was all-cause mortality, and the rate of ventilator care was compared between the groups. Results From a total of 7,590 patients diagnosed with Covid-19, two distinct cohorts were generated based on RAAS inhibitors prescribed within 6 months before Covid-19 diagnosis. A total of 1,111 patients was prescribed RAAS inhibitors, and 794 patients were prescribed antihypertensive drugs, excluding RAAS inhibitors. In propensity-score matched analysis, 666 pairs of data set were generated, and all-cause mortality of the RAAS inhibitor group showed no significant difference compared with the non-RAAS inhibitor group (14.6% vs. 11.1%; hazard ratio [HR], 0.79; 95% confidence interval [CI], 0.54-1.15; p = 0.22). The rate of ventilator care was not significantly different between the two groups (4.4% vs. 4.1%; HR, 1.04; 95%CI, 0.60-1.79; p = 0.89). Conclusions RAAS inhibitor treatment did not appear to increase the mortality of Covid-19 patients compared with other antihypertensive drugs, suggesting that they may be safely continued in Covid-19 patients.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	Public Library of Science (PLoS)
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Non-steroidal anti-inflammatory agent use may not be associated with mortality of coronavirus disease 19

Jungchan Park / Seung-Hwa Lee / Seng Chan You / Jinseob Kim / Kwangmo Yang

Scientific Reports, Vol 11, Iss 1, Pp 1-

2021 Volume 7

Abstract: Abstract Non-steroidal anti-inflammatory drugs (NSAIDs) have been widely used in patients with respiratory infection, but their safety in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated an association between ... ...

Abstract	Abstract Non-steroidal anti-inflammatory drugs (NSAIDs) have been widely used in patients with respiratory infection, but their safety in coronavirus disease 19 (Covid-19) patients has not been fully investigated. We evaluated an association between NSAID use and outcomes of Covid-19. This study was a retrospective observational cohort study based on insurance benefit claims sent to the Health Insurance Review and Assessment Service of Korea by May 15, 2020. These claims comprised all Covid-19-tested cases and history of medical service use for the past 3 years in these patients. The primary outcome was all-cause mortality, and the secondary outcome was need for ventilator care. Among 7590 patients diagnosed with Covid-19, two distinct cohorts were generated based on NSAID or acetaminophen prescription within 2 weeks before Covid-19 diagnosis. A total of 398 patients was prescribed NSAIDs, and 2365 patients were prescribed acetaminophen. After propensity score matching, 397 pairs of data set were generated, and all-cause mortality of the NSAIDs group showed no significant difference compared with the acetaminophen group (4.0% vs. 3.0%; hazard ratio [HR], 1.33; 95% confidence interval [CI], 0.63–2.88; P = 0.46). The rate of ventilator care also did not show significantly different results between the two groups (2.0% vs. 1.3%; HR, 1.60; 95% CI 0.53–5.30; P = 0.42). Use of NSAIDs was not associated with mortality or ventilator care in Covid-19 patients. NSAIDs may be safely used to relieve symptoms in patients with suspicion of Covid-19.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2021-03-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Book ; Online: Deep phenotyping of 34,128 patients hospitalised with COVID-19 and a comparison with 81,596 influenza patients in America, Europe and Asia

Edward Burn / Kristin Kostka / Anthony Sena / Martijn Schuemie / Seng Chan You

an international network study

2020

Abstract: Background In this study we phenotyped individuals hospitalised with coronavirus disease 2019 (COVID-19) in depth, summarising entire medical histories, including medications, as captured in routinely collected data drawn from databases across three ... ...

Abstract	Background In this study we phenotyped individuals hospitalised with coronavirus disease 2019 (COVID-19) in depth, summarising entire medical histories, including medications, as captured in routinely collected data drawn from databases across three continents. We then compared individuals hospitalised with COVID-19 to those previously hospitalised with influenza. Methods We report demographics, previously recorded conditions and medication use of patients hospitalised with COVID-19 in the US (Columbia University Irving Medical Center [CUIMC], Premier Healthcare Database [PHD], UCHealth System Health Data Compass Database [UC HDC], and the Department of Veterans Affairs [VA OMOP]), in South Korea (Health Insurance Review & Assessment [HIRA]), and Spain (The Information System for Research in Primary Care [SIDIAP] and HM Hospitales [HM]). These patients were then compared with patients hospitalised with influenza in 2014-19. Results 34,128 (US: 8,362, South Korea: 7,341, Spain: 18,425) individuals hospitalised with COVID-19 were included. Between 4,811 (HM) and 11,643 (CUIMC) unique aggregate characteristics were extracted per patient, with all summarised in an accompanying interactive website (http://evidence.ohdsi.org/Covid19CharacterizationHospitalization/). Patients were majority male in the US (CUIMC: 52%, PHD: 52%, UC HDC: 54%, VA OMOP: 94%,) and Spain (SIDIAP: 54%, HM: 60%), but were predominantly female in South Korea (HIRA: 60%). Age profiles varied across data sources. Prevalence of asthma ranged from 4% to 15%, diabetes from 13% to 43%, and hypertensive disorder from 24% to 70% across data sources. Between 14% and 33% were taking drugs acting on the renin-angiotensin system in the 30 days prior to hospitalisation. Compared to 81,596 individuals hospitalised with influenza in 2014-19, patients admitted with COVID-19 were more typically male, younger, and healthier, with fewer comorbidities and lower medication use. Conclusions We provide a detailed characterisation of patients hospitalised with COVID-19. Protecting groups known to be vulnerable to influenza is a useful starting point to minimize the number of hospital admissions needed for COVID-19. However, such strategies will also likely need to be broadened so as to reflect the particular characteristics of individuals hospitalised with COVID-19.
Keywords	COVID-19 ; OHDSI ; OMOP ; Common Data Model ; Deep Phenotyping ; covid19
Subject code	610
Language	English
Publishing date	2020-08-31
Publishing country	eu
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Olmesartan is not associated with the risk of enteropathy

Seng Chan You / Hojun Park / Dukyong Yoon / Sooyoung Park / Boyoung Joung / Rae Woong Park

The Korean Journal of Internal Medicine, Vol 34, Iss 1, Pp 90-

a Korean nationwide observational cohort study

2019 Volume 98

Abstract: Background/Aims Olmesartan, a widely used angiotensin II receptor blocker (ARB), has been linked to sprue-like enteropathy. No cases of olmesartan-associated enteropathy have been reported in Northeast Asia. We investigated the associations between ... ...

Abstract	Background/Aims Olmesartan, a widely used angiotensin II receptor blocker (ARB), has been linked to sprue-like enteropathy. No cases of olmesartan-associated enteropathy have been reported in Northeast Asia. We investigated the associations between olmesartan and other ARBs and the incidence of enteropathy in Korea. Methods Our retrospective cohort study used data from the Korean National Health Insurance Service to identify 108,559 patients (58,186 females) who were initiated on angiotensin converting enzyme inhibitors (ACEis), olmesartan, or other ARBs between January 2005 and December 2012. The incidences of enteropathy were compared among drug groups. Changes in body weight were compared after propensity score matching of patients in the ACEis and olmesartan groups. Results Among 108,559 patients, 31 patients were diagnosed with enteropathy. The incidences were 0.73, 0.24, and 0.37 per 1,000 persons, in the ACEis, olmesartan, and other ARBs groups, respectively. Adjusted rate ratios for enteropathy were: olmesartan, 0.33 (95% confidential interval [CI], 0.10 to 1.09; p = 0.070) and other ARBs, 0.34 (95% CI, 0.14 to 0.83; p = 0.017) compared to the ACEis group after adjustment for age, sex, income level, and various comorbidities. The post hoc analysis with matched cohorts revealed that the proportion of patients with significant weight loss did not differ between the ACEis and olmesartan groups. Conclusions Olmesartan was not associated with intestinal malabsorption or significant body weight loss in the general Korean population. Additional large-scale prospective studies of the relationship between olmesartan and the incidence of enteropathy in the Asian population are needed.
Keywords	angiotensin receptor antagonists ; olmesartan ; insurance claim review ; drug-related side effects and adverse reactions ; intestinal diseases ; Medicine ; R
Subject code	610
Language	English
Publishing date	2019-01-01T00:00:00Z
Publisher	The Korean Association of Internal Medicine
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Reclassification of moderate aortic stenosis based on data-driven phenotyping of hemodynamic progression

Iksung Cho / William D. Kim / Subin Kim / Kyu-Yong Ko / Yeonchan Seong / Dae-Young Kim / Jiwon Seo / Chi Young Shim / Jong-Won Ha / Makoto Mori / Aakriti Gupta / Seng Chan You / Geu-Ru Hong / Harlan M. Krumholz

Scientific Reports, Vol 13, Iss 1, Pp 1-

2023 Volume 9

Abstract: Abstract The management and follow-up of moderate aortic stenosis (AS) lacks consensus as the progression patterns are not well understood. This study aimed to identify the hemodynamic progression of AS, and associated risk factors and outcomes. We ... ...

Abstract	Abstract The management and follow-up of moderate aortic stenosis (AS) lacks consensus as the progression patterns are not well understood. This study aimed to identify the hemodynamic progression of AS, and associated risk factors and outcomes. We included patients with moderate AS with at least three transthoracic echocardiography (TTE) studies performed between 2010 and 2021. Latent class trajectory modeling was used to classify AS groups with distinctive hemodynamic trajectories, which were determined by serial systolic mean pressure gradient (MPG) measurements. Outcomes were defined as all-cause mortality and aortic valve replacement (AVR). A total of 686 patients with 3093 TTE studies were included in the analysis. Latent class model identified two distinct AS trajectory groups based on their MPG: a slow progression group (44.6%) and a rapid progression group (55.4%). Initial MPG was significantly higher in the rapid progression group (28.2 ± 5.6 mmHg vs. 22.9 ± 2.8 mmHg, P < 0.001). The prevalence of atrial fibrillation was higher in the slow progression group; there was no significant between-group difference in the prevalence of other comorbidities. The rapid progression group had a significantly higher AVR rate (HR 3.4 [2.4–4.8], P < 0.001); there was no between-group difference in mortality (HR 0.7 [0.5–1.0]; P = 0.079). Leveraging longitudinal echocardiographic data, we identified two distinct groups of patients with moderate AS: slow and rapid progression. A higher initial MPG (≥ 24 mmHg) was associated with more rapid progression of AS and higher rates of AVR, thus indicating the predictive value of MPG in management of the disease.
Keywords	Medicine ; R ; Science ; Q
Subject code	610
Language	English
Publishing date	2023-04-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Cycle-consistent adversarial networks improves generalizability of radiomics model in grading meningiomas on external validation

Yae Won Park / Seo Jeong Shin / Jihwan Eom / Heirim Lee / Seng Chan You / Sung Soo Ahn / Soo Mee Lim / Rae Woong Park / Seung-Koo Lee

Scientific Reports, Vol 12, Iss 1, Pp 1-

2022 Volume 9

Abstract: Abstract The heterogeneity of MRI is one of the major reasons for decreased performance of a radiomics model on external validation, limiting the model’s generalizability and clinical application. We aimed to establish a generalizable radiomics model to ... ...

Abstract	Abstract The heterogeneity of MRI is one of the major reasons for decreased performance of a radiomics model on external validation, limiting the model’s generalizability and clinical application. We aimed to establish a generalizable radiomics model to predict meningioma grade on external validation through leveraging Cycle-Consistent Adversarial Networks (CycleGAN). In this retrospective study, 257 patients with meningioma were included in the institutional training set. Radiomic features (n = 214) were extracted from T2-weighted (T2) and contrast-enhanced T1 (T1C) images. After radiomics feature selection, extreme gradient boosting classifiers were developed. The models were validated in the external validation set consisting of 61 patients with meningiomas. To reduce the gap in generalization associated with the inter-institutional heterogeneity of MRI, the smaller image set style of the external validation was translated into the larger image set style of the institutional training set using CycleGAN. On external validation before CycleGAN application, the performance of the combined T2 and T1C models showed an area under the curve (AUC), accuracy, and F1 score of 0.77 (95% confidence interval 0.63–0.91), 70.7%, and 0.54, respectively. After applying CycleGAN, the performance of the combined T2 and T1C models increased, with an AUC, accuracy, and F1 score of 0.83 (95% confidence interval 0.70–0.97), 73.2%, and 0.59, respectively. Quantitative metrics (by Fréchet Inception Distance) showed that CycleGAN can decrease inter-institutional image heterogeneity while preserving predictive information. In conclusion, leveraging CycleGAN may be helpful to increase the generalizability of a radiomics model in differentiating meningioma grade on external validation.
Keywords	Medicine ; R ; Science ; Q
Subject code	690
Language	English
Publishing date	2022-04-01T00:00:00Z
Publisher	Nature Portfolio
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Application of Epidemiological Geographic Information System

Jaehyeong Cho / Seng Chan You / Seongwon Lee / DongSu Park / Bumhee Park / George Hripcsak / Rae Woong Park

International Journal of Environmental Research and Public Health, Vol 17, Iss 7824, p

An Open-Source Spatial Analysis Tool Based on the OMOP Common Data Model

2020 Volume 7824

Abstract: Background: Spatial epidemiology is used to evaluate geographical variations and disparities in health outcomes; however, constructing geographic statistical models requires a labor-intensive process that limits the overall utility. We developed an open- ... ...

Abstract	Background: Spatial epidemiology is used to evaluate geographical variations and disparities in health outcomes; however, constructing geographic statistical models requires a labor-intensive process that limits the overall utility. We developed an open-source software for spatial epidemiological analysis and demonstrated its applicability and quality. Methods: Based on standardized geocode and observational health data, the Application of Epidemiological Geographic Information System (AEGIS) provides two spatial analysis methods: disease mapping and detecting clustered medical conditions and outcomes. The AEGIS assesses the geographical distribution of incidences and health outcomes in Korea and the United States, specifically incidence of cancers and their mortality rates, endemic malarial areas, and heart diseases (only the United States). Results: The AEGIS-generated spatial distribution of incident cancer in Korea was consistent with previous reports. The incidence of liver cancer in women with the highest Moran’s I (0.44; p < 0.001) was 17.4 (10.3–26.9). The malarial endemic cluster was identified in Paju-si, Korea ( p < 0.001). When the AEGIS was applied to the database of the United States, a heart disease cluster was appropriately identified ( p < 0.001). Conclusions: As an open-source, cross-country, spatial analytics solution, AEGIS may globally assess the differences in geographical distribution of health outcomes through the use of standardized geocode and observational health databases.
Keywords	spatial epidemiology ; disease clustering ; geographical information system ; Medicine ; R
Subject code	910
Language	English
Publishing date	2020-10-01T00:00:00Z
Publisher	MDPI AG
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Incorporation of Korean Electronic Data Interchange Vocabulary into Observational Medical Outcomes Partnership Vocabulary

Yeonchan Seong / Seng Chan You / Anna Ostropolets / Yeunsook Rho / Jimyung Park / Jaehyeong Cho / Dmitry Dymshyts / Christian G. Reich / Yunjung Heo / Rae Woong Park

Healthcare Informatics Research, Vol 27, Iss 1, Pp 29-

2021 Volume 38

Abstract: Objectives We incorporated the Korean Electronic Data Interchange (EDI) vocabulary into Observational Medical Outcomes Partnership (OMOP) vocabulary using a semi-automated process. The goal of this study was to improve the Korean EDI as a standard ... ...

Abstract	Objectives We incorporated the Korean Electronic Data Interchange (EDI) vocabulary into Observational Medical Outcomes Partnership (OMOP) vocabulary using a semi-automated process. The goal of this study was to improve the Korean EDI as a standard medical ontology in Korea. Methods We incorporated the EDI vocabulary into OMOP vocabulary through four main steps. First, we improved the current classification of EDI domains and separated medical services into procedures and measurements. Second, each EDI concept was assigned a unique identifier and validity dates. Third, we built a vertical hierarchy between EDI concepts, fully describing child concepts through relationships and attributes and linking them to parent terms. Finally, we added an English definition for each EDI concept. We translated the Korean definitions of EDI concepts using Google.Cloud.Translation.V3, using a client library and manual translation. We evaluated the EDI using 11 auditing criteria for controlled vocabularies. Results We incorporated 313,431 concepts from the EDI to the OMOP Standardized Vocabularies. For 10 of the 11 auditing criteria, EDI showed a better quality index within the OMOP vocabulary than in the original EDI vocabulary. Conclusions The incorporation of the EDI vocabulary into the OMOP Standardized Vocabularies allows better standardization to facilitate network research. Our research provides a promising model for mapping Korean medical information into a global standard terminology system, although a comprehensive mapping of official vocabulary remains to be done in the future.
Keywords	medical informatics ; controlled vocabulary ; national health programs ; biological ontologies ; knowledge bases ; Computer applications to medicine. Medical informatics ; R858-859.7
Subject code	001 ; 420
Language	English
Publishing date	2021-01-01T00:00:00Z
Publisher	The Korean Society of Medical Informatics
Document type	Article ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Feasibility and evaluation of a large-scale external validation approach for patient-level prediction in an international data network

Jenna M. Reps / Ross D. Williams / Seng Chan You / Thomas Falconer / Evan Minty / Alison Callahan / Patrick B. Ryan / Rae Woong Park / Hong-Seok Lim / Peter Rijnbeek

BMC Medical Research Methodology, Vol 20, Iss 1, Pp 1-

validation of models predicting stroke in female patients newly diagnosed with atrial fibrillation

2020 Volume 10

Abstract: Abstract Background To demonstrate how the Observational Healthcare Data Science and Informatics (OHDSI) collaborative network and standardization can be utilized to scale-up external validation of patient-level prediction models by enabling validation ... ...

Abstract	Abstract Background To demonstrate how the Observational Healthcare Data Science and Informatics (OHDSI) collaborative network and standardization can be utilized to scale-up external validation of patient-level prediction models by enabling validation across a large number of heterogeneous observational healthcare datasets. Methods Five previously published prognostic models (ATRIA, CHADS2, CHADS2VASC, Q-Stroke and Framingham) that predict future risk of stroke in patients with atrial fibrillation were replicated using the OHDSI frameworks. A network study was run that enabled the five models to be externally validated across nine observational healthcare datasets spanning three countries and five independent sites. Results The five existing models were able to be integrated into the OHDSI framework for patient-level prediction and they obtained mean c-statistics ranging between 0.57–0.63 across the 6 databases with sufficient data to predict stroke within 1 year of initial atrial fibrillation diagnosis for females with atrial fibrillation. This was comparable with existing validation studies. The validation network study was run across nine datasets within 60 days once the models were replicated. An R package for the study was published at https://github.com/OHDSI/StudyProtocolSandbox/tree/master/ExistingStrokeRiskExternalValidation . Conclusion This study demonstrates the ability to scale up external validation of patient-level prediction models using a collaboration of researchers and a data standardization that enable models to be readily shared across data sites. External validation is necessary to understand the transportability or reproducibility of a prediction model, but without collaborative approaches it can take three or more years for a model to be validated by one independent researcher. In this paper we show it is possible to both scale-up and speed-up external validation by showing how validation can be done across multiple databases in less than 2 months. We recommend that researchers ...
Keywords	Patient-level prediction ; Prognostic model ; External validation ; Transportability ; Collaborative network ; Medicine (General) ; R5-920
Subject code	690
Language	English
Publishing date	2020-05-01T00:00:00Z
Publisher	BMC
Document type	Article ; Online
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