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Background Early suspicion followed by assessing lung function with spirometry could decrease the underdiagnosis of chronic obstructive pulmonary disease (COPD) in primary care. We aimed to develop a nomogram to predict the FEV1/FVC ratio and the presence of COPD. Methods We retrospectively reviewed the data of 4241 adult patients who underwent spirometry between 2013 and 2019. By linear regression analysis, variables associated with FEV1/FVC were identified in the training cohort (n = 2969). Using the variables as predictors, a nomogram was created to predict the FEV1/FVC ratio and validated in the test cohort (n = 1272). Results Older age (β coefficient [95% CI], − 0.153 [− 0.183, − 0.122]), male sex (− 1.904 [− 2.749, − 1.056]), current or past smoking history (− 3.324 [− 4.200, − 2.453]), and the presence of dyspnea (− 2.453 [− 3.612, − 1.291]) or overweight (0.894 [0.191, 1.598]) were significantly associated with the FEV1/FVC ratio. In the final testing, the developed nomogram showed a mean absolute error of 8.2% between the predicted and actual FEV1/FVC ratios. The overall performance was best when FEV1/FVC Conclusion The developed nomogram could be used to identify potential patients at risk of COPD who may need further evaluation, especially in the primary care setting where spirometry is not available.

Background: Early suspicion followed by assessing lung function with spirometry could decrease the underdiagnosis of chronic obstructive pulmonary disease (COPD) in primary care. We aimed to develop a nomogram to predict the FEV1/FVC ratio and the presence of COPD.Methods: We retrospectively reviewed data of 4,241 adult patients who underwent spirometry between 2013 and 2019. By linear regression analysis, variables associated with FEV1/FVC were identified in the training cohort (n=2,969). Using the variables as predictors, a nomogram was created to predict the FEV1/FVC ratio and validated in the test cohort (n=1,272).Results: Older age (Odds ratio [OR], 0.858; 95% confidence interval [CI], 0.833-0.885), male sex (OR, 0.149; 95% CI, 0.064–0.348), current or past smoking history (OR, 0.036; 95% CI, 0.015–0.086), the presence of dyspnea (OR, 0.086; 95% CI, 0.027–0.275), and the absence of overweight (OR, 2.445; 95% CI, 1.210–4.942) were significantly associated with the FEV1/FVC ratio. In the final testing, the developed nomogram showed a mean absolute error of 0.822 (95% CI, 0.789–0.854) between the predicted and actual FEV1/FVC ratios. The overall performance was best when FEV1/FVC < 70% was used as a diagnostic criterion for COPD; the sensitivity, specificity, and balanced accuracy were 82.3%, 68.6%, and 75.5%, respectively.Conclusion: The developed nomogram could be used to identify potential patients at risk of COPD who may need further evaluation, especially in the primary care setting where spirometry is not available.

Summary Objective This study investigates the relationship between change in job status and mortality of newly diagnosed type II diabetes patients by gender. Methods Newly onset of individuals diagnosed with type II diabetes in the years 2003 and 2004, had 7 years follow-up using National Health Insurance Corporation (NHIC) sample cohort data. The individuals diagnosed with type II diabetes within this period were 14,861. After adjusting for age, initial income group, insulin treatment and medical service utilization, hazard ratio was analyzed using Cox's proportional hazard model. Results Mortality hazard ratio of continuously unemployed individuals is 3.78 times higher in males and 9.78 times higher in females than in those who keep their jobs. Also, individuals with a change in job status (e.g. from industrial worker to unemployed or self-employed), the mortality hazard ratio is 2.24 times higher in males and 5.23 times higher in females than in those who keep their jobs. The impact of change in job status change is largest for the middle class males. The middle class males has the higher mortality hazard ratio, 6.14 times in maintain unemployed and 4.12 times in change his job (industrial worker to unemployed or self-employer) than maintain one's job. Conclusions The continuous unemployment and the loss of job are related to risk of death in diabetic patients. The impact of unemployed is stronger than job change (loss or change). The impact of job status change is largest for the middle class man.

Background: Many countries have implemented their own price policies based on socioeconomic cost of obesity since WHO declared obesity as a worldwide epidemic disease. Korea’s obesity rate is accelerating. Methods: This study reviews 19 articles which have analysed the effect of price inflation policy, especially on sugar sweetened beverages. We assessed the effect of price policy on obesity using vote counting method, which is one of the methods of meta-analysis. Results: Based on the analysis of 19 research papers regarding the effectiveness of sugar tax, soda beverage tax and price inflation of fast food, 12 research papers proved that tax increase has positive impact in reducing obesity, while 7 research papers reported neutral effect. There was not a single paper stating that this policy negatively affects obesity reduction. Conclusion: Price policies may prove to be an effective method of intervention for controlling obesity. However, Korea should be cautious in introducing those policies since raising food prices is a sensitive issue in Korea. One major limitation of this study is the fact that not all of the papers concerning this field were included. Furthermore, there are difficulties in drawing a definite conclusion because of different indexes in evaluating policy effectiveness.