Irene Oi Ling Wong

The University of Hong Kong | HKU · School of Public Health

Promoting high vaccine uptake is a primary public health policy in mitigating the profound impact of COVID-19 pandemic. The evolution of the COVID-19 pandemic requires a dynamic evaluation of factors that are associated with COVID-19 vaccination uptake to inform a strategic plan on vaccination programmes. Using real-time population-based data that...

Introduction: In orthopedic oncology, computer navigation and 3D-printed guides facilitate precise osteotomies only after surgical exposure. Before surgeries start, it is challenging to mentally process and superimpose the virtual medical images onto patients' anatomy for preoperative surgical planning. Mixed Reality (MR) is an immersive technolog...

Background: Hong Kong contained COVID-19 for two years, but experienced a large epidemic of Omicron BA.2 in early 2022 and endemic transmission of Omicron subvariants thereafter. Methods: We examined the use and impact of pandemic controls in Hong Kong by analysing data on more than 1.7 million confirmed COVID-19 cases and characterizing non-pharma...

Socially disadvantaged individuals and communities consistently showed lower COVID-19 vaccination acceptance. We aimed to examine the psychological mechanisms that could explain such vaccination disparities. This study used data from serial population-based surveys conducted since the COVID-19 vaccination programme being launched in Hong Kong (N =...

Background The coronavirus disease (COVID-19) pandemic is slowing down, and countries are discussing whether preventive measures have remained effective or not. This study aimed to investigate a particular property of the trend of COVID-19 that existed and if its variants of concern were cointegrated, determining its possible transformation into an...

There is limited evidence on vaccine effectiveness against asymptomatic or mild Omicron infections. We estimated that recent third doses of mRNA or inactivated vaccines reduced the risk of self-reported infection by 52% (95% confidence interval: 17%-73%), among randomly sampled adults during the Omicron BA.2 dominated surge in Hong Kong.

We studied 2780 adults in Hong Kong who received CoronaVac inactivated virus vaccine (Sinovac) and BNT162b2 mRNA vaccine (“Comirnaty”, BioNTech/Fosun Pharma). We compared rates of antibody waning over time using an enzyme-linked immunosorbent assay for spike receptor binding domain and a surrogate virus neutralization test. We found stronger and mo...

Background: Antibiotics may alter colorectal cancer (CRC) risk due to gut dysbiosis. We aimed to study the specific and temporal effects of various antibiotics on CRC development in older individuals. Methods: This was a territory-wide retrospective cohort study. Subjects aged 60 years and older who did not have CRC diagnosed on screening/diagno...

We studied 2864 adults in Hong Kong who received CoronaVac inactivated virus vaccine (Sinovac) and BNT162b2 mRNA vaccine (Comirnaty, BioNTech/Fosun Pharma). We found stronger and more durable antibody responses to two doses of the mRNA vaccine, and slightly stronger initial antibody responses to each vaccine in younger adults and women.

Background: Hong Kong has an ageing Chinese population with high life expectancy and a rising number of cancer cases. While population ageing could lead to higher incidence, we aim to quantify the demographic and epidemiological contributions to this trend by disentangling the effect of these factors. Methods: We analysed secular trends of cance...

Objective We evaluated the temporal trend in gender ratios of first and last authors in the field of oncological research published in major general medical and oncology journals and examined the gender pattern in coauthorship. Design We conducted a retrospective study in PubMed using the R package RISmed. We retrieved original research articles p...

Background: Lupus nephritis (LN) is the most common secondary glomerular diseases that will cause end-stage renal disease (ESRD) and renal-related death. The cost-effectiveness of various treatments for LN recommended by official guidelines has not been investigated in China. Our study is to evaluate clinical prognosis and cost-effectiveness of the...

We constructed a coronavirus disease community vulnerability index using micro district-level socioeconomic and demographic data and analyzed its correlations with case counts across the 3 pandemic waves in Hong Kong, China. We found that districts with greater vulnerability reported more cases in the third wave when widespread community outbreaks...

Background The cost-effectiveness of mammography screening among Chinese women remains contentious. Here we characterized breast cancer (BC) epidemiology in Hong Kong and evaluated the cost-effectiveness of personalized risk-based screening. Methods We used the Hong Kong Breast Cancer Study (a case-control study with 3,501 cases and 3,610 controls...

Objectives: Hepatitis B virus infection is an important public health problem. We analyzed the cost-effectiveness of the first-line therapies including nucleotide analogues (NAs), namely tenofovir alafenamide fumarate (TAF), tenofovir disoproxil fumarate (TDF) and entecavir, and Peg-IFN for patients with chronic hepatitis B (CHB) in China. Method...

Objectives We aimed to compare the economic value of chemotherapy plus anti-epidermal growth factor receptor (anti-EGFR) monoclonal antibody (mAb) against chemotherapy with bevacizumab (Bev, an anti-vascular endothelial growth factor mAb) as first-line treatment in KRAS wild-type (WT), pan-RAS WT and pan-RAS WT left-sided metastatic colorectal canc...

Mammography has been deployed to screen for early breast cancer since the 1980s. Its use has recently and increasingly been called into question in populations with long-established programs, as well as in emerging economies. The biology of breast carcinogenesis differs from those of other cancers amenable to screening in that there is no obligate...

Importance Immune checkpoint inhibitors have been approved for use as a second-line therapy for hepatocellular carcinoma (HCC) in patients who previously received sorafenib. Pembrolizumab has shown substantial antitumor activity and a favorable toxicity profile as a second-line treatment of HCC. However, considering the high cost of pembrolizumab,...

Aims: Thiopurines are believed to increase cancer risks, but data from Asian patients are sparse. We determined the risks of malignancies in thiopurine users with inflammatory bowel disease (IBD) or other indications from Hong Kong. Methods: All patients who had received thiopurines between 2005 and 2009 in Hong Kong were identified from local elec...

Objective: To investigate what extent lead-time bias is likely to affect endoscopic screening effectiveness for esophageal cancer in the high-risk area in China. Methods: A screening model based on the epidemiological cancer registry data, yielding a population-level incidence and mortality rates, was carried out to simulate study participants i...

Background: Studies on healthcare-seeking behaviour usually adopted a patient care perspective, or restricted to specific disease conditions. However, pre-diagnosis symptoms may be more relevant to healthcare-seeking behaviour from a patient perspective. We described healthcare-seeking behaviours by specific symptoms related to respiratory and gas...

Background: Blood pressure (BP) and body mass index (BMI) trends during childhood and adolescence are complex, making context-specific projections necessary to inform prevention and presage changes. Objective: This study aimed to project BP and BMI in Hong Kong Chinese children and adolescents from 2015 to 2024 based on trends in BP and BMI obse...

Objectives Protests, riots and revolutions have long been a part of human history and are increasing globally, yet their impact on mental health remains largely unknown. We therefore systematically reviewed studies on collective actions and mental health. Method We searched PubMed, Web of Science, PsycINFO and CINAHL Plus for published studies fro...

Background: Mendelian randomization (MR) analyses have been increasingly used to seek evidence of causal associations. This systematic review aims at characterizing and evaluating the reporting of MR analyses in oncological studies. Methods: The PubMed database was searched to identify MR cancer studies until December 31, 2017. Two of the author...

Cataract and diabetic retinopathy are leading causes of blindness globally. Lifeline Express (LEX) has pioneered the provision of cataract surgery in rural China from custom-built trains and eye centres nationwide. Over the past two decades, LEX has provided free cataract surgery for over 180 000 patients in China. In China, half of the adult popul...

Background & aims: Although eradication of Helicobacter pylori infection reduces the risk of gastric cancer, few data are available on its effects in older subjects. We compared the age-specific risk of gastric cancer in a large cohort of subjects who received H pylori eradication therapy vs a matched general population. Methods: We searched the...

Inaccurate resection in pelvic tumors can result in compromised margins with increase local recurrence. Navigation-assisted and patient-specific instrument (PSI) techniques have recently been reported in assisting pelvic tumor surgery with the tendency of improving surgical accuracy. We examined and compared the accuracy of transferring a virtual p...

Hong Kong, in common with other Asian settings, has high rates of diabetes mellitus (DM) despite a relatively nonobese population. Given the rapid economic development in the region, most Asians grew up in limited living conditions. We examined the longitudinal mortality trends of DM. We assessed whether the first generation (birth cohorts in the 1...

Background: Projections of future trends in cancer incidence and mortality are important for public health planning. Methods: By using 1976-2010 data in Hong Kong, we fitted Poisson age-period-cohort models and made projections for future breast cancer incidence and mortality to 2025. Results: Age-standardised breast cancer incidence (/mortali...

There is little consensus among different early childhood education stakeholders in Hong Kong on whether it is beneficial or detrimental for children to receive an English bilingual education before the age of 6. This longitudinal study investigated the issue of potential 'detrimental effects of learning English' on Hong Kong kindergarten children'...

With economic development and population aging, ischaemic heart disease (IHD) is becoming a leading cause of mortality with widening inequalities in China. To forewarn the trends in China we projected IHD trends in the most economically developed part of China, i.e., Hong Kong. Based on sex-specific IHD mortality rates from 1976 to 2005, we project...

Recommendations about funding of interventions through the full spectrum of the disease often have been made in isolation. The authors of this report optimized budgetary allocations by comparing cost-effectiveness data for different preventive and management strategies throughout the disease course for breast cancer in Hong Kong (HK) Chinese women....

Retrospective multicenter study. To compare clinical outcomes and surgical-related adverse events in patients with multilevel cervical myelopathy (MCM) undergoing simple anterior, simple posterior, or 1-stage posterior-anterior surgical decompression strategies. Simple anterior, simple posterior, and 1-stage posterior-anterior surgical decompressio...

Hong Kong population has experienced drastic changes in its economic development in the 1940s. Taking advantage of Hong Kong's unique demographic and socioeconomic history, characterized by massive, punctuated migration waves from Southern China, and recent, rapid transition from a pre-industrialized society to the first ethnic Chinese community re...

Deviance information criterion (DIC) values (correct to four significant figures) for different combinations for age, period and cohort models for bacteria-related deaths due to septicemia and pneumonia in Hong Kong. (DOC)

Differentiated thyroid cancer survivors are at increased risk of nonsynchronous second primary malignancy, but the cause remains unclear. This study aimed to evaluate the association between radioiodine therapy and risk of nonsynchronous second primary malignancy and to examine whether the risk of nonsynchronous second primary malignancy in differe...

Introduction We aim to investigate longitudinal trends in bacterial disease related mortality in HK in order to describe how socio-economic transition affects mortality due to infections and to provide generalised aetiological insights. We use one of the major bacterial disease related death, septicaemia, as an exemplar. Methods We used local data...

There are few data on the degree to which thyroid cancer survivors are at risk of second primary malignancy (SPM). This study aimed at evaluating the risk of SPM in patients with differentiated thyroid carcinoma (DTC) and how the timing of SPM might affect the disease course. Among 1,043 patients diagnosed with DTC between 1970 and 2008, 27 (2.6%)...

To measure self-reported inpatient experience in Hong Kong. Data were derived from the 2005 Thematic Household Survey. 24,364 non-institutional and 3390 institutionalised respondents aged at least 18 years systematically drawn to represent the Hong Kong adult population, 6.9% of whom were admitted at least once as an inpatient during the previous 1...

To evaluate the presence of moral hazard, adjusted for the propensity to have self-purchased insurance policies, employer-based medical benefits, and welfare-associated medical benefits in Hong Kong. Based on 2005 population survey, we used logistic regression and zero-truncated negative binomial/Poisson regressions to assess the presence of moral...

Research on trends in cancer incidence has usually examined single sites in populations that long ago completed the economic transition. The trends in 11 cancers in three groups in the recently transitioned Hong Kong Chinese population were examined to delineate the effects of economic transition and provide generalised aetiological insights. Sex-s...

We examined the effect on self-rated health of neighbourhood-level income inequality in Hong Kong, which has a high and growing Gini coefficient. Data were derived from two population household surveys in 2002 and 2005 of 25,623 and 24,610 non-institutional residents aged 15 or over. We estimated neighbourhood-level Gini coefficients in each of 287...

Despite its wealth, excellent vital indices and robust health care infrastructure, Hong Kong has a relatively high incidence of tuberculosis (TB) (85.4 per 100 000). Hong Kong residents have also experienced a very rapid and recent epidemiological transition; the population largely originated from migration by southern Chinese in the mid 20th centu...

Breast cancer incidence should be assessed separately in different populations, as it differs substantially between Chinese and Caucasian women, and more generally in developing versus developed populations. Estimation of future trends is important for public health planning. On the basis of the recent breast cancer incidence trends, we projected f...

Background: Although the cost effectiveness of screening mammography in most western developed populations has been accepted, it may not apply to Chinese women, who have a much lower breast cancer incidence. The authors estimated the cost effectiveness of biennial mammography in Hong Kong Chinese women to inform evidence-based screening policies....

Background and objective: While there is strong association between income inequality and health between countries, states/provinces or large metropolitan areas within a country, it remains unclear whether such an effect persists at the level of neighbourhoods within a city. We examined the effect on health of neighbourhood-level income inequality...

Accurate and precise estimates of the incubation distribution of novel, emerging infectious diseases are vital to inform public health policy and to parameterize mathematical models. We discuss and compare different methods of estimating the incubation distribution allowing for interval censoring of exposures, using data from the severe acute respi...

Rationale: Whereas the cost-effectiveness of screening mammography in most western developed population has been accepted, these results may not apply to Chinese women with a much lower breast cancer incidence. We estimate the cost-effectiveness of biennial mammography in Hong Kong Chinese women to inform evidence-based screening polices. We also e...

A variety of Serfling-type statistical algorithms requiring long series of historical data, exclusively from temperate climate zones, have been proposed for automated monitoring of influenza sentinel surveillance data. We evaluated three alternative statistical approaches where alert thresholds are based on recent data in both temperate and subtrop...

An accurate prognostic model for patients with severe acute respiratory syndrome (SARS) could provide a practical clinical decision aid. We developed and validated prognostic rules for both high- and low-resource settings based on data available at the time of admission. We analyzed data on all 1755 and 291 patients with SARS in Hong Kong (derivati...

This study tests whether socio-economic status (SES), at either the individual or ecologic levels, exerts a direct impact on non-attendance or an indirect impact on attendance through longer waiting time for appointments and/or doctor-shopping behavior at four public specialist outpatient centers in Hong Kong. We collected information through three...

To quantify the disutility of waiting for a specialist consultation and to examine whether individuals' willingness-to-pay (WTP) to reduce waiting time is associated with doctor-shopping behavior in outpatient clinics of four large, public hospitals in Hong Kong. We performed a cross-sectional survey of 6495 outpatients on public sector waiting lis...

We examined for the presence of moral hazard among those covered by medical benefits or insurance schemes, whether provided for by employers or privately purchased and stratified by health care provider sector in Hong Kong. Data for this study were derived from the 2002 Thematic Household Survey, covering 24,610 non-institutional residents aged 15...

To better understand the distribution of resources and health care consumption patterns in different geo-ethnic and socio-economic settings, we sought to describe the patterns of illness, care-seeking behavior and health services utilization in Hong Kong compared to the US and UK. Data were derived from the 2002 Hong Kong Thematic Household Survey...

As yet, no one has written a comprehensive epidemiologic account of a severe acute respiratory syndrome (SARS) outbreak from an affected country. To provide a comprehensive epidemiologic account of a SARS outbreak from an affected territory. Epidemiologic analysis. The 2003 Hong Kong SARS outbreak. All 1755 cases and 302 deaths. Sociodemographic ch...

Accurate, objective models of triage for patients with suspected severe acute respiratory syndrome (SARS) could assess risks and improve decisions about isolation and inpatient treatment. To develop and validate a clinical prediction rule for identifying patients with SARS in an emergency department setting. Retrospective analysis using a 2-step co...

Improving response rates, particularly among physicians, is important to minimize nonresponder bias and increase the effective sample size in epidemiologic research. We conducted a randomized trial to examine the impact of prepayment vs. postpayment incentives on response rates. Self-completion postal questionnaires were mailed to 949 physicians wh...

We performed a follow-up survey to document changes in the level of computerization among physicians in Hong Kong between 2000 and 2001, specifically examining whether their self-reported intention to computerize various clinical or administrative tasks actually translated into computerization of these tasks 1 year later. Determining such a relatio...

We evaluated factors associated with physicians' perceptions towards the effects of computers on health care and on current levels of computerization in their practice. We also performed a contingent valuation to quantify physicians' perceived benefits from computerization in a hypothetical ambulatory, solo clinic. We surveyed 949 representative ph...