• Title/Summary/Keyword: 기록정보센터

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Inter-Rater Reliability of Carotid Intima-Media Thickness Measurements in a Multicenter Cohort Study (다기관 코호트 연구에서 경동맥 내막-중막 두께 측정의 측정자간 신뢰도 평가)

  • Lee, Jung Hyun;Choi, Dong Phil;Shim, Jee-Seon;Kim, Dae Jung;Park, Sung-Ha;Kim, Hyeon Chang
    • Journal of health informatics and statistics
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    • v.41 no.1
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    • pp.49-56
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    • 2016
  • Objectives: Carotid intima-media thickness (CIMT) and the presence of carotid artery plaque are widely used as preclinical markers of atherosclerosis. Due to operator dependency in measuring CIMT, it is important to evaluate the reliability of measuring CIMT and plaque between centers in a multicenter study. The purpose of this study is to evaluate the inter-rater reliability of CIMT and plaque presence among three clinical centers of the Cardiovascular and Metabolic Disease Etiology Research Center (CMERC). Methods: Twenty people without known cardiovascular disease (age 37-64) were enrolled during 2014-2015, and their left and right carotid arteries were examined repeatedly with ultrasonography for CIMT measurements at three clinical centers according to a predetermined protocol. Maximum and mean values of CIMT at distal common carotid artery were recorded. Plaque presence at a carotid artery was checked by an operator. The reliability of CIMT and carotid plaque presence was assessed using an intraclass correlation coefficient (ICC) and kappa statistics, respectively. Results: Calculated ICC was 0.647 (95% CI: 0.487-0.779) for maximum CIMT, and 0.758 (95% CI: 0.632- 0.854) for mean CIMT. In Bland Altman plot, most observed values were distributed within mean difference ${\pm}1.96$ SD ranges. Kappa statistics of plaque presence between two centers were 0.304 (center 1 and 2), 0.507 (center 1 and 3), and 0.606 (center 2 and 3), respectively, while Fleiss kappa for overall agreement was 0.445. Conclusions: The inter-rater reliability of CIMT measurements among three clinical centers turned out to be high, and the agreement of measuring carotid plaque presence was fair.

Dynamic Equilibrium Position Prediction Model for the Confluence Area of Nakdong River (낙동강 합류부 삼각주의 동적 평형 위치 예측 모델: 감천-낙동강 합류점 중심 분석 연구)

  • Minsik Kim;Haein Shin;Wook-Hyun Nahm;Wonsuck Kim
    • Economic and Environmental Geology
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    • v.56 no.4
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    • pp.435-445
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    • 2023
  • A delta is a depositional landform that is formed when sediment transported by a river is deposited in a relatively low-energy environment, such as a lake, sea, or a main channel. Among these, a delta formed at the confluence of rivers has a great importance in river management and research because it has a significant impact on the hydraulic and sedimentological characteristics of the river. Recently, the equilibrium state of the confluence area has been disrupted by large-scale dredging and construction of levees in the Nakdong River. However, due to the natural recovery of the river, the confluence area is returning to its pre-dredging natural state through ongoing sedimentation. The time-series data show that the confluence delta has been steadily growing since the dredging, but once it reaches a certain size, it repeats growth and retreat, and the overall size does not change significantly. In this study, we developed a model to explain the sedimentation-erosion processes in the confluence area based on the assumption that the confluence delta reaches a dynamic equilibrium. The model is based on two fundamental principles: sedimentation due to supply from the tributary and erosion due to the main channel. The erosion coefficient that represents the Nakdong River confluence areas, was obtained using data from the tributaries of the Nakdong River. Sensitivity analyses were conducted using the developed model to understand how the confluence delta responds to changes in the sediment and water discharges of the tributary and the main channel, respectively. We then used annual average discharge of the Nakdong River's tributaries to predict the dynamic equilibrium positions of the confluence deltas. Finally, we conducted a simulation experiment on the development of the Gamcheon-Nakdong River delta using recorded daily discharge. The results showed that even though it is a simple model, it accurately predicted the dynamic equilibrium positions of the confluence deltas in the Nakdong River, including the areas where the delta had not formed, and those where the delta had already formed and predicted the trend of the response of the Gamcheon-Nakdong River delta. However, the actual retreat in the Gamcheon-Nakdong River delta was not captured fully due to errors and limitations in the simplification process. The insights through this study provide basic information on the sediment supply of the Nakdong River through the confluence areas, which can be implemented as a basic model for river maintenance and management.