• 한국통신학회논문지
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• 제16권6호
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• pp.509-516
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• 1991

In this paper, we propose on objective evaluation model of telephone transmission qulity in order to estimate a satisfaction score regarding speech quality in a relephone network. As the degradantion factors of telephone transmission quality, this model takes into account transmission loss, noise, distortion, talker echo and sidetone. A performance index[PI] is introduced for five psychological factors affecting telephone speech qualty, and a Mean Opinion Score(MOS) is estimated from the sum of all Pis. The simulation results indicate theat the MOS obtained from the objective evaluation model is in good agreement with that of subjective evaluation.

• Korean Journal of Radiology
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• 제23권3호
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• pp.298-307
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• 2022

Objective: This study aimed to evaluate the effect of implementing the consensus statement from the Asian Society of Cardiovascular Imaging-Practical Tutorial 2020 (ASCI-PT 2020) on the reliability of cardiac MR with late gadolinium enhancement (CMR-LGE) myocardial viability scoring between observers in the context of ischemic cardiomyopathy. Materials and Methods: A total of 17 cardiovascular imaging experts from five different countries evaluated CMR obtained in 26 patients (male:female, 23:3; median age [interquartile range], 55.5 years [50-61.8]) with ischemic cardiomyopathy. For LGE scoring, based on the 17 segments, the extent of LGE in each segment was graded using a five-point scoring system ranging from 0 to 4 before and after exposure according to the consensus statement. All scoring was performed via web-based review. Scores for slices, vascular territories, and total scores were obtained as the sum of the relevant segmental scores. Interobserver reliability for segment scores was assessed using Fleiss' kappa, while the intraclass correlation coefficient (ICC) was used for slice score, vascular territory score, and total score. Inter-observer agreement was assessed using the limits of agreement from the mean (LoA). Results: Interobserver reliability (Fleiss' kappa) in each segment ranged 0.242-0.662 before the consensus and increased to 0.301-0.774 after the consensus. The interobserver reliability (ICC) for each slice, each vascular territory, and total score increased after the consensus (slice, 0.728-0.805 and 0.849-0.884; vascular territory, 0.756-0.902 and 0.852-0.941; total score, 0.847 and 0.913, before and after implementing the consensus statement, respectively. Interobserver agreement in scoring also improved with the implementation of the consensus for all slices, vascular territories, and total score. The LoA for the total score narrowed from ± 10.36 points to ± 7.12 points. Conclusion: The interobserver reliability and agreement for CMR-LGE scoring for ischemic cardiomyopathy improved when following guidance from the ASCI-PT 2020 consensus statement.

• 대한임상검사과학회지
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• 제48권2호
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• pp.54-61
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• 2016

증가하고 있는 심혈관질환을 예방하기 위한 연구와 함께 심혈관질환 위험도를 예측할 수 있는 평가도구에 대한 연구도 꾸준히 진행되고 있다. 가장 널리 알려져 있는 Framingham risk score (FRS)는 여러 선행 연구에서 그 타당성이 검증되었다. 본 연구에서는 연구 대상자들의 LDL 콜레스테롤과 총 콜레스테롤의 적용에 따른 FRS의 점수 차이를 살펴보고, 두 변수의 선택 적용에 따른 10년 내 심혈관질환 발생 위험도의 판정에 대한 일치도를 평가해 보고자 하였다. 2011 국민건강영양조사 데이터 중 심혈관질환 진단을 받은 자를 제외한 1,530명(남성 755명, 여성 775명)의 자료를 이용하였다. LDL 콜레스테롤 또는 총 콜레스테롤 중에 어떤 항목을 적용하느냐에 따라 FRS와 심혈관질환의 10년 예측위험도는 차이가 있었다. 남녀 모두 FRS는 LDL 콜레스테롤 적용 점수 보다 총콜레스테롤 적용 점수가 더 높았다. 위험도 10% 미만의 저위험군, 10~19%의 중등도 위험군, 20% 이상의 고위험군 분류에서 남성 106명, 여성 26명의 판정이 일치하지 않았다. 코헨의 카파 계수는 남성의 경우 0.718, 여성의 경우 0.884로 나타나 여성의 경우 더 높은 일치성을 보였다. 심혈관질환의 10년 예측위험도와의 관련성에서도 LDL 콜레스테롤을 포함한 회귀식 보다 총 콜레스테롤을 포함한 회귀식에서 남녀 모두 설명력이 더 높아 총 콜레스테롤을 반영한 FRS 산출과 10년 예측 위험도의 평가가 더 상관성이 더 높고, 더불어 남성 보다는 여성에서 더 일치하는 결과가 나타남을 알 수 있었다.

• 동의생리병리학회지
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• 제30권3호
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• pp.177-183
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• 2016

The purpose of this study was to evaluate the reliabilities of questions and diagnostic value of the Korean Sasang Constitutional Diagnostic Questionnaire(KS-15). The young adults aged 20's participated in this study. The first survey was conducted in march, 2016, and the second one was conducted two weeks later. Three hundred and three questionnaires and the informed consent were obtained from all participants. The test-retest kappa analysis was used to identify the reliabilities of the questions and diagnostic value, and the significance level was .05. The number of subjects was 303 [87(28.7%)males and 216(71.3%)females]. The Cronbach's α were .630 in 6 characteristic questions. The test-retest reliabilities of questions were ranged from .469 to 734. The agreement rate of KS-15 between the first and second constitutional diagnostic value was 87.13%(Kappa=0.794). The higher Sasang constitutional probability score in first survey resulted in the higher agreement rate between first and second diagnostic value. KS-15 seems to be a reliable implement. Further studies for the reliability of the people of different ages and suitable cut off point in Sasang constitutional probability score are needed for the practical use of KS-15.

• Korean Journal of Radiology
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• 제22권11호
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• pp.1764-1776
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• 2021

Objective: This study aimed to validate a deep learning-based fully automatic calcium scoring (coronary artery calcium [CAC]_auto) system using previously published cardiac computed tomography (CT) cohort data with the manually segmented coronary calcium scoring (CAC_hand) system as the reference standard. Materials and Methods: We developed the CAC_auto system using 100 co-registered, non-enhanced and contrast-enhanced CT scans. For the validation of the CAC_auto system, three previously published CT cohorts (n = 2985) were chosen to represent different clinical scenarios (i.e., 2647 asymptomatic, 220 symptomatic, 118 valve disease) and four CT models. The performance of the CAC_auto system in detecting coronary calcium was determined. The reliability of the system in measuring the Agatston score as compared with CAC_hand was also evaluated per vessel and per patient using intraclass correlation coefficients (ICCs) and Bland-Altman analysis. The agreement between CAC_auto and CAC_hand based on the cardiovascular risk stratification categories (Agatston score: 0, 1-10, 11-100, 101-400, > 400) was evaluated. Results: In 2985 patients, 6218 coronary calcium lesions were identified using CAC_hand. The per-lesion sensitivity and false-positive rate of the CAC_auto system in detecting coronary calcium were 93.3% (5800 of 6218) and 0.11 false-positive lesions per patient, respectively. The CAC_auto system, in measuring the Agatston score, yielded ICCs of 0.99 for all the vessels (left main 0.91, left anterior descending 0.99, left circumflex 0.96, right coronary 0.99). The limits of agreement between CAC_auto and CAC_hand were 1.6 ± 52.2. The linearly weighted kappa value for the Agatston score categorization was 0.94. The main causes of false-positive results were image noise (29.1%, 97/333 lesions), aortic wall calcification (25.5%, 85/333 lesions), and pericardial calcification (24.3%, 81/333 lesions). Conclusion: The atlas-based CAC_auto empowered by deep learning provided accurate calcium score measurement as compared with manual method and risk category classification, which could potentially streamline CAC imaging workflows.

• Korean Journal of Radiology
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• 제24권4호
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• pp.284-293
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• 2023

Objective: To validate a simplified ordinal scoring method, referred to as modified length-based grading, for assessing coronary artery calcium (CAC) severity on non-electrocardiogram (ECG)-gated chest computed tomography (CT). Materials and Methods: This retrospective study enrolled 120 patients (mean age ± standard deviation [SD], 63.1 ± 14.5 years; male, 64) who underwent both non-ECG-gated chest CT and ECG-gated cardiac CT between January 2011 and December 2021. Six radiologists independently assessed CAC severity on chest CT using two scoring methods (visual assessment and modified length-based grading) and categorized the results as none, mild, moderate, or severe. The CAC category on cardiac CT assessed using the Agatston score was used as the reference standard. Agreement among the six observers for CAC category classification was assessed using Fleiss kappa statistics. Agreement between CAC categories on chest CT obtained using either method and the Agatston score categories on cardiac CT was assessed using Cohen's kappa. The time taken to evaluate CAC grading was compared between the observers and two grading methods. Results: For differentiation of the four CAC categories, interobserver agreement was moderate for visual assessment (Fleiss kappa, 0.553 [95% confidence interval {CI}: 0.496-0.610]) and good for modified length-based grading (Fleiss kappa, 0.695 [95% CI: 0.636-0.754]). The modified length-based grading demonstrated better agreement with the reference standard categorization with cardiac CT than visual assessment (Cohen's kappa, 0.565 [95% CI: 0.511-0.619 for visual assessment vs. 0.695 [95% CI: 0.638-0.752] for modified length-based grading). The overall time for evaluating CAC grading was slightly shorter in visual assessment (mean ± SD, 41.8 ± 38.9 s) than in modified length-based grading (43.5 ± 33.2 s) (P < 0.001). Conclusion: The modified length-based grading worked well for evaluating CAC on non-ECG-gated chest CT with better interobserver agreement and agreement with cardiac CT than visual assessment.

• 대한예방한의학회지
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• 제20권2호
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• pp.17-26
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• 2016

Objectives : We presented the results of reliability study in advance, and analyzed agreement between Korean medicine doctors(KMDs)' diagnosis and cold-heat pattern identification questionnaire(CHPI)'s diagnosis. Methods : This survey was conducted from May 16 to 17, 2015. The subjects were 93 adults living in rural society. Diagnosis of CHPI was performed by 2 KMDs who have clinical experience more than 5 years. The KMDs' diagnosis was set as a reference index, and then we compare 23 items(cold pattern 11 items and heat pattern 12 items) of CHPI questionnaire and 15 items(cold pattern 8 items and heat pattern 7 items) that were brief form of it. We had cut-off value by standard of KMDs' diagnosis using receiver operating characteristic-curve(ROC-curve), with which we calculated agreement including kappa value. Correlation analysis between CHPI evaluation score by KMDs and by the questionnaire was fulfilled as well. Results : Agreement about 11 and 8 cold pattern items showed 87.1% together, and the value of kappa each recorded 0.742 and 0.741. Agreement about 12 and 7 heat pattern items suggested 81.7% and 78.5%, and the value of kappa showed 0.634 and 0.570. Correlation coefficients were 0.803 of 11 items and 0.761 of 8 items about cold pattern. In addition, correlation coefficients were 0.789 of 12 items and 0.767 of 7 items about heat pattern. The significant probability (p-value) was under 0.001. Conclusions : We have developed CHPI questionnaire involving reliability and agreement based on usual symptoms, and hope additional complements so that Korean medicine diagnostics and Korean preventive medicine would be improved.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제26권2호
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• pp.88-98
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• 2023

Purpose: Children with inflammatory bowel disease (IBD) frequently undergo clinical assessments, involving triadic communication between clinician, parent, and child. During such encounters parents are traditionally the main communicator of information on their child's IBD, including subjective symptom reports. The level of agreement between children and their parents for IBD symptoms is poorly understood, and this study aimed to examine this factor. Methods: This was a cross-sectional study among children with IBD, and one parent. A validated paediatric IBD symptom report tool (IBDnow) enabled children and their parent to rate seven pain, well-being, and stool metrics, with dyads completing the tool concurrently. Results were assessed using: Individual agreement: proportion of identical symptom reports by each dyad (ideal score >0.7); Category agreement: percentage of identical reports for IBDnow metrics for the cohort; Inter-rater reliability: Gwet's AC1 coefficient with higher scores indicating better reliability (maximum=1). Results: Seventy-four parent/child dyads participated; child's mean age 12.2 years (standard deviation [SD] 2.9, range 6-16), mean time since diagnosis 2.8 years (SD 3), 54% female, 73% had Crohn's Disease. Mean individual agreement level was 0.6, with 27% of dyads agreeing on ≥6/7 IBDnow metrics. Category agreement was reported by 61% of dyads, 20% of parents overestimated, and 19% underestimated, their child's symptoms. Inter-rater reliability ranged from fair to good. Conclusion: These results should improve clinician awareness of how IBD symptom reports from parents may introduce bias. Children should be considered the most important source of symptom reports, and tools such as IBDnow utilised to enhance communication.

• The Journal of Korean Physical Therapy
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• 제22권5호
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• pp.83-93
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• 2010

Purpose: The purpose of this study was to determine the reliability and validity of the Functional Movement Screen (FMS) for assessing Korean athletes. Methods: A total of 48 patients (37 males and 11 females) participated in this study. Data were acquired after translation of the FMS from English to Korean and cross-cultural adaptation of the this questionnaire. To determine inter-rater reliability, the relationship between the FMS scores obtained by two raters was evaluated using the Kappa coefficient, which was in total agreement with the Intra-Correlation Coefficient (ICC3,1). Concurrent validity was examined by correlating the FMS scores with the Oswestry disability index (ODI) scores and Visual analogue scale (VAS) scores. Results: The raters demonstrated excellent agreement on 7 (above 90%) of the 17 test (72.9 to 97.9%) components. Substantial agreement was seen in 11 of the 17 tests. Two components of the In-line lunge and rotatory stability tests demonstrated moderate agreement. It showed good inter-rater reliability: the Kappa coefficients ranged from 0.42 to 0.97. ICC3,1=0.42~0.99 and 0.93 (total FMS score). Cronbach's alpha for FMS was 0.80. It was not correlated with ODI or VAS. Conclusion: The Korean version of the FMS is a reliable instrument for measuring movement patterns of Korean athletes and for making decisions related to interventions for performance enhancement.

• Korean Journal of Radiology
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• 제22권7호
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• pp.1034-1043
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• 2021

Objective: The purpose of this meta-analysis was to investigate the pooled agreements of the coronary artery calcium (CAC) severities assessed by electrocardiogram (ECG)-gated and non-ECG-gated CT and evaluate the impact of the scan parameters. Materials and Methods: PubMed, EMBASE, and the Cochrane library were systematically searched. A modified Quality Assessment of Diagnostic Accuracy Studies-2 tool was used to evaluate the quality of the studies. Meta-analytic methods were utilized to determine the pooled weighted bias, limits of agreement (LOA), and the correlation coefficient of the CAC scores or the weighted kappa for the categorization of the CAC severities detected by the two modalities. The heterogeneity among the studies was also assessed. Subgroup analyses were performed based on factors that could affect the measurement of the CAC score and severity: slice thickness, reconstruction kernel, and radiation dose for non-ECG-gated CT. Results: A total of 4000 patients from 16 studies were included. The pooled bias was 62.60, 95% LOA were -36.19 to 161.40, and the pooled correlation coefficient was 0.94 (95% confidence interval [CI] = 0.89-0.97) for the CAC score. The pooled weighted kappa of the CAC severity was 0.85 (95% CI = 0.79-0.91). Heterogeneity was observed in the studies (I² > 50%, p < 0.1). In the subgroup analysis, the agreement between the CAC categorizations was better when the two CT examinations had reconstructions based on the same slice thickness and kernel. Conclusion: The pooled agreement of the CAC severities assessed by the ECG-gated and non-ECG-gated CT was excellent; however, it was significantly affected by scan parameters, such as slice thickness and the reconstruction kernel.