• 한국지능시스템학회논문지
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• 제13권4호
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• pp.386-390
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• 2003

데이터마이닝은 많은 양의 데이터로부터 의사결정에 유용한 패턴을 발견하는 과정으로서 최근 경영 및 공학 분야의 폭넓은 영역에서 많은 관심을 모으고 있다. 어떤 그룹을 여러 하위그룹으로 분류해내는 일은 데이터마이닝의 주요 내용 중 하나이다. 의사결정나무로 알려진 트리기반 기법은 그러한 분류모형을 수립하는 데 효율적인 방안을 제공한다 트리학습에 있어서 우선적인 관건은 목표변수에 의해 측정되는 노드불순도를 최소화하는 것이다. 하지만 공정관측, 마케팅과학, 임상분석 등과 같은 문제에서는 여러 목표변수를 동시에 고려해야 하는 상황이 쉽게 등장하는 데, 본 논문의 목적은 이처럼 다변량 목표변수를 갖는 데이터셋에서 활용할 수 있는 노드불순도 측정방안을 제시하는 데 있다. 아울러 수치 예를 이용하여 적용결과에 대해 논의한다.

• Journal of Preventive Medicine and Public Health
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• 제55권5호
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• pp.415-423
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• 2022

Economic evaluations in the healthcare are used to assess economic efficiency of pharmaceuticals and medical interventions such as diagnoses and medical procedures. This study introduces the main concepts of economic evaluation across its key steps: planning, outcome and cost calculation, modeling, cost-effectiveness results, uncertainty analysis, and decision-making. When planning an economic evaluation, we determine the study population, intervention, comparators, perspectives, time horizon, discount rates, and type of economic evaluation. In healthcare economic evaluations, outcomes include changes in mortality, the survival rate, life years, and quality-adjusted life years, while costs include medical, non-medical, and productivity costs. Model-based economic evaluations, including decision tree and Markov models, are mainly used to calculate the total costs and total effects. In cost-effectiveness or costutility analyses, cost-effectiveness is evaluated using the incremental cost-effectiveness ratio, which is the additional cost per one additional unit of effectiveness gained by an intervention compared with a comparator. All outcomes have uncertainties owing to limited evidence, diverse methodologies, and unexplained variation. Thus, researchers should review these uncertainties and confirm their robustness. We hope to contribute to the establishment and dissemination of economic evaluation methodologies that reflect Korean clinical and research environment and ultimately improve the rationality of healthcare policies.

• Clinical and Experimental Pediatrics
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• 제56권6호
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• pp.242-246
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• 2013

Purpose: The cardiopulmonary exercise test (CPET) is an important clinical tool for evaluating exercise capacity and is frequently used to evaluate chronic conditions including congenital heart disease. However, data on the normal CPET values for Korean children and adolescents are lacking. The aim of this study was to provide reference data for CPET variables in children and adolescents. Methods: From August 2006 to April 2009, 76 healthy children and adolescents underwent the CPET performed using the modified Bruce protocol. Here, we performed a medical record review to obtain data regarding patient' demographics, medical history, and clinical status. Results: The peak oxygen uptake ($VO_{2Peak}$) and metabolic equivalent ($MET_{Max}$) were higher in boys than girls. The respiratory minute volume $(V_E)/CO_2$ production ($VCO_2$) slope did not significantly differ between boys and girls. The cardiopulmonary exercise test data did not significantly differ between the boys and girls in younger age group (age, 10 to 14 years). However, in older age group (age, 15 to 19 years), the boys had higher $VO_{2Peak}$ and $MET_{Max}$ values and lower $V_E/VCO_2$ values than the girls. Conclusion: This study provides reference data for CPET variables in case of children and adolescents and will make it easier to use the CPET for clinical decision-making.

• 대한치과의사협회지
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• 제43권1호통권428호
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• pp.41-52
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• 2005

Information Technology has extended its scope to the medical field as well as dental field. Like medical field, network ststem for dental field requires acquisition, storage, and display of images. However, unlike the medical field, the system to integrate several information including medical images has not been developed according to industrial standard for management of digital image for medical use, so called DICOM conformance. which makes the digital environment in dental field more and more difficult and expensive for this standardization and comfortable communication in LAN and WAN. To solve this problem, the DICOM encoder and server has to be developed because the DICOM file can be easily retrieved with patient's information from the DICOM server in the system as DICOM file has the standard specification to integrate the patient's information. The information including image and other discrete data can be easily integrated in DICOM file and can be used without any difficulty for precise diagnosis and for contribution to the decision making for each treatment protocol. Therefore, the system composed of DICOM encoder and server in dental practive for DICOM file must be developed with prudent consideration of the several strategic factors: I) Enhanced diagnostic capability through the integrated information of image and clinical data. ii) Clinician-friendly interface to simulate the systemic treatment procedure in clinical practice iii) Implementation of multidisciplinary treatment protocol The development of DICOM encoder and server based on these strategic considerations will provide paperless and filmless hospital environments by the seamless integration and management of patient's history, several clinical data and clinical images through image processing for quantitative analysis. The system also allows clinicians to provide more predictable dental care for the patients.

• 한방재활의학과학회지
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• 제27권2호
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• pp.67-75
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• 2017

Objectives The study of the clinical effects of traditional east asian medicine (TEAM) using Taiwan national health insurance claim dataset (NHIRD) is useful in Korean Medicine research. We reviewed the clinical studies of TEAM using NHIRD as a whole through this study. Methods We comprehensively searched PUBMED and NHIRD DB for clinical effects of TEAM study using NHIRD from inception to 17, January 2017. As a result, 40 studies investigating the contribution of TEAM intervention to health benefit have been confirmed. We analyzed publication time, target disease, sample size, outcome measurement and main result of 40 searched studies. Results The number of TEAM studies using NHIRD grdually increasing. The topics of the team study using NHIRD covered a wide range of subjects including cardiovascular disease, tumor, gynecological disease, diabetes and kidney disease. The studies have shown large samples and reported significant effects on severe diseases. Conclusions The results of this study suggest that the study of Korean Medicine using Big data will be useful for decision making related to health care in Korea. However, considering the limited domestic Korean health insurance data, it will be necessary to activate the big data research of Korean Medicine through the establishment of a separate cohort in Korea.

• 한국간호교육학회지
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• 제13권1호
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• pp.32-40
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• 2007

Purpose: The purpose of this study was to develop and evaluate an integrated clinical evaluation program to increase the competency of senior nursing students. Method: A cross-sectional one group test design was utilized. Based on a framework derived from the prior studies, an integrated clinical evaluation program was developed. In order to assess the effect of the developed program, the senior students' experience with the program was measured. The participants were senior nursing students and the program was performed on November, 2005 after their semester was all finished. Result: The evaluation score for ability in application of nursing process was 83.87 and nursing skill was 85.69 by evaluators. The students reported that the program provided a chance to relearn and practice basic nursing skills and it was helpful in increasing decision making competency and their ability to apply the nursing process. Conclusion: This study suggests that the integrated clinical evaluation program contributes to cultivating a nurse with comprehensive nursing competencies and to improve the nursing students' knowledge, attitude, and skill.

• Annals of Clinical Neurophysiology
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• 제2권1호
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• pp.27-30
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• 2000

Reflex epilepsies are distinct but not clearly understood clinical entity. Various cerebral activities induced by simple stimulation including visual, auditory, somatosensory stimulation, as well as diverse functional tasks such as reading, calculation, complex thinking are believed to be seizure-inducing factors. We experienced two patients whose seizures were readily precipitated by complex, strenuous thinking. Both patients was teen-aged boy at the onset of seizure(13, and 15 years of age each) with normal physical and mental growth. Although first seizure was precipitated by watching TV and playing puzzles in each patient, initial diagnosis was idiopathic generalized epilepsy, possibly juvenile myoclonic epilepsy( JME). For the first few years, seizures were infrequent but mostly precipitated by the tasks needs concentration such as playing computer games, decision-making, mathematics, reading, or during the examination. EEG revealed various thinking process including reading hard books, drawing complex figure, complex calculation induced epileptic discharges even if it usually needs certain period of concentration. Phenytoin, valproic acid, clonazepam, vigabatrin, and lamotrigine sometimes abated their seizures but none of these made them seizure-free. Complex reflex epilepsy induced by thinking was proposed to be a separate type of epilepsy or a variant of JME. Age, sex, stereotypic seizure-inducing factors, clinical course, and refractory epilepsies in these patients highly suggested this type of epilepsy as a variant of JME but its refractoriness and unique provocation still needs more speculation.

• Archives of Plastic Surgery
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• 제48권5호
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• pp.553-558
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• 2021

The diagnosis of the main complications resulting from lipoabdominoplasty has not yet been standardized. Infrared thermal imaging has been used to assess possible complications, such as necrosis and changes in micro- and macro-circulation, based on perforator mapping techniques, among others. The objective of this study was to present two clinical cases involving thermal imaging monitoring of the healing process of lipoabdominoplasty in the immediate postoperative evaluation and its preliminary results. Infrared thermography was performed 24 hours after the operation and on postoperative days 5, 25, and 27. In clinical case 1, it was found that the delta-R (∆T_R)-defined as the difference in minimum temperature between the highest and lowest points in the SA3 region (caution suction area) following the classification established by Matarasso-was 0.4℃ at 24 hours after surgery and decreased to 0.1℃ on a postoperative day 5. There were no complications in this case. In contrast, in clinical case 2, the ∆T_R was 1.7℃ at 24 hours after surgery (upon hospital discharge) and remained high, at 2.2℃, on postoperative day 5. A higher ∆T_R was found in the second patient, who developed necrosis of the surgical wound. The ∆T_R thermal index may be a new tool for predicting possible complications, complementing the clinical evaluation and therapeutic decision-making.

• 대한임상독성학회지
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• 제20권2호
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• pp.75-81
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• 2022

Purpose: This study sought to compare the characteristics of patients with pathogen-positive and negative cultures, and to investigate factors predicting pathogen-positive culture results in patients of acute poisoning with suspected aspiration. Methods: Consecutive patients with acute poisoning admitted to an intensive care unit between January 2016 and December 2018 were retrospectively studied. Respiratory specimens were collected from the enrolled patients at the time of the suspected aspiration. We compared the characteristics of patients with pathogen-positive and negative culture results and analyzed the causative pathogens. Results: Among the 526 patients, 325 showed no clinical features that could be attributed to aspiration, and 201 patients had clinical features suggestive of aspiration. Of these, 113 patients had pathogen-positive culture, 61 were negative, and the specimens of 27 patients contained poor-quality sputum. In univariate analysis, patients with a positive culture showed a longer time to culture from ingestion (p=0.01), faster heart rate (p=0.01), and higher partial pressure of arterial oxygen to the fraction of inspired oxygen (PaO₂/FiO₂) (p=0.02) than patients with negative culture. Multivariate analysis demonstrated that PaO₂/FiO₂ (adjusted odd ratio, 1.005; 95% confidence interval [CI], 1.002-1.008; p=0.005) was a significant risk factor for pathogen-positive culture. The area under the receiver operating characteristic curve of PaO₂/FiO₂ was 0.591 (95% CI, 0.510-0.669, p=0.05). Gram-negative pathogens (GNPs) were predominant and at least one GNP was observed in 84 (73.3%) patients among those with pathogen positive culture. Conclusion: We failed to find any clinical factors associated with positive culture results. Antibiotics that cover GNPs could be considered when deciding the initial antibiotic regimen at the time of suspected aspiration.

• Korean Journal of Radiology
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• 제23권7호
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• pp.697-719
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• 2022

Gadoxetate magnetic resonance imaging (MRI) is widely used in clinical practice for liver imaging. For optimal use, we must understand both its advantages and limitations. This article is the outcome of an online advisory board meeting and subsequent discussions by a multidisciplinary group of experts on liver diseases across the Asia-Pacific region, first held on September 28, 2020. Here, we review the technical considerations for the use of gadoxetate, its current role in the management of patients with hepatocellular carcinoma (HCC), and its relevance in consensus guidelines for HCC imaging diagnosis. In the latter part of this review, we examine recent evidence evaluating the impact of gadoxetate on clinical outcomes on a continuum from diagnosis to treatment decision-making and follow-up. In conclusion, we outline the potential future roles of gadoxetate MRI based on an evolving understanding of the clinical utility of this contrast agent in the management of patients at risk of, or with, HCC.