• Title/Summary/Keyword: Clinical assessment

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Study on the Validity of Surface Electromyography as Assessment Tools for Facial Nerve Palsy

  • Ryu, Hye-Min;Lee, Seung-Jeong;Park, Eun-Jin;Kim, Su-Gyeong;Kim, Kyeong Han;Choi, Yoo Min;Kim, Jong Uk;Song, Beom Yong;Kim, Cheol Hong;Yoon, Hyun-Min;Yook, Tae-Han
    • Journal of Pharmacopuncture
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    • v.21 no.4
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    • pp.258-267
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    • 2018
  • Objectives: The purpose of this study was to find out validity of Surface Electromyography(sEMG) compared with Nerve Conduction Study and clinical assessment scale as assessment factors for facial palsy. Methods: We investigated 50 cases of patients with peripheral facial palsy who had records of sEMG and NCS to check. Then we analyzed the correlation between sEMG and NCS that carried out around 1 week after onset. And we analyzed the correlation between sEMG and clinical assessment scales that were measured three times around 1 week, 3-4 weeks and 5-6 weeks after onset. Clinical assessment scales used in this study were House-brackmann grade, Yanagihara unweighted grading scale and Sunnybrook facial grading system. We used Pearson's correlation for statistical analysis. Results: sEMG and NCS, measured at similar times, were statistically correlated. Especially, the correlation with the forehead region was high. And sEMG and clinical assessment scale, measured at same time, were statistically correlated, especially after 5 weeks from onset. Conclusion: According to this study, sEMG is expected to be useful to assessment facial palsy.

Validation Study of Clinical Utility and Usability on Korean Version of the Life-Space Assessment to Assess Community Mobility (지역사회 이동성을 측정하는 한국어판 생활공간 평가(Korean Version of the Life-Space Assessment; K-LSA)의 임상적 유용성 및 사용성 검증 연구)

  • Kim, Jeong-Hui;Chang, Moon-Young
    • The Journal of Korean society of community based occupational therapy
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    • v.8 no.1
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    • pp.1-10
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    • 2018
  • Objective : The purpose of study is to validate the clinical utility and usability of the Korean version of the Life Space Assessment(K-LSA) which is an assessment tool of community mobility of older adults. Methods : Surveys on the clinical utility and usability of the K-LSA are carried out with a total of aoaa60 occupational and physical therapists. The surveys included the multiple choice questions on the clinical utility and open questions on the usability. Responses to multiple questions are post processed by frequency analysis and technical statistics, and responses to the open questions are categorized by common factors in each questions. Results : Average value of clinical utility ranges from 3.6 to 4.0 with positive responses of 'fair (3 point)', 'agree (4 point)' and 'strongly agree (5 point)' being 95~100%. Average value for clinical usability ranges from 3.6 to 4 with positive answers of 'fair (3 point)', 'easy (4 point)' and 'very easy (5 point)' being 88.3~100%. Additionally out of open-type questions of clinical usability, it was pointed out that the concept of 'neighborhood' for the life space level 3 and 4 is unclear. Conclusion : The current study and research outcomes showed that the K-LSA is a validated tool in Korean health care system for the clinical utility and usability in measuring community mobility, and that it is straightforward in practical use. It will help clinicians and therapists promote the social participation of older adults, and set an intervention goal for enhancing community mobility. It will further help clinicians and researchers in education and research for medical intervention and goal-setting.

The Nutritional Assessment in Children - Understanding of Anthropometric Assessment and Biochemical Indexes in Children (소아의 영양 평가 - 소아 신체계측과 생화학적 지표의 특성을 중심으로)

  • Park, Kie Young
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.12 no.sup1
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    • pp.6-11
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    • 2009
  • Nutritional assessment is based on anthropometric, clinical, dietary and biochemical data. There is a lack of studies about the propriety of biochemical indexes for the nutritional assessment in children despite biochemical data in pediatric population are different from them in adult's in many respects. Serum albumin is useful index to evaluate the severity of malnutrition. Hemoglobin and hematocrit tend to decrease in malnutrition on account of defect of iron metabolism and to increase in metabolic syndrome on account of enhancement of erythropoiesis. But, unlike adult, total lymphocyte count is not so useful biochemical indexes in children. We should consider pediatric characteristic when interpret biochemical indexes for nutritional assessment in children, and nutritional status in children should be assessed comprehensively with anthropometric, clinical, dietary and biochemical data.

The development of CAMBRA; Updated CRA (Caries management by risk assessment (CAMBRA)의 발전; CRA 업데이트)

  • Lee, Su-Young
    • Journal of Korean society of Dental Hygiene
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    • v.21 no.4
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    • pp.321-336
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    • 2021
  • The aim of this study was to investigate the caries management by risk assessment (CAMBRA) development process and the latest updated caries risk assessment for the domestic settlement of the CAMBRA program and the activation of dental clinics. A system for CAMBRA was published in California Dental Association (CDA) in 2007. To investigate whether CAMBRA can be successfully implemented outside a university setting, a practice-based research network (PBRN) was created in the San Francisco Bay Area. Based on the CAMBRA-PRAN clinical studies, the caries risk assessment (CRA) tool was updated for patients aged 6 through adults in 2019. The CAMBRA system is expected to be widely and actively used in the dental field in Korea to contribute to oral health care.

Continuous Quality Improvement of Medical Equipments Based on Clinical Monitoring: A Case Study of Dental Implants (의료기기에 대한 임상모니터링 기반의 지속적 품질개선: 치과용 임플란트의 사례)

  • Kim, Myung-Duk;Eom, Tae-Gwan;Kim, Young-Jin
    • Journal of Korean Society for Quality Management
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    • v.36 no.2
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    • pp.59-66
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    • 2008
  • Dental implant has recently become one of the most viable treatment options for regaining the oral function and dental aesthetics compared with conventional fixed or removable dentures. Dental implants vary in material, dimensions, geometries, surface properties, and interface geometries. It has been reported that there has been a proliferation of manufacturers who produce implants using various materials and surface treatments, and the dentist needs to select from over 2,000 different dental implants and abutments in a specific treatment situation. Unfortunately, however, no metrics have been specifically identified for the purpose of quality assessment and selection of an appropriate dental implant. This study aims to provide practical guidelines for quality assessment of dental implant based on clinical data. Like other medical devices and materials, the superiority related to specific characteristics of the dental implant needs to be verified through extensive clinical studies. The procedures of clinical monitoring for dental implants have been proposed along with a case study to exemplify the usefulness of clinical monitoring for the purpose of continuous quality improvement in medical industry.

Imaging Evaluation of Peritoneal Metastasis: Current and Promising Techniques

  • Chen Fu;Bangxing Zhang;Tiankang Guo;Junliang Li
    • Korean Journal of Radiology
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    • v.25 no.1
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    • pp.86-102
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    • 2024
  • Early diagnosis, accurate assessment, and localization of peritoneal metastasis (PM) are essential for the selection of appropriate treatments and surgical guidance. However, available imaging modalities (computed tomography [CT], conventional magnetic resonance imaging [MRI], and 18fluorodeoxyglucose positron emission tomography [PET]/CT) have limitations. The advent of new imaging techniques and novel molecular imaging agents have revealed molecular processes in the tumor microenvironment as an application for the early diagnosis and assessment of PM as well as real-time guided surgical resection, which has changed clinical management. In contrast to clinical imaging, which is purely qualitative and subjective for interpreting macroscopic structures, radiomics and artificial intelligence (AI) capitalize on high-dimensional numerical data from images that may reflect tumor pathophysiology. A predictive model can be used to predict the occurrence, recurrence, and prognosis of PM, thereby avoiding unnecessary exploratory surgeries. This review summarizes the role and status of different imaging techniques, especially new imaging strategies such as spectral photon-counting CT, fibroblast activation protein inhibitor (FAPI) PET/CT, near-infrared fluorescence imaging, and PET/MRI, for early diagnosis, assessment of surgical indications, and recurrence monitoring in patients with PM. The clinical applications, limitations, and solutions for fluorescence imaging, radiomics, and AI are also discussed.

Assessing Suicidality in Adolescents (청소년의 자살 가능성에 대한 임상 평가)

  • Martin Graham;Kwak Young-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.17 no.2
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    • pp.98-105
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    • 2006
  • Objectives : To consider which questions are most useful clinically and to find a framework for assessment of suicidality or risk of suicide for adolescents. Methods : Authors reviewed and integrated both clinical works and researches about measures used to evaluate suicidal behaviors in adolescents. Results : The 'cascade approach' for assessment of suicidality was developed; the quality and quantity of 'distress' leads to an entry question to do with the 'quality of life' and whether it is worth living. These two questions lead to examinations of 'thoughts' which may lead to 'plans' which leads to 'threats' which then leads to 'deliberate self injury' and then on to a history of 'past suicide attempts'. Authors also suggested to use a summed score of cascade approach in clinical decisions and showed how to modify it up to different evaluation situations. Focusing on the good things helps not only to qualify suicidality but also to begin the search for solutions. Conclusion : In the clinical assessment process, while scales assist the clinician, there is nothing to supplant a sensitive clinical approach. The 'cascade approach' was proposed as a framework for assessing adolescents for suicidality.

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Evaluation of Clinical Competence in Plastic Surgery using OSCE(Objective Structured Clinical Examination): 3-Year Experience (객관구조화진료시험을 이용한 성형외과학 진료능력평가: 3년간의 경험)

  • Hwang, Kun;Lee, Se Il
    • Archives of Plastic Surgery
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    • v.32 no.6
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    • pp.675-682
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    • 2005
  • This is the evaluation report of clinical competence of undergraduate medical students in Plastic Surgery field using OSCE(Objective Structured Clinical Examination) executed in three years. OSCE comprises of assessment of subject, choice of clinical stations sampling, identification of components of clinical competence to be evaluated, the level of performance required, development of specification table, editing of OSCE presentation page and assessment of practicability and results exploitation. About fifty students were examined annually. Seven station stimuli with simulated patient participation were carried out. The mean OSCE score was $82.3{\pm}6.19$. The reliability of the total station was 0.72. The examination shows a positive response to the OSCE. Our experience shows OSCE's feasibility for Plastic Surgery during the initial course of education. Referring to our experiences, the Korean Society of Plastic and Reconstructive Surgeons (KPRS) applied the OSCE test for Korean Plastic Surgery Board Certification

Assessment of Appropriateness of Standard for Insurance Coverage on Chemotherapy used in Non-small Cell Lung Cancer (NSCLC) (비소세포폐암에 사용되는 항암화학요법의 요양급여기준 적절성 평가)

  • Kim, Jeong-Yeon;Park, Eun-Ji;Bae, Min-Kyung;Yoon, Jeong-Hyun
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.3
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    • pp.193-207
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    • 2011
  • Purpose: The purpose of this study is to assess appropriateness of current standard for insurance coverage by Health Insurance Review & Assessment Service (HIRA) on chemotherapy used in the treatment of advanced non-small cell lung cancer (NSCLC), by reviewing a variety of clinical evidences, and thereby, if needed, to propose an updated evidence-based recommendations. Methods: We collected data from HIRA regarding on the insurance standard which includes the scope and conditions for coverage on systemic chemotherapy of NSCLC. We performed a search for clinical databases and examined the most current clinical evidence from clinical literature including various clinical practice guidelines. Based on the collected data the appropriateness of HIRA standard for insurance coverage of chemotherapy of NSCLC was assessed. Results: Collected data demonstrated that HIRA standard did not reflect the most current clinical practice and evidence. Some were inappropriately listed in HIRA formulary and accepted as a chemotherapy being covered by insurance, despite the lack of evidences of clinical efficacy or superiority over other chemotherapeutic agents or regimens. In addition, there seems to be a need for a modification on the standard for insurance coverage of certain newer chemotherapeutic agents based on the current accumulated data showing their clinical efficacy and benefits in the selected group of NSCLC patients. Therefore, we concluded that current HIRA standard for insurance coverage on chemotherapy of NSCLC needs to be revised and we proposed an updated recommendation based on these latest clinical evidences. Conclusion: The standard for insurance coverage of chemotherapy should be continually examined its appropriateness based on the most recent clinical evidences in a timely manner so as to provide the most effective and safe therapy to cancer patients.

A Modified Length-Based Grading Method for Assessing Coronary Artery Calcium Severity on Non-Electrocardiogram-Gated Chest Computed Tomography: A Multiple-Observer Study

  • Suh Young Kim;Young Joo Suh;Na Young Kim;Suji Lee;Kyungsun Nam;Jeongyun Kim;Hwan Kim;Hyunji Lee;Kyunghwa Han;Hwan Seok Yong
    • Korean Journal of Radiology
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    • v.24 no.4
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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.