• Title/Summary/Keyword: Clinical reasoning

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Application of AIG Implemented within CLASS Software for Generating Cognitive Test Item Models

  • SA, Seungyeon;RYOO, Hyun Suk;RYOO, Ji Hoon
    • Educational Technology International
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    • v.23 no.2
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    • pp.157-181
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    • 2022
  • Scale scores for cognitive domains have been used as an important indicator for both academic achievement and clinical diagnosis. For example, in education, Cognitive Abilities Test (CogAT) has been used to measure student's capability in academic learning. In a clinical setting, Cognitive Impairment Screening Test utilizes items measuring cognitive ability as a dementia screening test. We demonstrated a procedure of generating cognitive ability test items similar as in CogAT but the theory associated with the generation is totally different. When creating cognitive test items, we applied automatic item generation (AIG) that reduces errors in predictions of cognitive ability but attains higher reliability. We selected two cognitive ability test items, categorized as a time estimation item for measuring quantitative reasoning and a paper-folding item for measuring visualization. As CogAT has widely used as a cognitive measurement test, developing an AIG-based cognitive test items will greatly contribute to education field. Since CLASS is the only LMS including AIG technology, we used it for the AIG software to construct item models. The purpose of this study is to demonstrate the item generation process using AIG implemented within CLASS, along with proving quantitative and qualitative strengths of AIG. In result, we confirmed that more than 10,000 items could be made by a single item model in the quantitative aspect and the validity of items could be assured by the procedure based on ECD and AE in the qualitative aspect. This reliable item generation process based on item models would be the key of developing accurate cognitive measurement tests.

A Study of Medical Abstraction on 'The Theory of Byeongin' (病因論) of Kim Goo Young (김구영(金久永)의 『병인론(病因論)』에 나타난 의학사상 연구)

  • Kim, Chong-Won;Kim, Namil;Cha, Wung-Seok
    • The Journal of Korean Medical History
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    • v.30 no.1
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    • pp.11-22
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    • 2017
  • This paper is a study on the life and clinical reasoning of Kim Goo Young (1958-2014). Offering a new perspective through his interpretation of Donguibogam (東醫寶鑑), Kim introduced his unique theory of Korean medicine, 'The Theory of Byeongin (病因論)'. Kim recognized the confusing situation of communication between people studying Korean medicine and tried to make a new standard based on the principle that many people can share. 'The Theory of Byeongin' offers a newly constituted "Donguibogam" focusing on 'Byeongin' (病因, pathologic origin) which can be translated as the cause of a disease. In so doing Kim recognized 'Byeongin' as the most important factor in 'Byeonjeung' (辨證, classifying the origin), or the classification method of symptoms. In addition, Kim recognized how 'Byeongin' was considered to be a diseased lifestyle, and tried interpreting. The patient's lifestyle to treat diseases. As a result, 'The Theory of Byeongin' is a theory consisting of an intuitive structure, reducing notable elements like Yin Yang Five Movement theory. The theory's significant characteristic is its easy application in clinical settings due the established core principles which are based on Kim's insight and clinical experience. This study contributes to the understanding of the theoretical and clinical development of Korean medicine through deeper studies on 'The Theory of Byeongin' and Kim's medical theory.

Comparative Analysis of Course Satisfaction and Student Assessment Results in Redesigned Problem-Based Learning (문제기반학습 교육과정 개편에 따른 과정 만족도 및 학생평가 결과 비교 분석 연구)

  • Kim, Sejin;Kim, Minjeong;Kong, Seom Gim;Jeong, Ho Joong
    • Korean Medical Education Review
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    • v.24 no.2
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    • pp.128-140
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    • 2022
  • The purpose of this study was to redesign a problem-based learning (PBL) curriculum and compare the differences between the previous and redesigned PBL based on the results of course satisfaction and student assessments. The PBL was redesigned using curriculum design guidelines (including revisions of curriculum objectives, learning components, learning environments, and assessment methods) that were developed based on previous studies and evaluation results. A comparative study was employed using course satisfaction surveys from the previous and redesigned curricula, and a total of 45 students participated. We also compared student assessment results from concept mapping, learning issue reports, modified essay questions, and reflection journals. We identified four key findings. First, we explored the possibility that the redesigned PBL could be implemented by student facilitators without professors as tutors. Second, the redesigned PBL fostered group dynamics that facilitated developing communication skills and collaborative learning through small-group discussions. Third, the new learning elements added in the redesigned PBL made a meaningful contribution to enhancing students' clinical reasoning based on hypothetico-deductive reasoning. Fourth, concept maps in redesigned PBL contained more complex and various nodes and connections, and the levels of the nodes were more appropriate. The implications of this study can provide meaningful preliminary information for redesigning PBL curricula for medical students to develop their essential competencies through PBL.

A Study of the Functional Anatomy of the Hand (손의 기능 해부에 대한 연구)

  • Park, Young-Han;Lee, Hyo-Jeong
    • Journal of Korean Physical Therapy Science
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    • v.13 no.1
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    • pp.61-74
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    • 2006
  • This study about functional anatomy of the hand. hand injuries are among the most common problems confronting patient, physical therapist and physicians. physical therapist should know about normal hand function and anatomical structure for hand injury, clinical reasoning and intervention. physical therapist should know about the Skeletal of the hand, Function of The Hand, Nerves of the hand, Sensation of the Hand, Intrinsic muscle, Power and Balance and Functional Position of the Hand. In this article, we discuss the physiologic properties of hand structure, biomechanical observation in hand function, sensation and nerves, hand positioning.

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A Comparative Study on the Individual Personality and Intelligence for Criminal (개인의 성격과 지능이 범죄에 미치는 영향에 관한 연구)

  • Rim, Sang-Gon
    • Korean Security Journal
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    • no.8
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    • pp.309-336
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    • 2004
  • Approximately equivalent to character disorder or character neuroses or behavioral reaction. For a discussion of the term as used currently, in the 1968 revision of psychiatric nomenclature(DSM-II). In DSM-I(1952 nomenclature), this term referred to those cases in which the personality, in its struggle for adjustment to internal and external stresses, utilized primarily a pattern of action or behavior rather than symptoms in the mental, somatic or emotional spheres. There is minimal subjective anxiety and little or no sense of distress. As thus defined, there are three main groups of personality disorder, personality pattern disturbance, personality trait disturbance and sociopathic, personality disturbance. Morton Prince asks whether a subconscious process can perform the same function as are ordinarily performed by conscious intelligence that is to say memory, perception, reasoning, imagination, volition, affectivity, etc? He cites clinical material at great length, concluding that the quality of the functions performed they frequently exhibit, that which is characteristic of intelligence.

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Excessive crying: behavioral and emotional regulation disorder in infancy

  • Kim, Joon-Sik
    • Clinical and Experimental Pediatrics
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    • v.54 no.6
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    • pp.229-233
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    • 2011
  • In the pediatric literature, excessive crying has been reported solely in association with 3-month colic and is described, if at all, as unexplained crying and fussing during the first 3 months of life. The bouts of crying are generally thought to be triggered by abdominal colic (over-inflation of the still immature gastrointestinal tract), and treatment is prescribed accordingly. According to this line of reasoning, excessive crying is harmless and resolves by the end of the third month without long-term consequences. However, there is evidence that it may cause tremendous distress in the mother-infant relationship, and can lead to disorders of behavioral and emotional regulation at the toddler stage (such as sleep and feeding disorders, chronic fussiness, excessive clinginess, and temper tantrums). Early treatment of excessive crying focuses on parent-infant communication, and parent-infant interaction in the context of soothing and settling the infant to sleep is a promising approach that may prevent later behavioral and emotional disorders in infancy.

A Case of Aphthous Stomatitis in a Healthy Adult Following COVID-19 Vaccination: Clinical Reasoning

  • Kim, Hye Kyoung;Kim, Mee Eun
    • Journal of Oral Medicine and Pain
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    • v.47 no.1
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    • pp.62-66
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    • 2022
  • Recent case studies raised the possibility that cutaneous and oral mucosal manifestations may be associated with the coronavirus disease 2019 (COVID-19) vaccination. A healthy 43-year-old male presented an acute aphthous stomatitis following Moderna COVID-19 vaccination. This rare case draws attention to a potential etiologic effect for oral mucosal manifestation from COVID-19 vaccination. Further investigation to shed light on prevalence and pathophysiologic association of this oral lesion and COVID-19 vaccination deserve attention.

Clinical Characteristics of Patients with Major Depressive Disorder on Military Service and Conscription Issues Using K-WAIS-IV : A Retrospective Study (한국판 성인용 웩슬러 지능검사 4판(K-WAIS-IV)으로 살펴본 병무용 진단서 대상 주요우울장애 환자의 특성 : 후향적 연구)

  • Kim, Jiyoung;Park, Eunhee
    • Anxiety and mood
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    • v.16 no.1
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    • pp.32-40
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    • 2020
  • Objective : The purpose of this study was to investigate the cognitive performance of major depressive disorder (MDD) in military service/conscription personnel who visited the psychiatric clinic for a medical certificate to consider the situation from the perspective of Korea's unique compulsory military system. We used the Korean Wechsler Adult Intelligence Scale-IV (K-WAIS-IV) as the test for verifying the suitable level of cognitive functioning for military service and as the embedded measure with reflecting suboptimal effort. Methods : The study was conducted on 56 (28 males, age 19-34) in/out-patients admitted to the psychiatry department and diagnosed with MDD (DSM-IV). All participants completed a structured clinical interview (MINI-Plus), as well as self-report questionnaires related to demographics and severity of clinical symptoms. K-WAIS-IV was administered to each subject to assess cognitive characteristics. Results : Military group showed significantly lower processing speed index (PSI) score including subtests of symbol search (SS) and coding (CD) score, compared to the control group. There was no other significant differences in the Full Scale IQ (FSIQ), Verbal Comprehension Index (VCI), Perceptual Reasoning Index (PRI), Working Memory Index (WMI) scores including sub-tests comprised of the above indices, and Reliable Digit Span (RDS), Enhanced-RDS-Revised (E-RDS-R) between the study and control groups. Conclusion : This study was the first effort to verify the characteristics of Korea's military group with MDD and suggest the applicability of PSI and processing speed of K-WAIS-IV as an embedded performance index to test sub-optimal effort or low motivation beyond the purpose of testing cognitive deficits.

A Clinical Nomogram Construction Method Using Genetic Algorithm and Naive Bayesian Technique (유전자 알고리즘과 나이브 베이지언 기법을 이용한 의료 노모그램 생성 방법)

  • Lee, Keon-Myung;Kim, Won-Jae;Yun, Seok-Jung
    • Journal of the Korean Institute of Intelligent Systems
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    • v.19 no.6
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    • pp.796-801
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    • 2009
  • In medical practice, the diagnosis or prediction models requiring complicated computations are not widely recognized due to difficulty in interpreting the course of reasoning and the complexity of computations. Medical personnel have used the nomograms which are a graphical representation for numerical relationships that enables to easily compute a complicated function without help of computation machines. It has been widely paid attention in diagnosing diseases or predicting the progress of diseases. A nomogram is constructed from a set of clinical data which contain various attributes such as symptoms, lab experiment results, therapy history, progress of diseases or identification of diseases. It is of importance to select effective ones from available attributes, sometimes along with parameters accompanying the attributes. This paper introduces a nomogram construction method that uses a naive Bayesian technique to construct a nomogram as well as a genetic algorithm to select effective attributes and parameters. The proposed method has been applied to the construction of a nomogram for a real clinical data set.

Bayesian Network-Based Analysis on Clinical Data of Infertility Patients (베이지안 망에 기초한 불임환자 임상데이터의 분석)

  • Jung, Yong-Gyu;Kim, In-Cheol
    • The KIPS Transactions:PartB
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    • v.9B no.5
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    • pp.625-634
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    • 2002
  • In this paper, we conducted various experiments with Bayesian networks in order to analyze clinical data of infertility patients. With these experiments, we tried to find out inter-dependencies among important factors playing the key role in clinical pregnancy, and to compare 3 different kinds of Bayesian network classifiers (including NBN, BAN, GBN) in terms of classification performance. As a result of experiments, we found the fact that the most important features playing the key role in clinical pregnancy (Clin) are indication (IND), stimulation, age of female partner (FA), number of ova (ICT), and use of Wallace (ETM), and then discovered inter-dependencies among these features. And we made sure that BAN and GBN, which are more general Bayesian network classifiers permitting inter-dependencies among features, show higher performance than NBN. By comparing Bayesian classifiers based on probabilistic representation and reasoning with other classifiers such as decision trees and k-nearest neighbor methods, we found that the former show higher performance than the latter due to inherent characteristics of clinical domain. finally, we suggested a feature reduction method in which all features except only some ones within Markov blanket of the class node are removed, and investigated by experiments whether such feature reduction can increase the performance of Bayesian classifiers.