• Title/Summary/Keyword: Clinical scoring system

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External Validation of a Clinical Scoring System for Hematuria

  • Lee, Seung Bae;Kim, Hyung Suk;Kim, Myong;Ku, Ja Hyeon
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.16
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    • pp.6819-6822
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    • 2014
  • Background: The aim of this study was to evaluate the accuracy of a new scoring system in Korean patients with hematuria at high risk of bladder cancer. Materials and Methods: A total of 319 consecutive patients presenting with painless hematuria without a history of bladder cancer were analyzed, from the period of August 2012 to February 2014. All patients underwent clinical examination, and 22 patients with incomplete data were excluded from the final validation data set. The scoring system included four clinical parameters: age (${\geq}50$ = 2 vs. <50 =1), gender (male = 2 vs. female = 1), history of smoking (smoker/ex-smoker = 4 vs. non-smoker = 2) and nature of the hematuria (gross = 6 vs. microscopic = 2). Results: The area under the receiver-operating characteristic curve (95% confidence interval) of the scoring system was 0.718 (0.655-0.777). The calibration plot demonstrated a slight underestimation of bladder cancer probability, but the model had reasonable calibration. Decision curve analysis revealed that the use of model was associated with net benefit gains over the treat-all strategy. The scoring system performed well across a wide range of threshold probabilities (15%-45%). Conclusions: The scoring system developed is a highly accurate predictive tool for patients with hematuria. Although further improvements are needed, utilization of this system may assist primary care physicians and other healthcare practitioners in determining a patient's risk of bladder cancer.

Evaluation of the correlation between gross lung score and microscopic diagnosis for swine pneumonia in Korean slaughterhouses (국내 도축돈에서 발생한 폐렴에 대한 실물 폐 병변 지수와 조직병리학적 진단의 상관성 평가)

  • Lee, Hong-Seok;Kim, Myung-Chul;Kim, Na-Yon;Hwang, Sung-Hyun;Ji, Sumin;Park, Young Kyung;Park, Yong Ho;Kim, Yongbaek
    • Korean Journal of Veterinary Research
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    • v.57 no.4
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    • pp.227-233
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    • 2017
  • To reduce swine production costs, a slaughter check system has been developed in countries with an advanced swine industry. Evaluation of lung lesions in carcasses is a critical part of the slaughter check system. This study was performed to collect background information for use in developing a slaughter check system in Korea. Lung tissues and their gross images were collected from slaughterhouses in Gyeonggi-do, Korea. Scoring of the gross lung lesions was performed on the lung images. Histopathologic examination was conducted to classify the pulmonary lesions as bronchopneumonia or interstitial pneumonia. Scores of the gross lung lesions were significantly different between bronchopneumonia and interstitial pneumonia groups (p < 0.001). A 90% confidence interval of gross lung lesion scores was established for the bronchopneumonia group, and the lesion scoring had a sensitivity of 100% and specificity of 77.3%. The gross lung lesion scoring test was subjected to a diagnostic distinction evaluation by examining the receiver operating characteristic curve and was appraised as having good discrimination for bronchopneumonia. Establishment of a gross lung lesion scoring test for the diagnosis of bronchopneumonia could be valuable as a screening test of macroscopic bronchopneumonia in swine slaughter check system.

Evaluation of Rotator Cuff Repair Using Korean Shoulder Scoring System

  • Shin, Sang-Jin;Lee, Juyeob;Ko, Young-Won;Park, Min-Gyue
    • Clinics in Shoulder and Elbow
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    • v.18 no.4
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    • pp.206-210
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    • 2015
  • Background: Assessment of the clinical outcomes after rotator cuff repair is essential for their effectiveness on treatment. The Korean Shoulder and Elbow Society devised the Korean Shoulder Scoring System (KSS) for patients with rotator cuff disorder. The purpose of this study was to evaluate the availability of the KSS for assessment of clinical outcomes in patients after arthroscopic rotator cuff repair, and for comparison with other appraisal scoring systems. Methods: A total of 130 patients with partial-thickness or full-thickness rotator cuff tear who underwent arthroscopic repair using a single row or double row suture bridge technique were enrolled. The average follow-up period was 25.9 months. All patients were classified according to various factors. Comparison within corresponding categories was performed, and the correlation between the KSS and other shoulder assessment methods including University of California Los Angeles (UCLA), Constant and American Shoulder and Elbow Surgeons (ASES) score was analyzed. Results: Total score of the KSS response had increased from 59.6 preoperatively to 88.96 at last follow-up. All KSS domains, including function, pain, satisfaction, range of motion, and muscle power had improved up to 24 months postoperatively. Statistical significance was observed mainly in preoperative measurements with number and size of torn tendons, and greater than or equal to grade 3 of fatty infiltration. The KSS was best correlated with the UCLA scoring system in both preoperative (r=0.785) and postoperative (r=0.951) measurements. Conclusions: The KSS was highly reliable and valid as a discriminative instrument, and it showed strong correlation with ASES and UCLA scoring systems.

Diagnostic Potential of Strain Ratio Measurement and a 5 Point Scoring Method for Detection of Breast Cancer: Chinese Experience

  • Parajuly, Shyam Sundar;Lan, Peng Yu;Yun, Ma Bu;Gang, Yang Zhi;Hua, Zhuang
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.4
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    • pp.1447-1452
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    • 2012
  • Aim: To evaluate the differential diagnostic potential of lesion stiffness assessed by the sonoelastographic strain index ratio (SR) and elastographic color scoring system (UE) for breast lesions. Materials and Methods: Three hundred and forty two breast masses (158 benign and 184 malignant) from 325 consecutive patients (mean age 44.2 years; range 16-81)who had been scheduled for a sonographically guided core biopsy were examined proposed by Itoh et al, with scoring 1-3=benign and 4-5=malignant. Strain and area ratios of each lesion were calculated within the same machine. Histological diagnosis was used as the reference standard. The area under the curve (AUC) and cut-off point were obtained by receiver operating curve and the cross table Fischer Test was carried out for assessing diagnostic value. Sensitivity, specificity, PPV, NPV, accuracy and false-discovery rates were compared. Results: The mean strain ratios for benign and malignant lesions were 1.87 and 7.9 respectively. (P<0.0001). When a cutoff point of 3.54 was used, SR had a sensitivity of 94.6%, a specificity 94.3%, a PPV of 95.1%, an NPV of 93.7% and an accuracy of 94.4%. The AUC values were 0.90 for the 5 point scoring system (UE) and 0.96 for the strain index ratio. The overall diagnostic performance was SR method was better (P<0.05). Conclusions: Strain ratio measurement could be another effective predictor in elastography imaging besides 5 the point scoring system for differential diagnosis of breast lesions.

Stratifying Patients with Haematuria into High or Low Risk Groups for Bladder Cancer: a Novel Clinical Scoring System

  • Tan, Guan Hee;Shah, Shamsul Azhar;Ann, Ho Sue;Hemdan, Siti Nurhafizah;Shen, Lim Chun;Abdul Galib, Nurudin Al-Fahmi;Singam, Praveen;Kong, Ho Chee Christopher;Hong, Goh Eng;Bahadzor, Badrulhisham;Zainuddin, Zulkifli Md
    • Asian Pacific Journal of Cancer Prevention
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    • v.14 no.11
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    • pp.6327-6330
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    • 2013
  • Haematuria is a common presentation of bladder cancer and requires a full urologic evaluation. This study aimed to develop a scoring system capable of stratifying patients with haematuria into high or low risk groups for having bladder cancer to help clinicians decide which patients need more urgent assessment. This cross-sectional study included all adult patients referred for haematuria and subsequently undergoing full urological evaluation in the years 2001 to 2011. Risk factors with strong association with bladder cancer in the study population were used to design the scoring system. Accuracy was determined by the area under the receiver operating characteristic (ROC) curve. A total of 325 patients with haematuria were included, out of which 70 (21.5%) were diagnosed to have bladder cancer. Significant risk factors associated with bladder cancer were male gender, a history of cigarette smoking and the presence of gross haematuria. A scoring system using 4 clinical parameters as variables was created. The scores ranged between 6 to 14, and a score of 10 and above indicated high risk for having bladder cancer. It was found to have good accuracy with an area under the ROC curve of 80.4%, while the sensitivity and specificity were 90.0% and 55.7%, respectively. The scoring system designed in this study has the potential to help clinicians stratify patients who present with haematuria into high or low r isk for having bladder cancer. This will enable high-risk patients to undergo urologic assessment earlier.

Clinical Study of Oriental Medical Treatment on a Patient with Alcoholic Polyneuropathy (알코올성 다발성 신경병증의 한방치료 효과)

  • Yeom, Seung Ryong
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.5
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    • pp.797-802
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    • 2012
  • Alcoholic polyneuropathy is a disorder of the peripheral nervous system that interferes with sensory, motor, and autonomic nerve function. This study was to report the effect of Oriental medical treatment on a patient with alcoholic polyneuropathy. Conservative Oriental medical treatment was done to a man of 84 years who was diagnosed as a alcoholic polyneuropathy and suffered from both distal dominant leg weakness & symmetrical paresthesia and ataxic gait. The changes of symptoms, reflexes and sensory test were checked by Toronto Clinical Neuropathy Scoring System(TCNSS). Reflexes, motor and sensory impairments were improved after the Oriental medical treatment. I reported good effects of Oriental medical treatment on alcoholic polyneuropathy. Oriental medical treatment can be helpful to improve the symptoms of alcoholic polyneuropathy.

A Clinical Study on the Value of a Scoring System of the Scanning Images in Liver Cirrhosis (간경변증(肝硬變症)의 간주사상판독(肝走査像判讀)에 있어서의 평점제적용(評點制適用)에 관(關)한 임상적(臨床的) 연구(硏究))

  • Chang, Ko-Chang
    • The Korean Journal of Nuclear Medicine
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    • v.4 no.2
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    • pp.41-53
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    • 1970
  • Although the radioisotope liver scan has primarily been of use in the detection of the intra-hepatic space occupying lesions, there has been an increasing awareness of its use in evaluation of liver function. In this study, the degree of hepatomegaly, changes in shape and mottling radiodensity on each lobe and splenic visualization in the liver scans done with colloidal radiogold were numerically expressed as scores under the arbitrary standard in 210 patients with liver cirrhosis. The clinical value of this scoring system was studied with special regards to the correlation between the radiogold hepatic uptake half time and conventional liver function tests. Following were the results; 1) The normal scan appeared in 6.7% of 210 patients with liver cirrhosis. 2) The colloidal radiogold hepatic uptake half time was abnormally and progressively prolonged in parallel to severity of hepatocellular dysfunction. The mean hepatic uptake half time in cirrhosis showing normal scan was $2.76{\pm}0.73$ minutes. 3) The scoring system was well correlated with the serum albumin and globulin levels, A/G ratio and BSP retention. There was some correlative tendency in alkaline phosphatase activity. 4) There was no correlation with the thymol turbidity test, cholesterol levels, transaminase activities and bilirubin levels. 5) The spleen was visualized in 38.6% of total patients with liver cirrhosis. Excluding normal scans in liver cirrhosis, the spleen was visualized in 41.3%. 6) The scoring system appears to confirm the clinical diagnosis and to give a reliable estimate of the degree of hepatocellular dysfunction in patients with liver cirrhosis.

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Usefulness of Clinical Scoring System in the Diagnosis of Group A Streptococcal Pharyngitis (인두염 환아에서 A군 연구균 검출의 임상적 점수제의 유용성)

  • Kim, Eun-Seong;Jung, Ji-Young;Cha, Sung-Ho;Lee, Hee-Joo
    • Pediatric Infection and Vaccine
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    • v.9 no.1
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    • pp.74-78
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    • 2002
  • Purpose : Proper diagnosis of group A streptococcal pharyngitis that may cause chronic diseases in childhood is not easy because its signs and symptoms would be nonspecific. Because results of classical throat culture delays for one to two days, we'd like to determine whether early antibiotics would be introduced with according to the clinical score system. This study was undertaken to evaluate of clinical usefulness of scoring system based on the clinical and laboratory findings. Methods : From Jan. 1998 to Dec. 2000, 10 clinical items based on modified 9 items by Breese in 1977 were checked in patients with pharyngitis who visited on outpatients clinic of pediatrics, Kyunghee University Hospital. We compared the results of throat culture with the points of clinical score system. Results : Out of 45 cases, the positive culture for Group A Streptococcus was 20 and negative culture was 25. When we applied more than 30 points of score, which correspond to 70 percentile of study population, the sensitivity and specificity were 35.0% and 96.0%, respectively. Conclusion : Although sensitivity was relatively low this scoring system, but the high specificity may be useful diagnostic tool in the areas where the rate of isolation of Group A Streptococcus is low.

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Development of a Novel Endoscopic Scoring System to Predict Relapse after Surgery in Intestinal Behçet's Disease

  • Park, Jung Won;Park, Yehyun;Park, Soo Jung;Kim, Tae Il;Kim, Won Ho;Cheon, Jae Hee
    • Gut and Liver
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    • v.12 no.6
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    • pp.674-681
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    • 2018
  • Background/Aims: The cumulative surgery rate and postoperative relapse of intestinal Behçet's disease (BD) have been reported to be high. This study aimed to establish a scoring system based on follow-up endoscopic findings that can predict intestinal BD recurrence after surgery. Methods: Fifty-four patients with intestinal BD who underwent surgery due to bowel complications and underwent follow-up colonoscopy were retrospectively investigated. Their clinical data, including colonoscopic findings, were retrieved. Classification and regression tree analysis was used to develop an appropriate endoscopic classification model that can explain the postsurgical recurrence of intestinal BD most accurately based on the following classification: e0, no lesions; e1, solitary ulcer <20 mm in size; e2, solitary ulcer ${\geq}20mm$ in size; and e3, multiple ulcers regardless of size. Results: Clinical relapse occurred in 37 patients (68.5%). Among 38 patients with colonoscopic recurrence, only 29 patients had clinically relapsed. Multivariate analysis identified higher disease activity index for intestinal BD at colonoscopy (hazard ratio [HR], 1.013; 95% confidence interval [CI], 1.005 to 1.021; p=0.002) and colonoscopic recurrence (HR, 2.829; 95% CI, 1.223 to 6.545; p=0.015) as independent risk factors for clinical relapse of intestinal BD. Endoscopic findings were classified into four groups, and multivariate analysis showed that the endoscopic score was an independent risk factor of clinical relapse (p=0.012). The risk of clinical relapse was higher in the e3 group compared to the e0 group (HR, 6.284; 95% CI, 2.036 to 19.391; p=0.001). Conclusions: This new endoscopic scoring system could predict clinical relapse in patients after surgical resection of intestinal BD.

A Clinical Report of Polyneuropathy Treated with Korean Medical Treatment (다발성 신경병증에 대한 한방 치험 1례)

  • Son, Byun-woo;Jeong, Hae-ryong;Hwang, Won-deok
    • The Journal of Internal Korean Medicine
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    • v.37 no.5
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    • pp.698-703
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    • 2016
  • Objective: To describe the effects of Korean medical treatment on a 51-year-old male patient with polyneuropathy and chief complaints of lower limb paralysis and dysarthria. Methods: The Toronto Clinical Neuropathy Scoring System (TCNSS) was used to evaluate the function of the lower limb and the symptoms of the patient were observed daily. We applied herbal medication and acupuncture daily, depending on the patient’s symptoms. Results: After the treatment, the TCNSS score was improved. Conclusions: In this case, Korean medical therapy was effective in improving lower limb function.