• Title/Summary/Keyword: Clinical scoring system

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Presumptive Diagnosis of Mycoplasma pneumoniae Pneumonia in Children (소아에서 마이코플라즈마 폐렴의 예기적 진단)

  • Lee, Chang Eon;Park, Su Jin;Kim, Won Duck
    • Journal of Yeungnam Medical Science
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    • v.29 no.2
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    • pp.89-95
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    • 2012
  • Background: As Mycoplasma pneumoniae pneumonia has increased in Korea, its relevance to infants, toddlers, and adolescents has magnified as well as. However, it is difficult to perform the serological test and PCR test routinely for diagnosis in actual clinical practice. Thus, the authors conducted this study to help clinicians do presumptive diagnosis of Mycoplasma pneumoniae pneumonia using clinical, radiological, and hematological findings. Methods: The study population consisted of 224 children between 1 month and 14 years old, hospitalized for radiographically confirmed pneumonia. Patients were divided into two groups of 100 children with Mycoplasma pneumoniae pneumonia, as diagnosed using the ELISA method. Groups with negative result in Mycoplasma IgM antibody test were classified into the viral group (98 patients with respiratory virus) and the bacterial group (46 patients with the bacteria detected in the blood sputum culture or antibiotic treatment except macrolide improved the patient's condition). These groups were compared and analyzed using clinical, hematological, and radiographic differences and scoring system. Results: Clinical, hematological, and radiographic characteristics of Mycoplasma pneumoniae pneumonia have shown the intermediate level results between bacterial pneumonia and viral pneumonia. In terms of scoring system, the mean score of Mycoplasma pneumoniae pneumonia was 4.23, which was the intermediate level between bacterial pneumonia (mean score=6.67) and viral pneumonia (mean score=1.48). Conclusion: Results suggest that the combination of the scoring system information can increase the accuracy in the diagnosis even if they may have difficulties on diagnosis, because clinical manifestations, hematological, and radiographic findings are nonspecific.

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Usefulness of the Clock Drawing Test as a Cognitive Screening Instrument for Mild Cognitive Impairment and Mild Dementia: an Evaluation Using Three Scoring Systems

  • Kim, Sangsoon;Jahng, Seungmin;Yu, Kyung-Ho;Lee, Byung-Chul;Kang, Yeonwook
    • Dementia and Neurocognitive Disorders
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    • v.17 no.3
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    • pp.100-109
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    • 2018
  • Background and Purpose: Although the clock drawing test (CDT) is a widely used cognitive screening instrument, there have been inconsistent findings regarding its utility with various scoring systems in patients with mild cognitive impairment (MCI) or dementia. The present study aimed to identify whether patients with MCI or dementia exhibited impairment on the CDT using three different scoring systems, and to determine which scoring system is more useful for detecting MCI and mild dementia. Methods: Patients with amnestic mild cognitive impairment (aMCI), vascular mild cognitive impairment (VaMCI), mild Alzheimer's disease (AD), mild vascular dementia (VaD), and cognitively normal older adults (CN) were included. All participants were administered the CDT, the Korean-Mini Mental State Examination (K-MMSE), and the Clinical Dementia Rating scale. The CDT was scored using the 3-, 5-, and 15-point scoring systems. Results: On all three scoring systems, all patient groups demonstrated significantly lower scores than the CN. However, while there were no significant differences among patients with aMCI, VaMCI, and AD, those with VaD exhibited the lowest scores. Area under the Receiver Operating Characteristic curves revealed that the three CDT scoring systems were comparable with the K-MMSE in differentiating aMCI, VaMCI, and VaD from CN. In differentiating AD from CN, however, the CDT using the 15-point scoring system demonstrated the most comparable discriminability with K-MMSE. Conclusions: The results demonstrated that the CDT is a useful cognitive screening tool that is comparable with the Mini-Mental State Examination, and that simple CDT scoring systems are sufficient for differentiating patients with MCI and mild dementia from CN.

A New Method of Plaque Scoring and Database Implementation (치아 플라그 인덱스 도출 및 데이터베이스 구성)

  • Shin, Seung-Won;Kim, Kyeong-Seop;Lee, Sun-Ju;Kim, Dong-In;Kim, Kee-Deog;Park, Won-Se
    • The Transactions of The Korean Institute of Electrical Engineers
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    • v.58 no.6
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    • pp.1200-1206
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    • 2009
  • In this study, a new method of dental plaque scoring is proposed by adopting new criteria to divide the tooth surface with utilizing the geometrical features of a tooth color image. For the possible clinical usage of our new plaque scoring system, GUI(Graphic User Interface) system is also implemented to estimate the numerical plaque index for a specific tooth by designing the supplementary database management module that handles dental plaque scores.

Arthroscopic PCL Reconstruction using fresh-frozen Achilles Allograft (동종 아킬레스건을 이용한 관절경적 후방 십자 인대 재건술)

  • Chun, Churl-Hong;Kim, Dong-Churl;Shin, Ho-Sik
    • Journal of the Korean Arthroscopy Society
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    • v.4 no.2
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    • pp.105-110
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    • 2000
  • Purpose : The purpose of this study was to evaluate the clinical results of fresh-frozen achilles allograft PCL reconstruction. Materials and Methods : 34 patients(35 cases) who was reconstructed PCL arthroscopically using achilles allograft were analyzed subjective and objective parameters, Telos stress arthrometer and Modified Feagin Scoring System. The average age was 36.2 years old($16\~57$ year) and average follow up period was 18.5 months($12\~27$ months). Result : The mean Lysholm Knee Scoring was improved from 47.5 to 87.4. Posterior translation by Telos arthrometer decreased to 2.3mm from 7.1mm. The modified Feagin scoring system showed 32 cases$(91.5\%)$ with excellent and good result. Conclusion : Clinical results of PCL reconstruction by Achilles allograft revealed good result as to scales. Achilles allograft provided enough initial tension with length and minimized the complication of using autograft. Therefore achilles fresh-frozen allograft in PCL reconstruction is a good substitute material for autograft.

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The evaluation of a scoring system in airway management after oral cancer surgery

  • Lee, Ho-Jin;Kim, Jin-Wook;Choi, So-Young;Kim, Chin-Soo;Kwon, Tae-Geon;Paeng, Jun-Youg
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.37
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    • pp.19.1-19.7
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    • 2015
  • Background: The purpose of this retrospective study was to investigate the usefulness of tracheostomy scoring system in the decision of postoperative airway management in oral cancer patients. Materials and methods: A total of 104 patients were reviewed in this retrospective study, who underwent radical resection with or without neck dissection and free flap reconstruction due to oral cancer. The patients were classified into three groups according to the timing of the extubation; extubated groups (n = 51), overnight intubation group (n = 45), and tracheostomy group (n = 8). Cameron's score was used to evaluate the relation between the state of the patient's airway and the type of the operation. Results: Tracheostomy was performed in eight patients (8/104, 7.7 %). A total of 22 patients (21.2 %) had more than 5 points of which 17 patients (77.3 %) did not have a tracheostomy and any postoperative emergency airway problems. The tracheostomy scores were significantly different among the three groups. Hospital stay showed a significant correlation with the tracheostomy score. Conclusions: The scoring system did not quite agree with the airway management of the authors' clinic; however, it can be one of the clinical factors predicting the degree of the postoperative airway obstruction and surgical aggressiveness for recovery. The further studies are needed for clinically more reliable scoring systems.

Scoring Model Based on Nodal Metastasis Prediction Suggesting an Alternative Treatment to Total Gastrectomy in Proximal Early Gastric Cancer

  • So, Seol;Noh, Jin Hee;Ahn, Ji Yong;Lee, In-Seob;Lee, Jung Bok;Jung, Hwoon-Yong;Yook, Jeong-Hwan;Kim, Byung-Sik
    • Journal of Gastric Cancer
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    • v.22 no.1
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    • pp.24-34
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    • 2022
  • Purpose: Total gastrectomy (TG) with lymph node (LN) dissection is recommended for early gastric cancer (EGC) but is not indicated for endoscopic resection (ER). We aimed to identify patients who could avoid TG by establishing a scoring system for predicting lymph node metastasis (LNM) in proximal EGCs. Materials and Methods: Between January 2003 and December 2017, a total of 1,025 proximal EGC patients who underwent TG with LN dissection were enrolled. Patients who met the absolute ER criteria based on pathological examination were excluded. The pathological risk factors for LNM were determined using univariate and multivariate logistic regression analyses. A scoring system for predicting LNM was developed and applied to the validation group. Results: Of the 1,025 cases, 100 (9.8%) showed positive LNM. Multivariate analysis confirmed the following independent risk factors for LNM: tumor size >2 cm, submucosal invasion, lymphovascular invasion (LVI), and perineural invasion (PNI). A scoring system was created using the four aforementioned variables, and the areas under the receiver operating characteristic curves in both the training (0.85) and validation (0.84) groups indicated excellent discrimination. The probability of LNM in mucosal cancers without LVI or PNI, regardless of size, was <2.9%. Conclusions: Our scoring system involving four variables can predict the probability of LNM in proximal EGC and might be helpful in determining additional treatment plans after ER, functioning as a good indicator of the adequacy of treatments other than TG in high surgical risk patients.

Patient Classification Technique based on Computerized Clinical Data and Nursing Workforce Management : Analysis case of a general Hospital (전산화된 임상 데이터에 기반한 환자 분류 체계 및 간호 인력 관리 방안 : 일개 종합병원 분석 사례)

  • Kim, Kyoungok;Park, Kyungsoon;Suh, Changjin
    • The Journal of the Korea Contents Association
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    • v.13 no.3
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    • pp.287-298
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    • 2013
  • To develop a technique classifying patients based on computerized clinical data followed by validity verification by comparing with nurse's examination. Class scores were determined by nurses for a day on 348 resident patients in 7 wards of a general hospital according to KPCS-1. The class scores were simultaneously evaluated by reviewing the computerized clinical data acquired from the hospital management information system. These two class scores were both significantly different among different departments as well as disease patterns. Intraclass correlation analysis resulted a very high correlation coefficient of 0.96(p<0.01) between the two scoring methods, but the clinical data scores were somewhat higher. An automated patient classification system seemed possible to be developed in future with further enhancement of the present results based on computerized clinical data without manual scoring, which can be applied for performance evaluation as well as workforce planning.

Diagnosis and Treatment of Myelodysplastic Syndrome in the Era of Genetic Testing (유전자 검사 시대 골수형성이상증후군의 진단과 치료)

  • Junshik Hong
    • The Korean Journal of Medicine
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    • v.99 no.1
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    • pp.11-16
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    • 2024
  • Myelodysplastic syndrome (MDS) is a heterogeneous disorder with diverse prognoses influenced by cytopenias, genetic variants, and myeloblast proportions in the bone marrow. Accurate prognosis prediction and tailored treatment plans are essential. The International Prognostic Scoring System-Molecular (IPSS-M), which additionally reflects the impact of MDS-related genetic mutations to the clinical and laboratory information, is anticipated to offer superior prognostic accuracy compared to existing systems like the Revised International Prognostic Scoring System (IPSS-R). Despite its statistical complexity, its web-based calculation and ease of discussing results with patients using intuitive data sets provide notable advantages. Progress in MDS treatment, exemplified by effective anemia correction with an erythropoiesis-maturation agent in SF3B1-mutated cases and efforts to refine poor prognoses in TP53-mutated cases, reflects the evolving landscape of genetic-based interventions in MDS. Advancements in genetic diagnostic technology, combined with enhanced knowledge of the bone marrow niche, are anticipated to lead to significant improvement in MDS treatment outcomes in the future.

Anterior Cruciate Ligament Augmentation Using Autogenous Semitendinosus Tendon (자가 반건양건을 이용한 전방 십자 인대 보강술)

  • Choi, Nam-Yong;Han, Chang-Hwan;In, Yong;Moon, Chan-Woong;Choi, Seung-Woog;Jin, Sung-Ki
    • Journal of the Korean Arthroscopy Society
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    • v.12 no.1
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    • pp.12-17
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    • 2008
  • Purpose: This study presents clinical results of anterior cruciate ligament(ACL) augmentation using autogenous two-strand semitendinosus tendon in the treatment of partial ACL tears with preservation of residual portion. Materials and Methods: From January 2004 to June 2006, twenty two patients who had an ACL injury underwent ACL augmentation using autogenous two-strand semitendinosus tendon were enrolled in this study. We evaluated the clinical results with regard to clinical findings(range of motion, Lachman test, pivot shift test), standard knee scales(Lysholm, Modified Feagin Scoring System), and KT-1000 arthrometer testing. Results: At minimum one year postoperatively, there was no limitation of range of motion. Lachman and pivot shift tests were negative in all knees. On instrumented anterior laxity test by KT-1000 arthrometer, mean side to side difference was improved from 4.6mm preoperatively to 1.7mm postoperatively. Average Lysholm score was improved from 70 to 92. Ninety one percent of cases were rated as good or excellent in Modified Feagin Scoring System. Conclusion: Augmentation using autogenous two-strand semitendinosus tendon with preservation of residual portion of the ACL seems to be an acceptable method for restoring knee stability and proprioceptive function.

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Validity and Reliability of a Clinical Performance Examination using Standardized Patients (호흡기계 표준화 환자를 이용한 간호대 학생의 임상수행능력평가 타당도와 신뢰도 검증)

  • Choi, Ja-Yun;Jang, Keum-Seong;Choi, Soon-Hee;Hong, Mi-Soon
    • Journal of Korean Academy of Nursing
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    • v.38 no.1
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    • pp.83-91
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    • 2008
  • Purpose: The purpose of this study was to test the validity of a modified clinical performance examination (CPX) for preclinical students in nursing. Method: 70 nursing students in their second semester of the junior year at C University participated in CPX. Scenarios and checklists were developed by our research team from September to October 2005. Six stations were organized. Evaluation included physical examination of a patient with lung cancer, education on usage of a metered dosage inhaler, and lobectomy postoperative care. Students were randomly assigned to a station. Result: There was a difference in the CPX scores according to stations. The agreement of scoring between trained faculty members and SPs was more than moderate (r=.647). The correlation between the CPX score and the average grade in the previous semester and between the CPX score and the average grade of a paper and pen test of the pulmonary system of adults was low (r=.276; r=.048). Conclusion: Traditional CPX is generally recommended, however, modified CPX is appropriate for preclinical students in the current Korean Nursing school setting if there are additional scoring systems to balance the testing level at each station.