• Title/Summary/Keyword: Concordance Correlation Coefficient

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Feasibility of the Threshold-Based Quantification of Myocardial Fibrosis on Cardiac CT as a Prognostic Marker in Nonischemic Dilated Cardiomyopathy

  • Na Young Kim;Dong Jin Im;Yoo Jin Hong;Byoung Wook Choi;Seok-Min Kang;Jong-Chan Youn;Hye-Jeong Lee
    • Korean Journal of Radiology
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    • v.25 no.6
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    • pp.540-549
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    • 2024
  • Objective: This study investigated the feasibility and prognostic relevance of threshold-based quantification of myocardial delayed enhancement (MDE) on CT in patients with nonischemic dilated cardiomyopathy (NIDCM). Materials and Methods: Forty-three patients with NIDCM (59.3 ± 17.1 years; 21 male) were included in the study and underwent cardiac CT and MRI. MDE was quantified manually and with a threshold-based quantification method using cutoffs of 2, 3, and 4 standard deviations (SDs) on three sets of CT images (100 kVp, 120 kVp, and 70 keV). Interobserver agreement in MDE quantification was assessed using the intraclass correlation coefficient (ICC). Agreement between CT and MRI was evaluated using the Bland-Altman method and the concordance correlation coefficient (CCC). Patients were followed up for the subsequent occurrence of the primary composite outcome, including cardiac death, heart transplantation, heart failure hospitalization, or appropriate use of an implantable cardioverter-defibrillator. The Kaplan-Meier method was used to estimate event-free survival according to MDE levels. Results: Late gadolinium enhancement (LGE) was observed in 29 patients (67%, 29/43), and the mean LGE found with the 5-SD threshold was 4.1% ± 3.6%. The 4-SD threshold on 70-keV CT showed excellent interobserver agreement (ICC = 0.810) and the highest concordance with MRI (CCC = 0.803). This method also yielded the smallest bias with the narrowest range of 95% limits of agreement compared to MRI (bias, -0.119%; 95% limits of agreement, -4.216% to 3.978%). During a median follow-up of 1625 days (interquartile range, 712-1430 days), 10 patients (23%, 10/43) experienced the primary composite outcome. Event-free survival significantly differed between risk subgroups divided by the optimal MDE cutoff of 4.3% (log-rank P = 0.005). Conclusion: The 4-SD threshold on 70-keV monochromatic CT yielded results comparable to those of MRI for quantifying MDE as a marker of myocardial fibrosis, which showed prognostic value in patients with NIDCM.

A Study on Aadjustment of the Patterns, and the Correlation between the Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (CaPSP) and Korean Medicine Doctors' Diagnosis (갱년기장애 및 폐경기 후 증후군 변증진단 도구의 변증분류 조정과 진단의 간의 진단일치도 연구)

  • Lee, In-Seon;Kim, Jong-Won;Jeon, Soo-Hyung;Chi, Gyoo-Yong;Kang, Chang-Wan
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.1
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    • pp.1-14
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    • 2021
  • Objectives: We studied for the adjustment of the patterns of 'The Diagnostic Tool for Climacteric and Postmenopausal Syndrome Pattern Identification (hereinafter CaPSPI)' (studyI) and the correlation between CaPSPI and Korean medicine doctors' diagnosis which was carried out without knowing the results of CaPSPI (studyII). Methods: The studyI followed the previous study method in 2018 (2018-3). The studyII was conducted from June 1, 2019 to July 10, 2020 with ◯◯ University Korean Medicine Hospital IRB's approval (2019-4). Doctors' diagnosis was conducted face-to-face with the subjects. Doctors' diagnosis was carried out based on the Kupperman's questionnaire, 'Diagnosis System of Oriental Medicine (hereinafter DSOM)' and four examinations (四診) records. The diagnosis was marked with 0 for 'no', 1 for 'somewhat', 2 for 'yes' and 3 for 'very yes'. The correlation between CaPSPI and the mean of doctors diagnostic scores were investigated statistically. Results: The studyI showed that heart-heat (心火) pattern was added. The Factor loading coefficient for heart-heat was 0.551 to 0.789, and the Cronbach's coefficient was 0.896. The studyII showed that the diagnosis (Kappa statistic) of two doctors showed statistically significant concordance (all eight patterns), with correlation of them were 0.3 or higher. And the correlation between the CaPSPI score and the mean of doctors' diagnostic score showed a statistically significant correlation, with liver qi depression (肝鬱) being the highest at 0.552 and dual deficiency of the heart-spleen (心脾兩虛) being the lowest at 0.301. Conclusions: Since the diagnosis results of CaPSPI showed a significant correlation with the diagnosis of Korean traditional medicine experts, it was believed that the CaPSPI results can be trusted and used for clinical purposes.

Small diagnostic scale for internet addiction (인터넷 중독 자가진단 소형척도 개발)

  • Oh, Kwang-Sik
    • Journal of the Korean Data and Information Science Society
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    • v.21 no.6
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    • pp.1203-1209
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    • 2010
  • Internet addiction is a serious social problem in information society. The purpose of this study is to develope a small diagnostic scale in order to detect internet addiction easily. The reliability and validity of K-scale and Kimberly Young-scale is investigated. Five small diagnostic scale is suggested by factor analysis and regression. The comparision of these small scale is established by correlation coefficient, chi-square test, gamma value of concordance in contingency table. In view of reliability and validity, we suggest a small diagnostic scale. The results of this study may be useful to detect internet addiction by oneself.

The Reliability and Validity of the Korean Version of the Cornell Assessment of Pediatric Delirium (한국어판 Cornell Assessment of Pediatric Delirium 소아 섬망 사정 도구의 검증)

  • Nam, Song Yi;Park, Ki Young;Choi, Su Jung
    • Journal of Korean Clinical Nursing Research
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    • v.26 no.2
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    • pp.254-264
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    • 2020
  • Purpose: This study was to examine the reliability and validity of the Korean version of the Cornell Assessment of Pediatric Delirium (CAPD). Methods: For testing the reliability of the Korean version of the CAPD, this study calculated the internal consistency (Cronbach's α) and the Interrater Correlation Coefficient (ICC) by comparing the independent assessment results of three nurses in Pediatric Intensive Care Unit (PICU). For testing the validity of the Korean version of the CAPD, the assessment result of the Korean version of the CAPD compared with that of the Diagnostic and Statistical Manual of Mental Disorders V (DSM-V). Receiver Operating Characteristics (ROC) analysis was used for measuring sensitivity and specificity. Results: Overall interrater reliability of the Korean version of the CAPD, ICC was .98 (95% CI .96~.99). Cronbach's α was .91 for eight items. The concordance between the Korean version of the CAPD and psychiatrist's diagnosis was 90.0%. When the Korean version of the CAPD has the cut point of 9, sensitivity was 93.8%, and specificity was 75.0%. The area under the curve indicated by the ROC analysis was .88. Conclusion: The Korean version of the CAPD showed good reliability and validity. This tool will be useful for pediatric delirium screening and management in Korean PICU.

CT-based quantitative evaluation of radiation-induced lung fibrosis: a study of interobserver and intraobserver variations

  • Heo, Jaesung;Cho, Oyeon;Noh, O Kyu;O, Young-Taek;Chun, Mison;Kim, Mi-Hwa;Park, Hae-Jin
    • Radiation Oncology Journal
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    • v.32 no.1
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    • pp.43-47
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    • 2014
  • Purpose: The degree of radiation-induced lung fibrosis (RILF) can be measured quantitatively by fibrosis volume (VF) on chest computed tomography (CT) scan. The purpose of this study was to investigate the interobserver and intraobserver variability in CT-based measurement of VF. Materials and Methods: We selected 10 non-small cell lung cancer patients developed with RILF after postoperative radiation therapy (PORT) and delineated VF on the follow-up chest CT scanned at more than 6 months after radiotherapy. Three radiation oncologists independently delineated VF to investigate the interobserver variability. Three times of delineation of VF was performed by two radiation oncologists for the analysis of intraobserver variability. We analysed the concordance index (CI) and inter/intra-class correlation coefficient (ICC). Results: The median CI was 0.61 (range, 0.44 to 0.68) for interobserver variability and the median CIs for intraobserver variability were 0.69 (range, 0.65 to 0.79) and 0.61(range, 0.55 to 0.65) by two observers. The ICC for interobserver variability was 0.974 (p < 0.001) and ICCs for intraobserver variability were 0.996 (p < 0.001) and 0.991 (p < 0.001), respectively. Conclusion: CT-based measurement of VF with patients who received PORT was a highly consistent and reproducible quantitative method between and within observers.

The Study on the Rater Reliabilities of Physical Therapy Students Pediatric Balance Scales items (물리치료과 학생들을 대상으로 아동균형척도의 항목별 측정자 신뢰도에 관한 연구)

  • Hwang, Ryoung;Kim, Gi-Won
    • Journal of the Korean Society of Physical Medicine
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    • v.8 no.1
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    • pp.137-145
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    • 2013
  • PURPOSE: The purpose of this study is to examine assessment of test-retest reliability for 13 items of pediatric balance scales, then the intrarater reliability among the raters. METHODS: Study participants included 6 children with spastic cerebral palsy who could walk. Raters were consist of seventy-four, 2nd year physical therapy major students. The children's ability to achieve physical balance was wideotaped for PBS items. The raters watched the tapes and evlauated each child twice. Test-retest reliability was analyzed using the Spearman correlation, and interrater reliability was analyzed using the Kendall's coefficient of concordance for ranks. RESULTS: The total PBS scores averaged 49.22 and 50.06 for first and second tests. Test-retest reliability of PBS individual items were between low and high. The low itmes were 3 items, and high were 4 itmes. Interrater reliability were low agreement. CONCLUSION: Based on the study, the pediatric balance scale is an effective evaluating tool for measuring functional balance of school age child. However, the agreement of students or beginner's interpretation is necessary in conjunction to this study results. On top of that, it is important to provide detailed explanation and repetitive training, which improves the analysis reliability. Also, each category subscores level for the pediatric balance scale must be examined carefully in conjunction to performing test, only after improving match quality via preceding practice.

A study on the clinical usefulness, validity, and test-retest reliability of the Spirokit, a device that combines the pulmonary function test and respiratory muscle strength test

  • Kim, Byeong-Soo;Lee, Myung-Mo
    • Physical Therapy Rehabilitation Science
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    • v.9 no.2
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    • pp.120-130
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    • 2020
  • Objective: This study was conducted to identify the clinical usefulness, validity, and reliability of the Spirokit, a device that combines the pulmonary function test (PFT) and respiratory muscle strength (RMS) test. Design: Cross-sectional study. Methods: Forty young adults (male: 23, female: 17) participated in a PFT and a RMS test. The concurrent validity for pulmonary function was assessed by comparing data obtained from MicroQuark and the Spirokit and the agreements between the MicroRPM and the Spirokit for RMS were compared. The test-retest reliability of the Spirokit was determined by comparing data obtained from the first and second sessions. The test and retest were performed at the same time after one day for the PFT and RMS test. Validity was estimated using intraclass correlation coefficients (ICCs), and by calculating 95% limits of agreement (LoA). To estimate interrater reliability, ICCs were calculated. Results: The Spirokit showed a high agreement intra class coefficient (ICC [2, 1]): 0.978-0.999, 95% limits of agreements (95% LOA): -0.798 to 0.847 with MicroQuark. It also showed a high level of concordance ICC (2, 1): 0.992 to 0.993, 95% LOA: -9.313 to 11.169 with MicroRPM. The test-retest reliability of the Spirokit was analyzed using ICC (2, 1), and showed a high level of reliability (ICC [2,1]=0.960 to 0.998). Standard error of measurement % (SEM%) was 0.12% to 3.39%, and minimum detectable change% (MDC%) was 0.02% to 3.79%, indicating high level of reliability. Conclusions: The Spirokit is a device with high validity and reliability that can be used to simultaneously measure PFT and RMS tests.

Assessment of the Angstrom-Prescott Coefficients for Estimation of Solar Radiation in Korea (국내 일사량 추정을 위한 Angstrom-Prescott계수의 평가)

  • Hyun, Shinwoo;Kim, Kwang Soo
    • Korean Journal of Agricultural and Forest Meteorology
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    • v.18 no.4
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    • pp.221-232
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    • 2016
  • Models to estimate solar radiation have been used because solar radiation is measured at a smaller number of weather stations than other variables including temperature and rainfall. For example, solar radiation has been estimated using the Angstrom-Prescott (AP) model that depends on two coefficients obtained empirically at a specific site ($AP_{Choi}$) or for a climate zone ($AP_{Frere}$). The objective of this study was to identify the coefficients of the AP model for reliable estimation of solar radiation under a wide range of spatial and temporal conditions. A global optimization was performed for a range of AP coefficients to identify the values of $AP_{max}$ that resulted in the greatest degree of agreement at each of 20 sites for a given month during 30 years. The degree of agreement was assessed using the value of Concordance Correlation Coefficient (CCC). When $AP_{Frere}$ was used to estimate solar radiation, the values of CCC were relatively high for conditions under which crop growth simulation would be performed, e.g., at rural sites during summer. The statistics for $AP_{Frere}$ were greater than those for $AP_{Choi}$ although $AP_{Frere}$ had the smaller statistics than $AP_{max}$ did. The variation of CCC values was small over a wide range of AP coefficients when those statistics were summarized by site. $AP_{Frere}$ was included in each range of AP coefficients that resulted in reasonable accuracy of solar radiation estimates by site, year, and month. These results suggested that $AP_{Frere}$ would be useful to provide estimates of solar radiation as an input to crop models in Korea. Further studies would be merited to examine feasibility of using $AP_{Frere}$ to obtain gridded estimates of solar radiation at a high spatial resolution under a complex terrain in Korea.

Deep Learning-Based Computed Tomography Image Standardization to Improve Generalizability of Deep Learning-Based Hepatic Segmentation

  • Seul Bi Lee;Youngtaek Hong;Yeon Jin Cho;Dawun Jeong;Jina Lee;Soon Ho Yoon;Seunghyun Lee;Young Hun Choi;Jung-Eun Cheon
    • Korean Journal of Radiology
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    • v.24 no.4
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    • pp.294-304
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    • 2023
  • Objective: We aimed to investigate whether image standardization using deep learning-based computed tomography (CT) image conversion would improve the performance of deep learning-based automated hepatic segmentation across various reconstruction methods. Materials and Methods: We collected contrast-enhanced dual-energy CT of the abdomen that was obtained using various reconstruction methods, including filtered back projection, iterative reconstruction, optimum contrast, and monoenergetic images with 40, 60, and 80 keV. A deep learning based image conversion algorithm was developed to standardize the CT images using 142 CT examinations (128 for training and 14 for tuning). A separate set of 43 CT examinations from 42 patients (mean age, 10.1 years) was used as the test data. A commercial software program (MEDIP PRO v2.0.0.0, MEDICALIP Co. Ltd.) based on 2D U-NET was used to create liver segmentation masks with liver volume. The original 80 keV images were used as the ground truth. We used the paired t-test to compare the segmentation performance in the Dice similarity coefficient (DSC) and difference ratio of the liver volume relative to the ground truth volume before and after image standardization. The concordance correlation coefficient (CCC) was used to assess the agreement between the segmented liver volume and ground-truth volume. Results: The original CT images showed variable and poor segmentation performances. The standardized images achieved significantly higher DSCs for liver segmentation than the original images (DSC [original, 5.40%-91.27%] vs. [standardized, 93.16%-96.74%], all P < 0.001). The difference ratio of liver volume also decreased significantly after image conversion (original, 9.84%-91.37% vs. standardized, 1.99%-4.41%). In all protocols, CCCs improved after image conversion (original, -0.006-0.964 vs. standardized, 0.990-0.998). Conclusion: Deep learning-based CT image standardization can improve the performance of automated hepatic segmentation using CT images reconstructed using various methods. Deep learning-based CT image conversion may have the potential to improve the generalizability of the segmentation network.

Can the body composition of crossbred dairy cattle be predicted by equations for beef cattle?

  • Neves, Maria Luciana Menezes Wanderley;de Souza, Evaristo Jorge Oliveira;Veras, Robson Magno Liberal;de Campos Valadares Filho, Sebastiao;Marcondes, Marcos Inacio;da Silva, Gabriel Santana;Barreto, Ligia Maria Gomes;de Andrade Ferreira, Marcelo;Veras, Antonia Sherlanea Chaves
    • Asian-Australasian Journal of Animal Sciences
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    • v.31 no.10
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    • pp.1604-1610
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    • 2018
  • Objective: The aim of the study was to evaluate the efficiency of the Hankins and Howe (HH46), Valadares Filho (V06), and Marcondes (M12) equations for predicting the physical and chemical composition of dairy crossbred bulls carcasses, as well as the chemical composition of their empty bodies. Methods: This study was conducted using 30 dairy crossbred bulls. One group of five animals was slaughtered at the beginning of the experiment, and the remaining were slaughtered 112 days later. Animals were distributed in a completely randomized design into treatments consisting different levels of concentrate (0%, 17%, 34%, 51%, and 68%). The physical and chemical compositions of the cattle were obtained from the right half of the carcass and using samples taken between the 9th and 11th ribs of the left half of the carcass. The estimated and experimentally determined values were compared using the correlation and concordance coefficient, as well as the mean square error of prediction (MSEP) and its components. Results: The HH46 equations were better at estimating the amount of muscle plus fat in the carcass. The amount of bone in the carcasses could not be well estimated by the HH46 and M12 models. The M12, HH46, and V06 equations were worst at estimating the amounts of protein, ether extract, and water in the carcass, respectively. In the empty body, the amounts of protein and water were well estimated by the HH46 equations. Protein, ether extract, and water were accurately estimated by the V06 equations, and ether extract by the M12 equations. Conclusion: The physical and chemical composition of dairy crossbred bull carcasses, as well as the chemical composition of their empty bodies, can be predicted using the equations tested here. The amount of bone in these carcasses could not be accurately predicted.