• Title/Summary/Keyword: Concordance Rate

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Validation of the Developed Nutritional Screening Tool for Hospital Patients (입원환자를 위해 개발된 영양검색 도구의 타당성 검증)

  • Lee, Jeong-Sook;Cho, Mi-Ran;Lee, Geum-Ju
    • Journal of Nutrition and Health
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    • v.43 no.2
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    • pp.189-196
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    • 2010
  • Malnutrition has been associated with higher hospital costs, mortality, rates of complications and longer length of hospital stay. Several nutritional screening tools have been developed to identify patients with malnutrition risk. However, many of those require much time and labor to administer and may not be applicable to a Korean population. Therefore, the aim of this study was to develop nutritional screening tool for Korean inpatients. Then we compare nutritional screening tools that developed and previously described. Seven hundred sixty-four patients at hospital admission were screened nutritional status and classified as well nourished, malnutrition stage 1 or stage 2 by the KNNRS (Kyunghee Neo Nutrition Risk Screening), PG-SGA (Patient-Generated Subjective Global Assessment) and NRS-2002 (Nutritional Risk Screening-2002). The KNNRS, PG-SGA and NRS-2002 respectively classified 28.7%, 51.3%, 48.5% of patients as malnourished status. Compared to the PG-SGA, the KNNRS had sensitivity 60.7% (95% CI 54.2-67.0) and specificity 81.2% (95% CI 75.3-85.2). Agreement was fair between KNNRS and PG-SGA (k = 0.34). Compared to the NRS-2002, the KNNRS had sensitivity 57.8% (95% CI 53.4-60.9) and specificity 64.4% (95% CI 60.2-69.8). Agreement was poor between KNNRS and NRS-2002 (k = 0.18). These result should include that the KNNRS and PGSGA have clinical relevance and fair concordance. However the rate of malnourished patients by KNNRS were less than by PG-SGA. For more effectivity of nutritional screening and management, the criteria of KNNRS would be better revised.

Fragment Analysis for Detection of the FLT3-Internal Tandem Duplication: Comparison with Conventional PCR and Sanger Sequencing (FLT3-ITD 검출을 위한 절편분석법: 일반 중합효소연쇄반응 및 직접염기서열분석법과의 비교)

  • Lee, GunDong;Kim, Jeongeun;Lee, SangYoon;Jang, Woori;Park, Joonhong;Chae, Hyojin;Kim, Myungshin;Kim, Yonggoo
    • Laboratory Medicine Online
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    • v.7 no.1
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    • pp.13-19
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    • 2017
  • Background: We evaluated a sensitive and quantitative method utilizing fragment analysis of the fms-like tyrosine kinase 3-internal tandem duplication (FLT3-ITD), simultaneously measuring mutant allele burden and length, and verified the analytical performance. Methods: The number and allelic burden of FLT3-ITD mutations was determined by fragment analysis. Serial mixtures of mutant and wild-type plasmid DNA were used to calculate the limit of detection of fragment analysis, conventional PCR, and Sanger sequencing. Specificity was evaluated using DNA samples derived from 50 normal donors. Results of fragment analysis were compared to those of conventional PCR, using 481 AML specimens. Results: Defined mixtures were consistently and accurately identified by fragment analysis at a 5% relative concentration of mutant to wild-type, and at 10% and 20% ratios by conventional PCR and direct sequencing, respectively. No false positivity was identified. Among 481 AML specimens, 40.1% (193/481) had FLT3-ITD mutations. The mutant allele burden (1.7-94.1%; median, 28.2%) and repeated length of the mutation (14-153 bp; median, 49 bp) were variable. The concordance rate between fragment analysis and conventional PCR was 97.7% (470/481). Fragment analysis was more sensitive than conventional PCR and detected 11 additional cases: seven had mutations below 10%, three cases represented conventional PCR failure, and one case showed false negativity because of short ITD length (14 bp). Conclusions: The new fragment analysis method proved to be sensitive and reliable for the detection and monitoring of FLT3-ITD in patients with AML. This could be used to simultaneously assess ITD mutant allele burden and length.

Production of Feather-Sexing Korean Native Commercial Chickens (깃털 성감별 상업용 토종 실용닭 생산)

  • Sea Hwan Sohn;Eun Jung Cho;Seul Gy Lee;Junho Lee;Suyong Jang;Kwijoong Yong
    • Korean Journal of Poultry Science
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    • v.51 no.2
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    • pp.65-71
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    • 2024
  • The feather-sexing method is widely used commercially for chick sex identification. However, for feather-sexing to be industrially practical, the early-feathering (EF) and late-feathering (LF) genes must existed within the foundation stock, a suitable feather-sexing lines must be established, and the accuracy of sex identification by feather-sexing must be ensured. Therefore, this study introduces the method of constructing the Korean native chickens (KNC) feather-sexing lines using EF and LF genes and evaluates the effectiveness of feather sex determination on commercial chicks produced from the constructed KNC lines. The results showed that both EF and LF chickens existed within the foundation stock, with the frequency of LF genes ranging from 0 to 0.205. In feather-sexing line establishment, the paternal strain of the grandparent stock (GPS) was fixed as EF (kk) for both sexes, while the maternal strain was composed of males with LF homozygotes (ZKZK) and females with EF (ZkW). Thus, in the parent stock (PS), male breeder had EF (ZkZk) and female breeder had LF (ZKW), resulting in chicks produced from their crosses having LF (ZKZk) for males and EF (ZkW) for females, allowing sex determination based on feather development. Additionally, to evaluate the effectiveness of feather-sexing for the produced commercial chicks, a study was conducted on 1,000 samples of the produced chicks to investigate the concordance between vent-sexing and feather-sexing, showing a matching rate of 93.1%.

Correlation of p53 Protein Overexpression, Gene Mutation with Prognosis in Resected Non-Small Cell Lung Cancer(NSCLC) Patients (비소세포폐암에서 p53유전자의 구조적 이상 및 단백질 발현이 예후에 미치는 영향)

  • Lee, Y.H.;Shin, D.H.;Kim, J.H.;Lim, H.Y.;Chung, K.Y.;Yang, W.I.;Kim, S.K.;Chang, J.;Roh, J.K.;Kim, S.K.;Lee, W.Y.;Kim, B.S.;Kim, B.S.
    • Tuberculosis and Respiratory Diseases
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    • v.41 no.4
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    • pp.339-353
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    • 1994
  • Background : The p53 gene codes for a DNA-binding nuclear phosphoprotein that appears to inhibit the progression of cells from the G1 to the S phase of the cell cycle. Mutations of the p53 gene are common in a wide variety of human cancers, including lung cancer. In lung cancers, point mutations of the p53 gene have been found in all histological types including approximately 45% of resected NSCLC and even more frequently in SCLC specimens. Mutant forms of the p53 protein have transforming activity and interfere with the cell-cycle regulatory function of the wild-type protein. The majority of p53 gene mutations produce proteins with altered conformation and prolonged half life; these mutant proteins accumulate in the cell nucleus and can be detected by immunohistochemical staining. But protein overexpression has been reported in the absence of mutation. p53 protein overexpression or gene mutation is reported poor prognostic factor in breast cancer, but in lung cancer, its prognostic significance is controversial. Method : We investigated the p53 abnormalities by nucleotide sequencing, polymerase chain reaction-single strand conformation polymorphism(PCR-SSCP), and immunohistochemical staining. We correlated these results with each other and survival in 75 patients with NSCLC resected with curative intent. Overexpression of the p53 protein was studied immunohistochemically in archival paraffin- embedded tumor samples using the D07(Novocastra, U.K.) antibody. Overexpression of p53 protein was defined by the nuclear staining of greater than 25% immunopositive cells in tumors. Detection of p53 gene mutation was done by PCR-SSCP and nucleotide sequencing from the exon 5-9 of p53 gene. Result: 1) Of the 75 patients, 36%(27/75) showed p53 overexpression by immunohistochemical stain. There was no survival difference between positive and negative p53 immunostaining(overall median survival of 26 months, disease free median survival of 13 months in both groups). 2) By PCR-SSCP, 27.6%(16/58) of the patients showed mobility shift. There was no significant difference in survival according to mobility shift(overall median survival of 27 in patients without mobility shift vs 20 months in patients with mobility shift, disease free median survival of 8 months vs 10 months respectively). 3) Nucleotide sequence was analysed from 29 patients, and 34.5%(10/29) had mutant p53 sequence. Patients with the presence of gene mutations showed tendency to shortened survival compared with the patients with no mutation(overall median survival of 22 vs 27 months, disease free median survival of 10 vs 20 months), but there was no statistical significance. 4) The sensitivity and specificity of immunostain based on PCR-SSCP was 67.0%, 74.0%, and that of the PCR-SSCP based on the nucleotide sequencing was 91.8%, 96.2% respectively. The concordance rate between the immunostain and PCR-SSCP was 62.5%, and the rate between the PCR-SSCP and nucleotide sequencing was 95.3%. Conclusion : In terms of detection of p53 gene mutation, PCR-SSCP was superior to immunostaining. p53 gene abnormalities either overexpression or mutation were not a significant prognostic factor in NSCLC patients resected with curative intent. However, patients with the mutated p53 gene showed the trends of early relapse.

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Information Privacy Concern in Context-Aware Personalized Services: Results of a Delphi Study

  • Lee, Yon-Nim;Kwon, Oh-Byung
    • Asia pacific journal of information systems
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    • v.20 no.2
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    • pp.63-86
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    • 2010
  • Personalized services directly and indirectly acquire personal data, in part, to provide customers with higher-value services that are specifically context-relevant (such as place and time). Information technologies continue to mature and develop, providing greatly improved performance. Sensory networks and intelligent software can now obtain context data, and that is the cornerstone for providing personalized, context-specific services. Yet, the danger of overflowing personal information is increasing because the data retrieved by the sensors usually contains privacy information. Various technical characteristics of context-aware applications have more troubling implications for information privacy. In parallel with increasing use of context for service personalization, information privacy concerns have also increased such as an unrestricted availability of context information. Those privacy concerns are consistently regarded as a critical issue facing context-aware personalized service success. The entire field of information privacy is growing as an important area of research, with many new definitions and terminologies, because of a need for a better understanding of information privacy concepts. Especially, it requires that the factors of information privacy should be revised according to the characteristics of new technologies. However, previous information privacy factors of context-aware applications have at least two shortcomings. First, there has been little overview of the technology characteristics of context-aware computing. Existing studies have only focused on a small subset of the technical characteristics of context-aware computing. Therefore, there has not been a mutually exclusive set of factors that uniquely and completely describe information privacy on context-aware applications. Second, user survey has been widely used to identify factors of information privacy in most studies despite the limitation of users' knowledge and experiences about context-aware computing technology. To date, since context-aware services have not been widely deployed on a commercial scale yet, only very few people have prior experiences with context-aware personalized services. It is difficult to build users' knowledge about context-aware technology even by increasing their understanding in various ways: scenarios, pictures, flash animation, etc. Nevertheless, conducting a survey, assuming that the participants have sufficient experience or understanding about the technologies shown in the survey, may not be absolutely valid. Moreover, some surveys are based solely on simplifying and hence unrealistic assumptions (e.g., they only consider location information as a context data). A better understanding of information privacy concern in context-aware personalized services is highly needed. Hence, the purpose of this paper is to identify a generic set of factors for elemental information privacy concern in context-aware personalized services and to develop a rank-order list of information privacy concern factors. We consider overall technology characteristics to establish a mutually exclusive set of factors. A Delphi survey, a rigorous data collection method, was deployed to obtain a reliable opinion from the experts and to produce a rank-order list. It, therefore, lends itself well to obtaining a set of universal factors of information privacy concern and its priority. An international panel of researchers and practitioners who have the expertise in privacy and context-aware system fields were involved in our research. Delphi rounds formatting will faithfully follow the procedure for the Delphi study proposed by Okoli and Pawlowski. This will involve three general rounds: (1) brainstorming for important factors; (2) narrowing down the original list to the most important ones; and (3) ranking the list of important factors. For this round only, experts were treated as individuals, not panels. Adapted from Okoli and Pawlowski, we outlined the process of administrating the study. We performed three rounds. In the first and second rounds of the Delphi questionnaire, we gathered a set of exclusive factors for information privacy concern in context-aware personalized services. The respondents were asked to provide at least five main factors for the most appropriate understanding of the information privacy concern in the first round. To do so, some of the main factors found in the literature were presented to the participants. The second round of the questionnaire discussed the main factor provided in the first round, fleshed out with relevant sub-factors. Respondents were then requested to evaluate each sub factor's suitability against the corresponding main factors to determine the final sub-factors from the candidate factors. The sub-factors were found from the literature survey. Final factors selected by over 50% of experts. In the third round, a list of factors with corresponding questions was provided, and the respondents were requested to assess the importance of each main factor and its corresponding sub factors. Finally, we calculated the mean rank of each item to make a final result. While analyzing the data, we focused on group consensus rather than individual insistence. To do so, a concordance analysis, which measures the consistency of the experts' responses over successive rounds of the Delphi, was adopted during the survey process. As a result, experts reported that context data collection and high identifiable level of identical data are the most important factor in the main factors and sub factors, respectively. Additional important sub-factors included diverse types of context data collected, tracking and recording functionalities, and embedded and disappeared sensor devices. The average score of each factor is very useful for future context-aware personalized service development in the view of the information privacy. The final factors have the following differences comparing to those proposed in other studies. First, the concern factors differ from existing studies, which are based on privacy issues that may occur during the lifecycle of acquired user information. However, our study helped to clarify these sometimes vague issues by determining which privacy concern issues are viable based on specific technical characteristics in context-aware personalized services. Since a context-aware service differs in its technical characteristics compared to other services, we selected specific characteristics that had a higher potential to increase user's privacy concerns. Secondly, this study considered privacy issues in terms of service delivery and display that were almost overlooked in existing studies by introducing IPOS as the factor division. Lastly, in each factor, it correlated the level of importance with professionals' opinions as to what extent users have privacy concerns. The reason that it did not select the traditional method questionnaire at that time is that context-aware personalized service considered the absolute lack in understanding and experience of users with new technology. For understanding users' privacy concerns, professionals in the Delphi questionnaire process selected context data collection, tracking and recording, and sensory network as the most important factors among technological characteristics of context-aware personalized services. In the creation of a context-aware personalized services, this study demonstrates the importance and relevance of determining an optimal methodology, and which technologies and in what sequence are needed, to acquire what types of users' context information. Most studies focus on which services and systems should be provided and developed by utilizing context information on the supposition, along with the development of context-aware technology. However, the results in this study show that, in terms of users' privacy, it is necessary to pay greater attention to the activities that acquire context information. To inspect the results in the evaluation of sub factor, additional studies would be necessary for approaches on reducing users' privacy concerns toward technological characteristics such as highly identifiable level of identical data, diverse types of context data collected, tracking and recording functionality, embedded and disappearing sensor devices. The factor ranked the next highest level of importance after input is a context-aware service delivery that is related to output. The results show that delivery and display showing services to users in a context-aware personalized services toward the anywhere-anytime-any device concept have been regarded as even more important than in previous computing environment. Considering the concern factors to develop context aware personalized services will help to increase service success rate and hopefully user acceptance for those services. Our future work will be to adopt these factors for qualifying context aware service development projects such as u-city development projects in terms of service quality and hence user acceptance.