• Title/Summary/Keyword: Diagnosis Instrument

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Clinical Practice Guidelines on Pediatric Gastroesophageal Reflux Disease: A Systematic Quality Appraisal of International Guidelines

  • Harris, Jacob;Chorath, Kevin;Balar, Eesha;Xu, Katherine;Naik, Anusha;Moreira, Alvaro;Rajasekaran, Karthik
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.109-120
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    • 2022
  • Purpose: While regurgitation is a common and often benign phenomenon in infants and younger children, it can also be a presenting symptom of gastroesophageal reflux disease (GERD). If untreated, GERD can lead to dangerous or lifelong complications. Clinical practice guidelines (CPGs) have been published to inform clinical diagnosis and management of pediatric GERD, but to date there has been no comprehensive review of guideline quality or methodological rigor. Methods: A systematic literature search was performed, and a total of eight CPGs pertaining to pediatric GERD were identified. These CPGs were evaluated using the Appraisal of Guidelines for Research and Evaluation instrument. Results: Three CPGs were found to be "high" quality, with 5 of 6 domains scoring >60%, one "average" quality, with 4 of 6 domains meeting that threshold, and the remaining four "low" quality. Conclusion: Areas of strength among the CPGs included "Scope and Purpose" and "Clarity and Presentation," as they tended to be well-written and easily understood. Areas in need of improvement were "Stakeholder Involvement," "Rigor of Development," and "Applicability," suggesting these CPGs may not be appropriate for all patients or providers. This analysis found that while strong CPGs pertaining to the diagnosis and treatment of pediatric GERD exist, many published guidelines lack methodological rigor and broad applicability.

Study on the Possibility of Quantitative Measurement of Abdominal Examinations in Korean Medicine - A Focus on Diagnosis of Abdominal Coldness in Functional Dyspepsia Patients - (한의 복진 정량화 연구 - 기능성 소화불량 환자의 복냉 진단을 중심으로 -)

  • Lee, Jae-hong;Cho, Soo-ho;Ko, Seok-jae;Kim, Jin-sung;Park, Jae-woo
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.495-510
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    • 2018
  • Objective: This study was designed to investigate the possibility of quantification of the diagnosis of abdominal coldness (AC) in patients with functional dyspepsia (FD). Methods: Forty-four patients with FD were enrolled in this study. Three Korean medicine doctors each randomly examined all abdomens. Diagnosis of AC was made by consensus of at least two of the doctors. Body temperature (oral by digital oral thermometer) and skin temperature (by digital infrared thermal imaging [DITI]) were measured, followed by administration of the Cold and Heat questionnaire (CHQ) and the Instrument of Pattern Identification for Functional Dyspepsia (IPIFD). Results: Of the 44 patients with FD, 22 were assigned to the AC group and 22 to the non-AC group. The concordance rate of diagnosis among the three doctors was 63.6% (28/44), with a ${\kappa}$ of 0.504, indicating means moderate agreement). Neither the oral nor the skin temperatures showed statistically significant differences between the AC and non-AC groups. However, the CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD were higher in AC group and showed statistically significant differences (p=0.010 and 0.009). Conclusions: This is the first study conducting quantitative measurements of abdominal coldness in patients with FD. Although oral and skin temperature showed no statistical significance between AC and non-AC groups, the concordance rate of diagnosis of AC among the three Korean Medicine doctors was moderate. The CHQ scores and 'Simultaneous Occurrence of Cold and Heat Syndromes pattern' scores of the IPIFD also suggest that diagnosis of AC is relevant to cold and heat patterns, and these questionnaires could be utilized as supportive data for the diagnosis of AC. Further studies should be conducted for the purpose of quantifying and standardizing abdominal examinations in Korean Medicine.

New Algorithm of Determining the Floating and Sinking Pulse with a Pulse Diagnosis Instrument (맥진기를 이용한 새로운 부침맥 판단 방법)

  • Kim, Sung-Hun;Kim, Jae-Uk;Lee, Yu-Jung;Kim, Keun-Ho;Kim, Jong-Yoel
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.6
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    • pp.1221-1225
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    • 2009
  • The pulse diagnosis is an important and universally used method in Oriental Medicine. Since the traditional method of palpating the pulse relies on the subjective sense in the fingers of an Oriental Medical Doctor(OMD), there has been continued need for more objective method for pulse diagnosis. Recently, various pulse analyzers have been developed to meet such objective palpation and interpretation. However, most of these attempts were not successful to replace OMD's own palpation by fingers. To improve the performance of the pulse analyzers, one should develop machine-appropriate interpretations for the pulse images in the literature, in addition to the improvement in the repeatability and reproducibility. One of such widely-used pulse images to be interpreted is the floating and sinking pulse. The floating and sinking pulses are the two representative pulse images informing us how strong pressure one should apply to obtain the maximal pulse strength. A previous study suggested a convenient and unified measure for the floating and sinking pulses by defining the coefficient of the floating-sinking pulse(CFS). We found the original definition of the CFS could be erroneous under some situations. To improve the performance, we introduce new CFS algorithm for determining the floating and sinking pulse with a pulse analyzers(3-D MAC). To test the performance of the newly suggested algorithm, we conducted a clinical study comparing the agreement ratio with the floating and sinking pulse diagnosis by the OMDs. We found that, among the subjects who are diagnosed with having either the floating pulse or sinking pulse, the new CFS algorithm showed 55.3% diagnosis rate and 73.0% concordance rate, which are about 3% and 6% improvement in the diagnosis rate and agreement rate, respectively, compared to the original CFS algorithm.

Suggestion on an Innovative Pulse Diagnosis System based on Technical Trend Analysis (맥진기술동향 조사를 통한 맥진기 개발방안 제안)

  • Lee, Yu-Jung;Lee, Jean;Kim, Jang-Yeol
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.1
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    • pp.174-179
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    • 2009
  • Arterial pulse palpation is an important diagnostic method in Oriental Medicine, particularly for obtaining information about a patient's health conditions or illness, or for confirming a diagnostic conclusion based on the patient's pulsation. The pulse analyzer is both a leading Oriental Medical equipment and a promising tool with such a strong industrial ripple effect that it was selected as one of the four strategic tools for world Oriental Medical instrument market domination at a recent survey. Although various pulse analyzers had been developed, however, most of these were not widely used for clinical diagnosis, due perhaps to lack of the appliance's reliability caused by its inability to reflect the requirements of the clinicians. Thus, in this thesis, the clinical requirements for the pulse analyzer were identified and analyzed by conducting a questionnaire survey among Oriental Medicine clinicians. By looking into the basic functions of a pulse analyzer, the required measurement time, and the medical insurance fee required were determined and among others, the appliance's specific requirements were determined. Moreover, by investigating on the latest patent trend, the technical elements that are needed for the development of a next-generation pulse analyzer were identified. Through these processes, the flow of the technology that must be developed for the pulse analyzer was determined, and the direction for the development of the specific pulse analyzer hardware, sensor, and diagnostic algorithm was identified and proposed.

An Analysis of Related Factors for Major Nursing Diagnoses Identified for Instituionalized Elders (일 시설노인에게 나타난 주요 간호진단의 관련요인 분석)

  • Hur, Hea-Kung;Park, So-Mi;Kim, Gi-Yon;Shin, Yun-Hee;Yim, Eun-Shil
    • Korean Journal of Adult Nursing
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    • v.15 no.1
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    • pp.126-136
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    • 2003
  • Purpose: The purpose of this study was to analyze related factors for major nursing diagnoses used in caring for institutionalized elders. Method: This study was a descriptive study. The participants were 92 residents in a long-term care facility in Wonju, selected by convenience sampling. The instrument was a checklist designed on the basis of the related factors suggested by NANDA (1997) and a literature review. Data was collected by chart review, observation, and interviews with the participants. Data was analyzed using descriptive statistics with the SPSS WIN program. Result: The most frequent nursing diagnosis was 'risk for injury', 'self-esteem disturbance', 'activity intolerance', 'impaired phyical mobility', and 'powerlessness'. The most frequent component for related factors for the five component for each nursing diagnosis was the physical component, followed by the social component. Common related factors for the nursing diagnoses were 'pain', 'change of emotional state/disorder', 'cognitive disorder', 'change of physical structure and function', and 'physical impairment', and 'immobility'. Conclusion: The results of this study can contribute to the development of appropriate nursing intervention programs for elders (eg. 'Injury Prevention Programs', 'Self-esteem Improvement Programs' etc.). Clinical guidelines that gerontological nurses can use to accurately assess health problems and select appropriate nursing interventions may be developed.

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INTERRATER RELIABILITY OF CARIES DIAGNOSIS BY LASER FLUORESCENCE (레이저형광 우식진단법의 검사자간 신뢰도에 관한 연구)

  • Lee, Kwang-Hee
    • Journal of the korean academy of Pediatric Dentistry
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    • v.28 no.4
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    • pp.668-672
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    • 2001
  • The purpose of study was to measure the interrater reliability of the caries diagnostic instrument, Diagnodent(KaVo, Germany), using a new laser fluorescence technique. Occlusal surfaces and smooth surfaces of one hundred extracted human premolars and molars were examined by four dentists. Pearson correlation coeffcients were 0703 to 0.870 for occlusal surfaces and 0.764 to 0.932 for smooth surfaces (P<0.01, all). Reliability coefficients which were calculated by intraclass correlation coefficients were 0.9450 for occlusal surfaces and 0.9605 for smooth surfaces. Therefore, the interrater reliability of caries diagnosis by Diagnodent is very high, and the rater training would be necessary more for occlusal surfaces than for smooth surfaces.

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Development of overhead distribution line diagnosis system program (가공 배전선로 진단시스템 프로그램 개발)

  • Dong Hyun Chung;Deok Jin Lee
    • Smart Media Journal
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    • v.12 no.5
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    • pp.81-87
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    • 2023
  • In this paper, accidents in high-voltage overhead distribution lines, which provide stable power supply in the power system, cause inconvenience in life and disruption of production of companies. 22.9 [kV] high-voltage overhead power distribution lines aim to improve reliability and stability, such as damage caused by rain, snow, wind, etc., or electric shock prevention. Therefore, in order to prevent wire disconnection accidents due to deterioration of electrical conductivity or tensile strength due to corrosion of overhead distribution lines, it is necessary to prevent unexpected accidents in the future through regular inspection and repair. In order to diagnose deterioration due to corrosion of distribution lines, a diagnostic system (measuring instrument) is installed on the wires to monitor the condition of the wires. The manager on the ground receives the measured data through ZigBee wireless communication, controls the diagnosis system through the diagnosis system program, and grasps the condition of the overhead distribution line through the measured data and photographed photos, and predicts the life of the wire along with the visual inspection method. developed a program.

Neuropsychiatric Aspect of Traumatic Brain Injury (두부외상의 신경정신과적 관점)

  • Kim, Young Chul
    • Korean Journal of Biological Psychiatry
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    • v.2 no.2
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    • pp.157-168
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    • 1995
  • The neuropsychiatric sequelae of traumatic brain unjury(TBI) are effects on complex aspect of behavior, cognition and emotional expression. They include psychiatric disorders such as depression, psychosis, personality change, dementia, and postconcussion syndrome. The damage is done not only to the cortex of the brain but also to subcortical and axial structures. The diffuse degeneration of cerebral white mailer is axonal damage that is caused by mechanical forces shearing the neuronal fiber at the moment of impact(diffuse axonal injury, DAI). The DAI and the changed receptor-agonist mechanism ore the most important mechanisms in genesis of neuropsychiatric sequalae by mild TBI. The most important instrument for diagnosis of neuropsychiatric sequalae of TBI is a physician or psychiatrist with experience and knowledge. The most effective therapeutic tool is a professional who understands the nature of the problem.

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Smartphone-based Chemistry Instrumentation: Digitization of Colorimetric Measurements

  • Chang, Byoung-Yong
    • Bulletin of the Korean Chemical Society
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    • v.33 no.2
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    • pp.549-552
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    • 2012
  • This report presents a mobile instrumentation platform based on a smartphone using its built-in functions for colorimetric diagnosis. The color change as a result of detection is taken as a picture through a CCD camera built in the smartphone, and is evaluated in the form of the hue value to give the well-defined relationship between the color and the concentration. To prove the concept in the present work, proton concentration measurements were conducted on pH paper coupled with a smartphone for demonstration. This report is believed to show the possibility of adapting a smartphone to a mobile analytical transducer, and more applications for bioanalysis are expected to be developed using other built-in functions of the smartphone.

Construction of 154kV Intelligent Substation for Verification Test (154kV급 실증시험용 인텔리전트 변전소 구축)

  • Chung, Y.H.;Kim, M.S.;Kim, J.B.;Lee, H.S.;Choi, I.H.;Lee, D.I.
    • Proceedings of the KIEE Conference
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    • 2006.07a
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    • pp.456-457
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    • 2006
  • We have carried out the construction of the 154kV intelligent substation with KEPRI. The Intelligent substation is built in Gochang testing facility of KEPCO and consists of electronic instruments for GIS(gas insulated switchgear), digital control panel, remote monitoring and diagnosis system, and digital relay system. Rogowski coil type CT(RCT) and capacitive voltage divider(CVD) are introduced compared with the instrument transformer of conventional type. Digital control Panel(DCP) replaces the LCP(local control panel) which is drived for mechanical operation. For the monitoring of the condition of GIS and TR, various sensors are used. In this Paper, we mention the synopsis and report the progress state of project.

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