• 지능정보연구
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• 제4권1호
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• pp.115-131
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• 1998

Customer service process is one of the most important processes in today's competitive business environment. Among the various activities of customer service process, equipment malfunction diagnosis activity should be performed fast and accurately. When a customer calls the service center and reports the observed symptoms, he/she describes them in layman's terms. Therefore, the customer-reported symptoms have not been considered helpful information for service representatives. However, in order to perform diagnosis activity fast and accurately, we need to make use of the customer-reported symptoms actively. In this research, we developed three systems called R-EMD (Rule-based Equipment Malfunction Diagnostic system), C-EMD (Case-based Equipment Malfunction Diagnostic system) and R&C-EMD (Rule & Case-based Equipment Malfunction Diagnostic system), each of which diagnoses equipment malfunctions using the customer-reported symptoms. R&C-EMD is a hybrid system that utilizes both rule-based and case-based technologies. The diagnosis rules used in R&C-EMD and R-EMD were not acquired from service manuals or interviews with service representatives. Rater, we extracted them directly from the past diagnosis cases based on symptoms' frequencies. By this way, we were able to overcome the knowledge acquisition bottleneck. Using the real 100 malfunction diagnosis cases, we evaluated the performances of R&C-EMC, R-EMD and C-EMD in terms of speed and accuracy. In diagnosis time, R&C-EMD took longer than R-EMD and shorter than C-EMD. However, R&C-EMC was the best in accuracy.

• 사상체질의학회지
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• 제24권3호
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• pp.1-16
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• 2012

Objectives For the methodological review on the accuracy study of questionnaire for Sasang constitution diagnosis, we searched the various diagnostic accuracy study of the questionnaires for Sasang constitution. Methods We searched MEDLINE, the Cochrane Library, KISS, and DBPIA. Additionally, We hand-searched the main oriental medical journals. All articles were independently reviewed and selected by two evaluators. And selected articles were assessed by "Quality Assessment of Diagnostic Accuracy Studies Tool"(QUADAS Tool) for the methodological review. Results The twenty eight studies initially identified studies were included in the methodological review. The part of "Acceptable reference standard", "Uninterpretable results reported" and "Withdrawals explained" was very weak in the risk of bias. The part of "Representative spectrum", "Acceptable delay between tests", "Incorporation avoided", "Reference standard results blinded", "Index test results blinded" was unclear in the description. Conclusions For the further study on the accuracy study of Sasang constitution diagnosis, we have to improve the aforementioned errors. Additionally, the checklist for the description of study might be needed.

• Advances in pediatric surgery
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• 제7권2호
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• pp.105-111
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• 2001

To investigate the diagnostic accuracy and applicability of barium enema(BE) and rectal suction biopsy with acetyl cholinesterase(AChE) histochemistry in the diagnosis of neonatal Hirschsprung's disease(HD), we retrospectively reviewed the findings of BE and AChE staining in 96 neonates with suspected HD during a 10-year period from January 1991 to December 2000. Sixty-nine cases of HD(58 males and 11 females) and 27 cases of non-HD are included in this study. In regard to BE, HD was based on definite transitional zone, suspicious HD on reversed rectosigmoid index(RSI <1), and non-HD on normal RSI(RSI>1). The histochemical criterion used for the diagnosis of HD was that of Chow et al(1977), i.e., the presence of many coarse discrete cholinergic nerve fibers in the muscularis mucosae and in the immediately subjacent submucosa regardless of infiltration of cholinergic nerve fibers in the lamina propria. Of 66 neonates with HD who underwent BE, transitional zone was identified in 33 cases(50 %) and reversed RSI in 19 cases(21 %), microcolon in 4 cases and normal finding in 10 cases(15 %) while of 27 neonates with non-HD, there was normal finding in 16 cases and reversed RSI in 9 cases(41 %). Thus diagnostic accuracy based on transitional zone was 64 %. The positive predictive value of reversed RSI for the diagnosis of HD was 68 %. Of 42 neonates with HD who underwent AChE histochemistry, there were 41 AChE-positive reactions and one AChE-negative reaction in a neonate with total colonic aganglionosis, while of 27 cases of non-HD, there were one equivocal AChE-positive reaction and 26 AChE-negative reactions. Thus AChE histochemical study showed a 97 % diagnostic accuracy with a 98 % sensitivity and a 96 % specificity. In conclusion, we believe that BE is valuable as a first diagnostic step since about 80 % of neonates with HD show significant radiologic findings such as a transitional zone or reversed RSI. AChE histochemical study was a more reliable diagnos tic tool showing a 97 % diagnostic accuracy, and is part.

• Journal of Preventive Medicine and Public Health
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• 제31권3호
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• pp.471-480
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• 1998

This study was undertaken in order to estimate the accuracy of disease code of the Korean National Medical Insurance Data and disease the characteristics related to the accuracy. To accomplish these objectives, 2,431 cases coded as notifiable acute communicable diseases (NACD) were randomly selected from 1994 National Medical Insurance data file and family medicine specialists reviewed the medical records to confirm the diagnostic accuracy and investigate the related factors. Major findings obtained from this study are as follows : 1. The accuracy rate of disease code of NACD in National Medical Insurance data was very low, 10.1% (95% C.I. : 8.8-11.4). 2. The reasons of inaccuracy in disease code were 1) claiming process related administrative error by physician and non-physician personnel in medical institutions (41.0%), 2) input error of claims data by key punchers of National Medical Insurer (31.3%) and 3) diagnostic error by physicians (21.7%). 3. Characteristics significantly related with lowering the accuracy of disease code were location and level of the medical institutions in multiple logistic regression analysis. Medical institutions in Seoul showed lower accuracy than those in Kyonngi, and so did general hospitals, hospitals and clinics than tertiary hospitals. Physician related characteristics significantly lowering disease code accuracy of insurance data were sex, age group and specialty. Male physicians showed significantly lower accuracy than female physicians; thirties and fortieg age group also showed significantly lower accuracy than twenties, and so did general physicians and other specialists than internal medicine/pediatric specialists. This study strongly suggests that a series of policies like 1) establishment of peer review organization of National Medical Insurance data, 2) prompt nation-wide expansion of computerized claiming network of National Medical Insurance and 3) establishment and distribution of objective diagnostic criteria to physicians are necessary to set up a national disease surveillance system utilizing National Medical Insurance claims data.

• Asian Pacific Journal of Cancer Prevention
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• 제15권21호
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• pp.9077-9083
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• 2014

Background: This study aimed to summarize the potential diagnostic value of serum DKK1 levels in cancer detection. Materials and Methods: Serum DKK1 was measured using enzyme-linked immunosorbent assay in a case-control study. Then we performed a meta-analysis and the pooled sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic (sROC) curves were used to evaluate the overall test performance. Results: Serum DKK1 levels were found to be significantly upregulated in gastric cancer as compared to controls. ROC curve analysis revealed an AUC of 0.636, indicating the test has the potential to diagnose cancer with poor accuracy. The summary estimates of the pooled sensitivity, specificity and diagnostic odds ratio in meta-analysis were 0.55 with a 95% confidence interval (CI) (0.53-0.57), 0.86 (95%CI, 0.84-0.88) and 12.25 (95%CI, 5.31-28.28), respectively. The area under the sROC was 0.85. Subgroup analysis revealed that the diagnostic accuracy of serum DKK1 in lung cancer (sensitivity: 0.69 with 95%CI, 0.66-0.74; specificity: 0.95 with 95%CI, 0.92-0.97; diagnostic odds ratio: 44.93 with 95%CI, 26.19-77.08) was significantly higher than for any other cancer. Conclusions: Serum DKK1 might be useful as a noninvasive method for confirmation of cancer diagnosis, particularly in the case of lung cancer.

• Asian Pacific Journal of Cancer Prevention
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• 제14권8호
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• pp.4699-4704
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• 2013

Background: MicroRNAs have been demonstrated to play important roles in the development and progression of colorectal cancer. Several studies utilizing microRNAs as diagnostic biomarkers for colorectal cancer (CRC) have been reported. The aim of this meta-analysis was to comprehensively and quantitatively summarize the diagnostic value of microRNAs for detecting colorectal cancer. Methods: We searched PubMed, Embase and Cochrane Library for published studies that used microRNAs as biomarkers for the diagnosis of colorectal cancer. Summary estimates for sensitivity, specificity and other measures of accuracy of microRNAs in the diagnosis of colorectal cancer were calculated using the bivariate random effects model. A summary receiver operating characteristic (SROC) curve was also generated to summarize the overall effectiveness of the test. Result: Thirteen studies from twelve published articles met the inclusion criteria and were included. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odd ratio of microRNAs for the diagnosis of colorectal cancer were 0.81 (95%CI: 0.79-0.84), 0.78 (95%CI: 0.75-0.82), 4.14 (95%CI: 2.90-5.92), 0.24 (95%CI: 0.19-0.30), and 19.2 (95%CI: 11.7-31.5), respectively. The area under the SROC curve was 0.89. Conclusions: The current evidence suggests that the microRNAs test might not be used alone as a screening tool for CRC. Combining microRNAs testing with other conventional tests such as FOBT may improve the diagnostic accuracy for detecting CRC.

• Journal of Gastric Cancer
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• 제21권3호
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• pp.246-257
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• 2021

Purpose: It is unclear whether high-definition (HD) imaging improves visibility and diagnostic ability in early gastric cancer (EGC) compared with standard-definition (SD) imaging. We aimed to compare the diagnostic performance and visibility scores of HD and SD ultraslim endoscopes in EGC. Materials and Methods: We used HD and SD ultraslim endoscopes to obtain 60 images with similar compositions of gastric environments. Of the 60 images, 30 showed EGC (15 images for each modality) and 30 showed no EGC (15 images for each modality). Seventeen endoscopists evaluated the presence and location of the lesions in each image. Diagnostic ability was compared between modalities. The color difference between a lesion and the surrounding mucosa (ΔE) was measured and compared between the modalities. Results: The ability of HD to detect EGC was significantly higher than that of SD (accuracy: 80.8% vs. 71.6%, P=0.017; sensitivity: 94.9% vs. 76.5%, P<0.001; positive predictive value, 76.2% vs. 55.3%, P<0.001; and negative predictive value (NPV), 94.1% vs. 73.5%, P<0.001). The ability of HD to determine the horizontal extent of EGC was significantly higher than that of SD (accuracy: 71.0% vs. 57.8%, P=0.004; sensitivity: 75.3% vs. 49.0%, P<0.001; NPV, 72.9% vs. 55.9%, P<0.001; and area under the curve: 0.891 vs. 0.631, P=0.038). The mean ΔE was significantly higher for HD than for SD (10.3 vs. 5.9, P=0.011). Conclusions: The HD ultraslim endoscope showed a higher diagnostic performance in EGC than the SD endoscope because it provided good color contrast.

• 사상체질의학회지
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• 제25권4호
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• pp.289-296
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• 2013

Objectives This study was aimed to validate Sasang Constitution Questionnaire for Japanese (SSCQ-J). Methods Sasang Constitution Questionnaire for Patients (SSCQ-P) was developed by joint researches between the Society of Sasang Constitutional Medicine and Korea Institute of Oriental Medicine. We translated SSCQ-P into Japanese and modified some items of that for Japanese. By getting approval from the Institutional Review Board（IRB）of School of Medicine, Keio University, we conducted a questionnaire survey of patients who visited Oriental Medicine Center from early January until mid-February 2011. The total of 364 patients filled out that Questionnaire and gave an interview with a Sasang constitution specialist. Using this Questionnaire data, we made Sasang constitutional classification functions and calculated diagnostic accuracy rate of SSCQ-J using discrimination analysis. Results 1. Male group's diagnostic accuracy rate of SSCQ-J was 77.01% and female was 78.10%. 2. Diagnostic accuracy of SSCQ-J was a little higher than SSCQ-P Conclusions 1. SSCQ-J can be considered to have good discriminant power compared with SSCQ-P 2. Further research with SSCQ-J will be helpful in the comparison study on the usual symptoms between Korean and Japanese as well as development of good discriminant function.

• Asian Pacific Journal of Cancer Prevention
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• 제15권22호
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• pp.9865-9869
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• 2014

Background: Transthoracic fine needle aspiration (FNA) is one of several methods for establishing tissue diagnosis of lung lesions. Other tissue or cell sources for diagnosis include sputum, endobronchial biopsy, washing and brushing, endobronchial FNA, transthoracic core needle biopsy, biopsy from thoracoscopy or thoracotomy. The purpose of this study was to compare the sensitivity and specificity of FNA and other diagnostic tests in diagnosing lung lesions. Materials and Methods: The population included all patients undergoing FNA for lung lesions at Meir Medical Center from 2006 through 2010. Information regarding additional tissue tests was derived from the electronic archives of the Department of Pathology, patient records and files from the Department of Oncology. Sensitivity, specificity, diagnostic accuracy, and positive and negative predictive values were calculated for each test. Results: FNA was carried out in 245 patients. Malignant tumors were diagnosed in 190 cases (78%). They included adenocarcinoma (43%), squamous cell carcinoma (15%), non-small cell carcinoma, not otherwise specified (19%), neurondocrine tumors (7%), metastases (9%) and lymphoma (3%). The specificity of FNA for lung neoplasms was 100%; sensitivity and diagnostic accuracy were 87%. Conclusions: FNA is the most sensitive procedure for establishing tissue diagnoses of lung cancer. Combination with core needle biopsy increases the sensitivity. Factors related to the lesion (nature, degenerative changes, location) and to performance of all stages of test affect the ability to establish a diagnosis.

• 대한세포병리학회지
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• 제18권2호
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• pp.112-118
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• 2007

Fine needle aspiration cytology (FNAC) has become a highly preferred, minimally invasive diagnostic tool of choice in the diagnosis of a palpable breast mass owing to its sensitivity, specificity, cost-effectiveness, and expediency. Although breast needle biopsies have been widely employed recently due to the increased detection rate of non-palpable early lesions, the importance of the use of FNAC cannot be underestimated. It comprises part of the diagnostic triad for the breast along with a physical examination and mammography, which together contribute to an increasing diagnostic accuracy. The differential diagnosis of a benign and malignant lesion is of the utmost importance in the diagnosis of breast lesions, and therefore the understanding of the possible diagnostic pitfalls is of great importance.